In the middle of the last century, it was believed that prostatitis develops in old age.Today, the disease has become "younger", diagnosed in fertile men aged 30-40.The inflammation tends to become chronic, which makes therapy much more difficult.Doctors successfully solve men's health problems of any complexity.Urologists at the medical center develop personal therapeutic regimens, use the best drugs and master modern methods of prostate disease treatment.
"Another Man's Heart"
The prostate is a small unpaired exocrine gland controlled by hormonal activity.The organ is located at the bottom of the pelvis, below the bladder.The wider edge of the prostate covers the neck of the bladder.The back part is against the front wall of the rectum.The anterior part of the gland takes place in the pubic region of the junction of the pelvic bones.In the male body, the prostate performs three key functions:
- engine - control of the separation of urine and seminal fluid (therefore sperm does not enter the bladder;
- secretory - production of secretions responsible for the quality of seminal fluid and maintaining a stable erection;
- barrier - protection against infection of the upper parts of the urinary system.
The functionality of the prostate begins to manifest itself during puberty and becomes fully functional by the age of 18-20.A decline in the active functioning of organs is noted in men who have crossed the fifty-year mark.
Types and forms of prostatitis
The type of disease is determined by the cause:
- Bacterial prostatitis.It occurs as a complication of infectious and inflammatory processes in the urogenital tract (less often in other body systems).
- Abacterial prostatitis.It develops against the background of physiological disorders of neurological, psychoneurological etiology, chronic diseases and an unhealthy lifestyle.
The inflammatory process is triggered by congestive (stagnation) phenomena in the gland tissues, caused by organic disorders or infection.
The forms are classified according to the nature of the symptom manifestation and the course of the disease:
- Acute inflammation.Characteristic of the bacterial type of the disease.Followed by intense manifestation of specific symptoms.
- Chronic prostatitis.It is unstable.Latent periods are followed by relapses with pronounced symptoms.In 95% of cases, it is of abacterial origin.
Symptoms of chronic prostatitis often disappear, while the inflammatory process progresses.The undulating course of the disease is the reason for untimely contact with a urologist, which subsequently leads to expensive treatment of complications.
Causes of prostatitis
Stagnation of blood circulation and prostate secretion occurs for reasons that correspond to the type of classification of the disease.
| Causes of infectious type | Causes of bacterial species |
|---|---|
| Sexually Transmitted Infections (STIs):
Bacterial diseases of intestines, skin, respiratory organs caused by staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgias, rheumatism, neuroses, mechanical injuries of the spine and genital organs, intraprostatic reflux, chronic constipation (constipation), distress, history of urological diseases (cystitis, urethritis, etc.), physical inactivity, diseases of the endocrine system |
The provoking factors are irregular sexual intercourse (complete absence of sex), systematic hypothermia, chronic alcoholism.
Symptoms of an acute form of the disease
Acute prostatitis is characterized by severe manifestations of prostate inflammation.Neighboring organs and systems are involved in the process, and psycho-emotional stability is impaired.
Key symptoms:
- From the urinary system.Polakiuria (frequent urination) with swelling of the urine, burning sensation, pain in the urethra.Urine becomes cloudy.The urge to empty the bladder is often false.
- From the reproductive system.Pain in the perineum, reduced potency, painful ejaculation.During intimacy (or immediately after) there is discomfort in the area of the head of the penis and testicles.
- From the nervous system.Acute muscle pain in the lumbar and sacral region, lower abdomen.
- Psychoemotional disorders.Increased nervousness, anxiety, irritability.
- From the digestive system.Constipation, aggravation of hemorrhoids.
- From the side of the autonomic nervous system.Lack of appetite, headache, low body temperature (37-38 ℃), symptoms of body intoxication.Usual actions cause rapid fatigue and the desire to lie down.
Against the background of inflammation, existing chronic diseases worsen.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to a violation of the morphological structure and functioning of the organ.In the phase of remission, the pathology reminds itself of increased fatigue and reduced performance.Disorders of the urinary system are characterized by repeated (often false) urges to empty the bladder, which become more frequent at night.
Urination is moderately painful, after passing urine there is a feeling of incomplete emptying.A prostatic secretion with a yellowish mucous consistency and an unpleasant smell (prostatorrhea) flows spontaneously from the urethra.
Patients suffer from chronic pelvic pain syndrome - painful painful sensations localized in the lower third of the abdomen, pelvic and external genital organs, in the perineal, lumbar and sacral regions.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection accompanied by pain;
- libido suppression;
- accelerated or difficult (often painful) ejaculation.
Against the background of sexual disorders, psycho-emotional instability develops.Man is susceptible to depression and sudden mood swings - from aggression to apathy.Eventually, it leads to absolute sexual impotence (impotence).
In the period of relapse, the symptoms correspond to the acute form of the disease, but are less intense.Exacerbation is caused by:
- General hypothermia.After a long stay in cold water or frost, all chronic inflammatory diseases, including prostatitis, worsen.
- Limitation of mobility.With physical inactivity, blood circulation in the pelvic organs is disturbed.Blood stagnation leads to prostate swelling, which compresses nerve endings and the urethra.
- Alcohol abuse.Under the influence of alcohol, a chronic course of inflammatory processes is activated.
- Long-term abstinence from intimate relationships.Lack of sexual intercourse leads to stagnation of prostate secretions, which causes deterioration.
- Tight underwear.Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate.
Relapse of the disease is caused by unhealthy eating habits.An abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased cholesterol concentration in the blood), as a result of which atherosclerosis occurs.Cholesterol plaques obstruct the free flow of blood, causing blockages in the prostate.An excess of constipating foods in the menu leads to excessive tension in the muscles of the perineum.
Complications of prostatitis
If acute inflammation is not treated in time, purulent masses accumulate in the tissues of the prostate and an abscess of the gland occurs.The condition is characterized by febrile temperature (39 ℃), chills, sharp intense pain in the perineum, ischuria (inability to empty the bladder independently).The only treatment method is an operation to open the suppuration and bougienage of the urethra (expansion of the urethra using a special metal bougie).
Lack of correct diagnosis, neglect of symptoms, long-term self-treatment of chronic prostatitis are the reasons for the development of dangerous complications:
- prostate adenoma is a benign tumor that is susceptible to malignancy (malignancy) if not treated properly;
- stone formation in the gland;
- Epididymo-orchitis is an inflammation of the testicles;
- vesiculitis - inflammation of seminal vesicles;
- infertility (the first stage of the disease requires long-term therapy, the second is practically incurable);
- impotence;
- Sclerosis of the prostate is the death of prostate cells.
Timely examination of the prostate in men will help to avoid serious consequences of the inflammatory disease.
Prostate examination
A rectal examination of the prostate is an unpleasant but extremely necessary procedure.It enables early detection of serious diseases such as adenoma, prostatitis and malignant tumors.
Indications for rectal examination of the prostate
Every man over 40 should see a urologist at least once a year.The earlier the inflammatory process, benign and malignant neoplasms are diagnosed, the greater the chances for complete restoration of the prostate.The patient receives gentler treatment, retains libido, sexual activity and the ability to conceive.
Sometimes men under 40 show warning signs, but delay seeing a urologist.Indications for urgent prostate examination are:
- pain of any intensity in the perineal area;
- erectile dysfunction;
- early ejaculation;
- decrease in the amount of released sperm;
- discomfort during sexual intercourse and defecation.
Do not ignore problems with urination - too frequent urge, pain, feeling of an empty bladder, unpleasant changes in the smell and color of urine.If you notice at least one sign, be sure to make an appointment with a urologist.
How is a digital prostate examination performed?
A few hours before the procedure, you must refrain from:
- sexual contact;
- masturbation;
- Playing sports;
- cycling;
- physical work.
Before visiting the doctor, it is necessary to empty the bladder and make a cleansing enema with salt water or chamomile decoction.
Before examining the prostate, the man takes a knee-elbow position, lies on his side with his legs bent, or stands leaning forward and resting his hands on the table.The doctor puts on sterile gloves and smears the index finger and the patient's anus with petroleum jelly or lubricant.
During a rectal examination of the prostate, the doctor massages the lobes of the prostate from the sides towards the middle.With the help of palpation you can assess:
- size and shape;
- texture and elasticity of organs;
- the symmetry of its elements;
- expressiveness of contours and longitudinal furrows;
- the presence of pain, lumps and nodes.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, prostate secretions are obtained during the procedure.This fluid is sent for analysis that shows the content of bacteria, leukocytes, red blood cells and pathogenic microorganisms.
Based on the results of the digital prostate examination, the doctor can prescribe additional diagnostic measures.This includes clinical analysis of urine and blood, testing for tumor markers, ultrasound of the prostate and so on.
Disease diagnosis
Establishing an accurate diagnosis consists of several stages:
- first consultation with a urologist;
- a set of laboratory tests;
- hardware examination of the prostate;
- repeated examination at the doctor.
Consultations with a urologist include:
- identification of symptoms, their characteristics (duration, intensity);
- history taking (previous illnesses);
- clarification of information about working conditions, lifestyle characteristics, habits and regularity of sexual relations;
- visual assessment of the external genitalia for the presence of rash, redness, swelling, discharge from the urethra;
- palpation of inguinal lymph nodes;
- palpation rectal examination of the prostate (determination of pain, contours, density, elasticity of the gland, assessment of the state of the interlobar septum);
- collection of biomaterials for laboratory research;
- giving tests.
Appointments with doctors do not have strict time limits.In the specialized clinic, maximum time and attention is given to each patient.
For the differential diagnosis of bacterial and bacterial prostatitis, in order to determine the form of the disease, a man takes blood, urine, prostate secretions and a swab from the urethra.
The doctor takes a sample of prostate secretion with his own hand during a rectal examination of the gland.Disposable medical gloves, lubricant (vaseline, gel lubricant, glycerin) that facilitates penetration into the rectal ampoule and sterile glasses are used for the examination.The penetration depth does not exceed 5 cm.The professional qualifications and experience of the urologist ensure the safety and painlessness of the procedure.
Venous blood is collected using modern vacutainers.The medical center strictly adheres to the rules of sterility for the collection of biological material.
Laboratory tests
Research is carried out by experienced experts in a clinical diagnostic laboratory.The laboratory department of the medical center is equipped with modern equipment that allows performing tests of any complexity.
The list of tests includes:
- Bacteriological swab culture to determine STI.A sample of biomaterial is planted on nutrient media suitable for the growth of pathogenic microorganisms.Active reproduction and colony formation of a particular pathogen indicate the presence of an infection.Based on the bacterial culture, an antibiogram is performed in order to determine the resistance of the pathogen to antibiotics.
- General urinalysis.Deviation from the norm (leukocyturia, bacteriuria, cylindruria, etc.) indicates the presence of an inflammatory process.
- A blood test for PSA (prostate-specific antigen) is a tumor marker of the male reproductive system.It is performed using the highly accurate chemiluminescent immunoassay (CHLA) method.
- Study of prostate secretions (microscopy and culture).It allows you to determine inflammation, the presence of microbes (E. coli, staph, etc.)
Comprehensive screening for sexually transmitted diseases can be done with the help of a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate.It is performed using a cylindrical sensor with a diameter of no more than 1.5 cm, inserted into the rectum.The sensor is pre-lubricated, and special disposable attachments (condom) are placed on top.The data is transferred to the monitor, where the urologist visually assesses pathological changes in the prostate.
Repeat appointment
Upon reappointment, the physician:
- evaluates the test results;
- creates a personal therapeutic regimen taking into account the type, form, nature of the course of prostatitis, drug tolerance and the patient's age;
- prescribes control studies.
We offer an appointment at a time convenient for the patient by phone or through the website by filling out an online form.
Prostatitis therapy
In the clinic, a man can undergo a complete course of prostatitis treatment.The therapeutic course for acute prostatitis includes three phases:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the gland;
- consolidation of results, prevention of complications.
The first stage
For prostatitis of infectious etiology, antibiotics are initially prescribed to destroy the infectious agent.The choice of drug is based on the results of the antibiogram.Medicines from several pharmacological groups are used in parallel:
- Alpha adrenergic blockers.Medicines help to relax the smooth muscle tissue of the prostate and bladder neck, reduce the internal pressure in the urethra, normalize the outflow of urine and reduce the swelling of the gland.
- Enzymes.They dilute the secretion of the prostate, increase the local immunity of the organ, enhance the antibacterial effect and reduce inflammatory manifestations.
- Immunomodulators for restoring immunity.
- Non-steroidal anti-inflammatory drugs (NSAIDs).They reduce the inflammatory process and relieve pain.
The doctor chooses the drugs and the dose personally according to the symptoms, type and form of the disease.
The second stage
After the acute symptoms subside, they move on to medications and methods that help stabilize the gland.Drug treatment includes:
- vascular drugs (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urine excretion;
- anti-inflammatory drugs;
- drugs to restore erection.
Oral drugs and rectal suppositories (regenerative, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used in complex treatment.
Special methods include prostate massage.The mechanical impact on the prostate allows you to:
- speed up blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activate exchange processes;
- establish drainage of secretions;
- normalize bladder emptying;
- increase the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are performed for therapeutic and preventive purposes.
Types of massage:
- using a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external hardware (performed using a special massager).
The third phase
The treatment ends with ozone therapy and laser therapy.Rectal ozonotherapy consists of daily administration of freshly prepared ozonated isotonic sodium chloride solution.
Laser treatment of prostate inflammation is a progressive physiotherapeutic technique that allows you to quickly achieve positive dynamics and prevent prostatitis complications.Directional action of the rectal laser:
- regenerates gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves blood flow to the prostate and the condition of blood vessels.
The frequency of sessions is 2-4 times a week, the duration of one procedure is 10-20 minutes.Based on the doctor's decision, laser therapy begins with the second phase of treatment.
Phytotherapeutic agents are additionally used.
Features of treatment of chronic prostatitis
This form of prostatitis is characterized by an undulating course, in which the exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms.In some cases, the symptoms are constantly observed, but they have a faded, mild character.In most cases, men suffer for a long time in the form of difficulty urinating, dull pain in the lower abdomen and perineum, and weakened potency.Patients with this diagnosis often consult a doctor precisely at the time of worsening symptoms.
Treatment of chronic prostatitis begins with a detailed examination designed to find out what caused the inflammatory process.Based on the diagnostic results, the urologist selects drugs from several groups:
- Antibacterial drugs are prescribed to patients diagnosed with chronic bacterial prostatitis, as well as for diseases of non-bacterial origin.In addition to suppressing the activity of pathogenic microflora, drugs from this group help reduce inflammation.
- Alpha-blockers are prescribed to patients with severe urinary disorders.Medicines improve the rate of urine flow and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pain in the pelvis and pronounced symptoms of chronic prostatitis in the acute phase.
- Urologists recommend the use of hormonal agents for the active growth of prostate gland tissue against the background of chronic inflammation.
- Immunomodulators are used for chronic prostatitis of any origin, be it allergic, bacterial or abacterial prostatitis.
In addition, agents are used that stimulate blood circulation in the pelvic organs and the prostate itself, as well as potency stimulants.Treatment methods such as prostate massage, physiotherapy (electrophoresis, shock wave therapy, UHF and more), a set of exercise therapy exercises to relax the muscles of the perineum and pelvic floor, as well as laser therapy also help to improve the prognosis.
All these methods are widely used in clinics, which makes it possible to achieve high treatment results, even if the patient is diagnosed with chronic calculous prostatitis, one of the forms of complicated chronic inflammation of the prostate.Specialists of the center pay special attention to preserving the functions of the genitourinary system in men, thanks to which patients can lead a full life after therapy and even become parents.Only complex treatment with the use of properly selected drugs, physiotherapy and prostate massage can achieve a positive treatment result.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Change in eating habits.A balanced diet with limited intake of fatty and high-calorie foods.Enriching the diet with vegetables, fruits, products for men's health (nuts, honey, seafood, etc.).
- Physical activity (regular exercise helps normalize blood circulation in the genital area).
- Protected sex is the use of protective contraception (condom) to protect against sexually transmitted diseases.
- Regular sex is a pleasant and useful prevention of congestive phenomena in the prostate.
- Limit alcohol.Alcohol abuse leads to a decrease in potency, libido and inhibition of testosterone synthesis.
- A complete vacation.Psychoemotional overload, insomnia (insomnia), physical fatigue are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and examinations for STIs.Disease is easier to prevent than to treat.
Urologists perform preventive examinations of the prostate.