In the middle of the last century, it was believed that prostatitis developed in old age.Today the disease has become “younger”, diagnosed in fertile men aged 30 to 40.Inflammation tends to become chronic, which makes therapy much more difficult.Doctors successfully solve men's health problems of any complexity.The medical center's urologists develop personal therapeutic regimens, use the best medicines and master modern methods of treating prostate diseases.
"Heart of the Second Man"
The prostate is a small unpaired exocrine gland controlled by hormonal activity.The organ is located in the lower part of the pelvis, below the bladder.The widest edge of the prostate covers the neck of the bladder.The posterior part is adjacent to the anterior wall of the rectum.The front part of the gland occupies a place in the pubic region at the junction of the pelvic bones.In the male body, the prostate performs three main functions:
- motor - control of the separation of urine and seminal fluid (which is why sperm does not enter the bladder);
- secretory - production of secretion responsible for the quality of seminal fluid and the maintenance of a stable erection;
- barrier - protection against infections of the upper parts of the urinary system.
The functionality of the prostate begins to manifest itself during puberty, becoming fully functional around 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).
- Bacterial prostatitis.It develops in the context of physiological disorders of neurological and psychoneurological etiology, chronic diseases and an unhealthy lifestyle.
The trigger for the inflammatory process is congestive phenomena (stagnation) in the gland tissues, caused 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's unstable.Latent periods are followed by relapses with pronounced symptoms.In 95% of cases it is of bacterial origin.
Symptoms of chronic prostatitis usually disappear, while the inflammatory process progresses.The undulating course of the disease is the reason for premature contact with the urologist, which subsequently leads to expensive treatment for complications.
Causes of prostatitis
Stagnation of blood circulation and prostate secretion occurs for reasons corresponding to the type of disease classification.
| Causes of the 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 genitals, intraprostatic reflux, chronic constipation (constipation), suffering, 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.Adjacent organs and systems are involved in the process and psycho-emotional stability is disturbed.
Main symptoms:
- From the urinary system.Pollakiuria (frequent urination) with dripping urine, burning sensation, pain in the urethra.The 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.
- Psychoemotional 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 body temperature (37–38 ℃), symptoms of body intoxication.Habitual actions cause rapid fatigue and the urge to lie down.
Against the background of inflammation, existing chronic diseases worsen.
Signs of chronic prostatitis
Prolonged inflammation of the prostate gland leads to disruption of the morphological structure and performance of the organ.In the remission phase, the pathology reminds of itself with increased fatigue and decreased performance.Urinary system disorders are characterized by repeated (often false) urges to empty the bladder, becoming more frequent at night.
Urination is moderately painful, after excretion of urine there is a feeling of incomplete emptying.A prostatic secretion of mucous consistency with a yellowish color and unpleasant odor (prostatorrhea) flows spontaneously from the urethra.
Patients are tormented by chronic pelvic pain syndrome - painful sensations localized in the lower third of the abdomen, pelvic and external genital organs, in the perineal region, lumbar and sacral regions.
Chronic prostatitis is accompanied by sexual health disorders:
- unstable erection accompanied by pain;
- suppression of libido;
- accelerated or difficult ejaculation (often painful).
Against the background of sexual disorders, psycho-emotional instability progresses.A man is prone 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 disease, including prostatitis, worsens.
- Mobility limitation.With physical inactivity, blood circulation in the pelvic organs is impaired.Blood stagnation leads to swelling of the prostate gland, which compresses the nerve endings and urethra.
- Alcohol abuse.The chronic course of inflammatory processes is activated under the influence of alcohol.
- Prolonged 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.
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), resulting in the development of atherosclerosis.Cholesterol plaques obstruct free blood flow, causing congestion in the prostate.An excess of foods that cause constipation on 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 and intense pain in the perineum, ischuria (inability to empty the bladder on one's own).The only method of treatment is an operation to open the suppuration and urethral bougienage (expansion of the urethra using a special metal bougie).
Lack of correct diagnosis, neglect of symptoms, prolonged 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;
- Orchiepididymitis is inflammation of the testicle;
- vesiculitis - inflammation of the seminal vesicles;
- infertility (the first degree of the disease requires prolonged therapy, the second is practically intractable);
- impotence;
- Prostate sclerosis is the death of prostate cells.
Timely examination of the prostate gland in men will help avoid the serious consequences of inflammatory disease.
Prostate exam
Rectal examination of the prostate is an unpleasant but extremely necessary procedure.Allows early detection of serious diseases, such as adenoma, prostatitis and malignant tumors.
Indications for rectal examination of the prostate
Every man over 40 should visit a urologist at least once a year.The sooner the inflammatory process, benign and malignant neoplasms are diagnosed, the greater the chances of complete restoration of the prostate.The patient receives a gentler treatment, maintains libido, sexual activity and the ability to fertilize.
Sometimes men under 40 discover warning signs but put off visiting the urologist.Indications for urgent prostate examination are:
- pain of any intensity in the perineal region;
- erectile dysfunction;
- premature ejaculation;
- decrease in the volume of sperm released;
- discomfort during sexual intercourse and defecation.
Do not ignore problems when urinating - very frequent urge, pain, feeling of an empty bladder, unpleasant changes in the smell and color of urine.If you notice even one sign, make an appointment with a urologist.
How is a digital prostate exam performed?
A few hours before the procedure, you should avoid:
- sexual contact;
- masturbation;
- play sports;
- to go by bicycle;
- physical work.
Before consulting a doctor, it is necessary to empty the bladder and do a cleansing enema with salt water or chamomile decoction.
Before examining the prostate, the man lies in the knee-elbow position, lies on his side with his legs bent or leans forward and rests his hands on the table.The doctor puts on sterile gloves and lubricates the patient's index finger and anus with petroleum jelly or lubricant.
During a rectal prostate exam, the doctor massages the lobes of the prostate from the sides to the center.With the help of palpation you can assess:
- size and shape;
- texture and elasticity of the organ;
- symmetry of its elements;
- expressiveness of contours and longitudinal grooves;
- 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, secretions from the prostate 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 prostate exam, your doctor may prescribe additional diagnostic measures.This includes a clinical analysis of urine and blood, tumor marker tests, prostate ultrasound, and so on.
Diagnosis of the disease
Making an accurate diagnosis consists of several steps:
- initial consultation with a urologist;
- a set of laboratory tests;
- hardware examination of the prostate;
- repeated consultation with the doctor.
Consultation with a urologist includes:
- identification of symptoms, their characteristics (duration, intensity);
- take anamnesis (past 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 rashes, redness, swelling, discharge from the urethra;
- palpation of the inguinal lymph nodes;
- rectal palpation 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;
- test assignment.
A medical appointment does not have strict deadlines.In a specialized clinic, each patient receives maximum time and attention.
For differentiated diagnosis of bacterial and bacterial prostatitis, to determine the form of the disease, a man takes blood tests, urine, prostate secretions and a smear from the urethra.
The doctor takes a sample of prostate secretion with his own hands during a rectal examination of the gland.For the examination, disposable medical gloves, lubricant (vaseline, lubricating gel, glycerin) that facilitates penetration into the rectal ampoule and sterile glasses are used.The penetration depth does not exceed 5 cm.The professional qualifications and experience of urologists guarantee the safety and painlessness of the procedure.
Venous blood is collected in modern vacutainers.The medical center strictly follows sterility standards for collecting biological material.
Laboratory tests
The 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 tests of any complexity to be carried out.
The list of tests includes:
- Bacteriological culture of smears to determine STIs.A sample of biomaterial is planted in a nutrient medium favorable to 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 to determine the resistance of the 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 high-precision chemiluminescence immunoassay (CHLA) method.
- Study of prostate secretions (microscopy and culture).Allows you to determine inflammation, presence of microbes (E. coli, staphylococci, etc.)
A comprehensive screening for STDs can be done using a blood sample.
Hardware diagnosis is TRUS (transrectal ultrasound) of the prostate.It is carried out 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 accessories (condom) are placed on top.The data is transmitted to a monitor, where the urologist visually assesses pathological changes in the prostate.
Repeated query
At the new 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 scheduling at a convenient time for the patient by phone or via the website by filling out the online form.
Prostatitis therapy
In the clinic, a man can undergo full treatment for prostatitis.Course therapy for acute prostate inflammation 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 medication is based on the results of the antibiogram.At the same time, medicines from different pharmacological groups are used:
- Alpha-adrenergic blockers.Medications help relax the smooth muscle tissue of the prostate and bladder neck, reduce internal pressure in the urethra, normalize urine flow, and reduce swelling of the gland.
- Enzymes.They dilute prostate secretions, increase the organ's local immunity, 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 personally selects medications and dosage in accordance with the symptoms, type and form of the disease.
Second stage
After acute symptoms are relieved, they move on to medications and methods that help stabilize the gland.Drug treatment includes:
- vascular medicines (to improve the blood supply to the prostate);
- immunostimulants;
- medicines that normalize the urinary excretion process;
- anti-inflammatory medications;
- medications to restore erection.
In complex treatment, oral medications and rectal suppositories are used (regenerating, antibacterial, immunostimulant, anti-inflammatory, analgesic).
Special methods include prostate massage.Mechanical impact on the prostate allows:
- accelerate blood circulation;
- strengthen the walls of capillaries and blood vessels;
- activate exchange processes;
- establish an outlet for 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 (performed with a special massager).
Third stage
The treatment is complemented with ozone therapy and laser therapy.Rectal ozone therapy consists of daily administration of a freshly prepared ozonized isotonic sodium chloride solution.
Treatment of prostate inflammation 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 glandular 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 to 4 times a week, the duration of one procedure is 10 to 20 minutes.Based on the decision of the attending physician, laser therapy begins in the second stage of treatment.
In addition, herbal 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 mild, fading character.In most cases, men endure inconveniences for a long time in the form of difficulty urinating, dull pain in the lower abdomen and perineum, and weakening of potency.Patients with this diagnosis often turn to the doctor precisely during an exacerbation of symptoms.
Treatment of chronic prostatitis begins with a detailed examination to find out what caused the inflammatory process.Based on the diagnostic results, the urologist selects drugs from several groups:
- Antibacterial drugs are prescribed for 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 medications are prescribed for patients with severe urinary disorders.Medications improve urinary flow rate and relieve symptoms.
- Muscle relaxants are prescribed to patients with chronic pelvic pain and pronounced symptoms of chronic prostatitis in the acute phase.
- Urologists recommend the use of hormonal agents for the active growth of prostate glandular tissue against the background of chronic inflammation.
- Immunomodulators are used for chronic inflammation of the prostate 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 much more), a set of therapeutic 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 the clinic, 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 fathers.Only with complex treatment using properly selected medications, physiotherapy and prostate massage is it possible to obtain a positive treatment result.
Prevention of inflammatory processes in the prostate
Preventive measures include:
- Changing eating habits.A balanced diet with limited fatty and high-calorie foods.Enrich your diet with vegetables, fruits, human health products (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 bacterial prostatitis.
- Regular visits to the urologist and STI tests.The disease is easier to prevent than to treat.
Urologists perform preventive prostate exams.