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 30-40 year old men.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 treating prostate diseases.
"Second 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, under the bladder.The wider edge of the prostate covers the neck of the bladder.The posterior part is adjacent to the anterior wall of the rectum.The frontal part of the gland occupies a place in the pubic area of the junction of the pelvic bones.In the male body, the prostate performs three key functions:
- motor - control of the separation of urine and seminal fluid (due to this, sperm does not enter the bladder;
- secretory - production of secretion 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 gland begins to manifest itself during puberty, becoming fully functional by the age of 18–20.A decline in the active functioning of the organ is recorded 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 disruptions of neurological, psychoneurological etiology, chronic diseases, and unhealthy lifestyle.
The trigger of the inflammatory process is congestive (stagnation) phenomena in the tissues of the gland, provoked by organic disorders or infection.
The forms are classified according to the nature of the manifestation of symptoms and the course of the disease:
- Acute inflammation.Characteristic of a bacterial type of disease.Accompanied 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.
The symptoms of chronic prostatitis are often erased, 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 for complications.
Causes of prostatitis
Stagnation of blood circulation and prostatic secretion occurs for reasons corresponding to the type of classification of the disease.
| Causes of infectious type | Causes of bacterial species |
|---|---|
| Sexually transmitted infections (STIs):
Bacterial diseases of the intestines, skin, respiratory organs caused by the activity of staphylococci, enterococci, Escherichia coli, Proteus, Klebsiella, etc. |
Neuralgia, rheumatism, neurosis, 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 |
Provoking factors include irregular sexual intercourse (complete absence of sex), systematic hypothermia, chronic alcoholism.
Symptoms of the acute form of the disease
Acute prostatitis is characterized by severe manifestations of inflammation in the prostate gland.Adjacent organs and systems are involved in the process, and psycho-emotional stability is disrupted.
Key symptoms:
- From the urinary system.Pollakiuria (frequent urination) with dripping outflow of 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, decreased potency, painful ejaculation.During intimacy (or immediately after), discomfort occurs 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.
- Psycho-emotional disorders.Increased nervousness, anxiety, irritability.
- From the digestive system.Constipation, exacerbation of hemorrhoids.
- From the side of the autonomic nervous system.Lack of appetite, headache, low-grade body temperature (37–38 ℃), symptoms of body intoxication.Habitual actions cause rapid fatigue and a desire to lie down.
Against the background of inflammation, existing chronic diseases worsen.
Signs of chronic prostatitis
Prolonged inflammation of the prostate leads to disruption of the morphological structure and performance of the organ.In the remission stage, the pathology reminds itself of itself with increased fatigue and decreased performance.Disorders of the urinary system are characterized by repeated (often false) urges to empty the bladder, becoming more frequent at night.
Urination is moderately painful, after urine excretion there is a feeling of incomplete emptying.A prostatic secretion of mucous consistency with a yellowish color and an unpleasant odor (prostatorrhea) spontaneously flows from the urethra.
Patients are plagued by chronic pelvic pain syndrome - aching painful sensations localized in the lower third of the abdomen, pelvic and external genital organs, in the perineal area, lumbar and sacral regions.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection accompanied by pain;
- suppression of libido;
- accelerated or difficult (often painful) ejaculation.
Against the background of sexual disorders, psycho-emotional instability progresses.A man is subject to depression and sudden changes in mood - from aggression to apathy.Ultimately, this leads to absolute sexual impotence (impotence).
During the relapse period, the symptoms correspond to the acute form of the disease, but are less intense.Exacerbation is provoked by:
- General hypothermia.After a long stay in cold water or frost, any chronic inflammatory diseases, including prostatitis, worsen.
- Limitation of mobility.With physical inactivity, blood circulation in the pelvic organs is impaired.Stagnation of blood leads to swelling of the prostate, which compresses the nerve endings and the urethra.
- Alcohol abuse.The chronic course of inflammatory processes is activated under the influence of alcohol.
- Long-term abstinence from intimate relationships.Lack of sexual intercourse leads to stagnation of prostate secretions, which provokes an exacerbation.
- Tight underwear.Mechanical compression of the external genitalia disrupts the normal blood supply to the prostate gland.
Relapse of the disease is caused by unhealthy eating habits.The abundance of fatty foods in the diet is one of the causes of hypercholesterolemia (increased concentration of cholesterol in the blood), as a result, atherosclerosis develops.Cholesterol plaques obstruct free blood flow, causing congestion in the prostate.An excess of foods that cause constipation in the menu leads to excessive tension in the perineal muscles.
Complications of prostatitis
If acute inflammation is not treated in a timely manner, purulent masses accumulate in the prostate tissues and an abscess of the gland develops.The condition is characterized by febrile temperature (39 ℃), chills, sharp intense pain in the perineum, ischuria (inability to empty the bladder independently).The only method of treatment 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-medication of chronic prostatitis are the reasons for the development of dangerous complications:
- prostate adenoma is a benign tumor that is prone to malignancy (malignancy) if treated incorrectly;
- formation of stones in the gland;
- Epididymo-orchitis is inflammation of the testicle;
- vesiculitis - inflammation of the seminal vesicles;
- infertility (the first degree of the disease requires long-term therapy, the second is practically untreatable);
- impotence;
- Prostate sclerosis is the death of prostate cells.
Timely examination of the prostate in men will help to avoid the serious consequences of the inflammatory disease.
Prostate examination
A rectal examination of the prostate is an unpleasant but extremely necessary procedure.It allows early detection of serious diseases such as adenoma, prostatitis, and malignant tumors.
Indications for rectal examination of the prostate
Every man over the age of 40 should visit 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 gland.The patient receives more gentle treatment, retains libido, sexual activity and the ability to fertilize.
Sometimes men under 40 years of age discover warning signs, but postpone a visit to the urologist.Indications for urgent prostate examination are:
- pain of any intensity in the perineal area;
- erectile dysfunction;
- early ejaculation;
- decrease in the volume of sperm released;
- discomfort during sexual intercourse and defecation.
Do not ignore problems with urination - too frequent urge, pain, feeling of an unemptied 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?
Several hours before the procedure, you must refrain from:
- sexual contact;
- masturbation;
- playing sports;
- riding a bicycle;
- physical labor.
Before visiting a doctor, you need to empty your bladder and do a cleansing enema with salted 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 lubricates his index finger and the patient's anus with Vaseline or lubricant.
During a rectal examination of the prostate, the doctor massages the lobes of the prostate gland from the sides to the center.With the help of palpation you can evaluate:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- expressiveness of contours and longitudinal furrow;
- the presence of pain, lumps and knots.
These data make it possible to determine whether there are pathological changes in the prostate.
In addition, during the procedure, prostate secretions are obtained.This liquid is sent for analysis, which shows the content of bacteria, leukocytes, red blood cells, and pathogenic microorganisms.
Based on the results of a digital examination of the prostate, the doctor may prescribe additional diagnostic measures.These include a clinical analysis of urine and blood, testing for tumor markers, ultrasound of the prostate gland, and so on.
Diagnosis of the disease
Making an accurate diagnosis consists of several stages:
- initial consultation with a urologist;
- a set of laboratory tests;
- hardware examination of the prostate;
- repeated appointment with the doctor.
Consultation with a urologist includes:
- identification of symptoms, their characteristics (duration, intensity);
- taking anamnesis (past diseases);
- clarification of information about working conditions, lifestyle characteristics, habits, and regularity of sexual relations;
- visual assessment of the external genitalia for the presence of rashes, redness, swelling, discharge from the urethra;
- palpation of the inguinal lymph nodes;
- palpation rectal examination of the prostate (determining pain, contours, density, elasticity of the gland, assessing the condition of the interlobar septum);
- collection of biomaterial for laboratory research;
- assignment of tests.
A medical appointment does not have strict time limits.In a specialized clinic, each patient is given maximum time and attention.
For differentiated diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes tests of blood, urine, prostate secretions, and a smear from the urethra.
The doctor takes a sample of prostatic secretion with his own hand during a rectal examination of the gland.For examination, disposable medical gloves, a lubricant (vaseline, gel lubricant, glycerin) that facilitates penetration into the rectal ampulla, and sterile glasses are used.The depth of penetration does not exceed 5 cm. Professional qualifications and experience of urologists 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 collecting biological material.
Laboratory tests
Research is carried out by experienced specialists 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 culture of a smear to determine STIs.A sample of biomaterial is planted on nutrient media favorable for the growth of pathogenic microorganisms.Active reproduction and formation of colonies of a particular pathogen indicate the presence of an infection.Based on bacterial culture, an antibiogram is performed to determine the resistance of pathogens to antibiotics.
- General urine analysis.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 a highly accurate chemiluminescence immunoassay (CHLA) method.
- Study of prostatic secretions (microscopy and culture).Allows you to determine inflammation, the presence of microbes (E. coli, staphylococcus, etc.)
A comprehensive screening for STIs can be done using a blood sample.
Hardware diagnostics is TRUS (transrectal ultrasound) of the prostate gland.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 put on top.The data is transmitted to a monitor, where the urologist visually assesses pathological changes in the prostate gland.
Repeated appointment
Upon re-appointment, the doctor:
- evaluates test results;
- draws up 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 to make an appointment at a time convenient for the patient by phone or through the website by filling out the online form.
Prostatitis therapy
In the clinic, a man can undergo a full course of treatment for prostatitis.Course therapy for acute inflammation of the prostate gland includes three stages:
- relief of symptoms and inflammation;
- restoration of functions, stabilization of the gland;
- consolidation of results, prevention of complications.
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.In parallel, medications of several pharmacological groups are used:
- Alpha adrenergic blockers.The drugs help relax the smooth muscle tissue of the prostate and bladder neck, reduce internal pressure in the urethra, normalize the outflow of urine, and reduce swelling of the gland.
- Enzymes.They dilute prostatic secretions, increase local immunity of the organ, enhance the antibacterial effect, and reduce inflammatory manifestations.
- Immunomodulators to restore immunity.
- Nonsteroidal anti-inflammatory drugs (NSAIDs).They reduce the inflammatory process and relieve pain.
The doctor selects medications and dosage personally according to the symptoms, type, and form of the disease.
Second stage
After acute symptoms are relieved, they move on to drugs and methods that help stabilize the gland.Drug treatment includes:
- vascular medications (to improve blood supply to the prostate);
- immunostimulants;
- drugs that normalize the process of urine excretion;
- anti-inflammatory drugs;
- medications to restore erection.
In complex treatment, oral medications and rectal suppositories (regenerating, antibacterial, immunostimulating, anti-inflammatory, analgesic) are used.
Special methods include prostate massage.Mechanical impact on the prostate gland allows you to:
- speed up blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activate exchange processes;
- establish an outflow of secretions;
- normalize bladder emptying;
- increase the effectiveness of drug therapy;
- restore sexual activity.
Massage procedures are carried out for therapeutic and preventive purposes.
Types of massage:
- using a dilator (bougie);
- internal palpation;
- non-invasive (no penetration);
- penetrating or external hardware (carried out using a special massager).
Third stage
The treatment is completed by ozone therapy and laser therapy.Rectal ozone therapy consists of daily administration of a freshly prepared ozonated isotonic sodium chloride solution.
Treatment of inflammation of the prostate gland with a laser is a progressive physiotherapeutic technique that allows you to quickly achieve positive dynamics and prevent complications of prostatitis.Directional action of the rectal laser:
- regenerates gland cells;
- relieves inflammation and pain;
- strengthens local immunity;
- improves blood supply 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 decision of the attending physician, laser therapy begins with the second stage of treatment.
Additionally, phytotherapeutic agents are used.
Features of the treatment of chronic prostatitis
This form of prostatitis is characterized by a wave-like course, in which an exacerbation of chronic prostatitis is replaced by a period of complete absence of unpleasant symptoms.In some cases, symptoms are observed constantly, but have a faded, mild character.In most cases, men endure inconvenience for a long time in the form of impaired urination, dull pain in the lower abdomen and perineum, and weakened potency.Patients with this diagnosis often turn to a doctor precisely during an exacerbation of 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 medications 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 in this group help reduce inflammation.
- Alpha-blocker drugs 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 pelvic pain and pronounced symptoms of chronic prostatitis in the acute stage.
- Urologists recommend using hormonal agents for active growth of glandular tissue of the prostate against a background of chronic inflammation.
- Immunomodulators are used for chronic inflammation of the prostate of any origin, be it allergic, bacterial or abacterial prostatitis.
Additionally, 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 much more), a set of exercise therapy exercises to relax the muscles of the perineum and pelvic floor, as well as laser therapy also help 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 gland.The center’s specialists pay special attention to preserving the functions of the genitourinary system in men, thanks to which patients after therapy can lead a full life and even become parents.Only with complex treatment with the use of properly selected medications, physiotherapy and prostate massage can a positive result in treatment be achieved.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Changing eating habits.A balanced diet with limited 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 barrier 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.
- Complete rest.Psycho-emotional overload, insomnia (insomnia), physical fatigue are provocateurs of abacterial prostatitis.
- Regular visits to the urologist and examinations for STIs.The disease is easier to prevent than to treat.
Urologists provide preventive examinations of the prostate gland.