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Prostatitis

The prostate gland is a prostatitis (an organ of a man's gender and reproduction system) and the change is the result of this process of its physiological functions.

Symptoms of linear inflammation

Spread

According to various sources, prostatitis occurs at 35-40 % and according to some authors, 70 % of men from 18 to 50 years old.Representative routes in the circulation rate of the disease and a collection of problems occur at the same time occupy a leading position between urinary diseases.

Classify

There are many classifications of prostatitis, so a very special term.The most common is the classification of prostatitis proposed by the US National Health Institute (NIH) in 1995:

Type Representation
Type I Prostatitis acute bacteria
Type II Chronic bacterial prostatitis
Type III Prostatitis becomes chronic
Type IIIA Chronic pelvic pain syndrome
Type IIIB Chronic pelvic pain syndrome (prostate)
Type IV Prostatitis hepatitis sinimptomatic

The classification of this prostatitis is based on clinical signs, the presence or absence of leukocytes and microorganisms in the secret of prostate, ejaculation and urine.

Type I

Prostatitis acute bacteriaIt is expressed by acute infectious inflammation of the prostate with all related signs:

  • Increasing leukocytes in urine;
  • the presence of bacteria in urine;
  • Signs of common infections (increase in body temperature, toxic symptoms).

Type II

Chronic bacterial prostatitis- It comes with appropriate symptoms and an increase in the number of white blood cells and bacteria in the secret of prostate, ejaculation and urine obtained after the prostate massage.

Type III

Chronic pelvic pain syndrome (KTR)- The leading clinical symptom is pain syndrome for more than 3 months in the absence of pathogenic microorganisms in the secret of the prostate, ejaculation and urine obtained after the prostate massage.The separation of III A and III B is the presence of increased number of white blood cells.

Type III A

Chronic pelvic pain syndrome- characterized by the presence of pain and prostatitis symptoms, and increased leukocytes recorded in the excretion of the prostate, ejaculation and parts of the urine, after the prostate massage, pathogenic microorganisms are not detected in these samples.

Type III B

Inflammation syndrome of chronic pelvic pain- Characterized by the presence of pain syndrome and prostatitis symptoms, while there is no increase in leukemia and not detected by methods of pathogenic microorganisms in the secret of prostate, ejaculation and urine obtained after prostate massage.

Type IV

Prostatitis hepatitis sinimptomatic- The absence of typical symptoms of prostatitis, the disease is detected by accidents during the histological testing of the prostate tissue samples related to diagnosis for other reasons (for example, conducting prostate biopsy due to an increase in the level of a specific antigen - PSA).

Diagnosis of prostatitis

The symptoms of prostatitis are extremely diverse, but they can be combined into some groups.

Pain syndrome

Due to the insufficient blood supply due to inflammation or spasms of blood vessels for pre -gland feeding, the process of starving oxygen of the gland tissue is recorded, due to the result of pathological oxidation, which is formed affecting the end of the prostate.Because the prostate conservation is associated with the conservation of pelvic floor, penis, scrotum, testicular, rectum - localization of pain is different.The following pain symptoms are the most common:

  • Discomfort or pain in the perineum - basically appearing after physical exertion, sex, alcohol in the form of overtaking attacks;
  • The feeling of hot potatoes in the rectum;
  • Pain (discomfort) in testes - patients described as Ache, then twisted, also related to different stimulating factors;
  • Uncomfortable, rubber and pain in the urethra - mainly related to the change of pH of the prostate's secret on the acid side.The source of the prostate gland is irritable on the mucous membrane of the urethra, so more pain, more often in the form of a fire, occurs after an urination or sexual action, when part of the secret when reducing the muscle of the gland.

Urination disorder syndrome

Links to the close conservation of the prostate and bladder, as well as the participation of prostate muscles in urination.Difficult to urinate can come with the following manifestations:

  • Foreign urination - frequent urination (occurring 3 times per hour) with sharp and sudden calls (unable to withstand) and quite small parts;
  • A feeling of not completely bladder drum - after urinating, it felt that the urine was still in the bladder;
  • A stream of weak or non -continuous urine - this can also be attributed to the symptoms of the last release - despite all the efforts of the patient after urinating from the canal, a drop of urine is still released.

Violate ejaculation and orgasm

It is associated with the prostatitis damage of the surface of the seeds (colliculite) on the surface that the nervous receptors send the signal to the structures of the brain, where the orgasm feeling is formed.Prostatitis does not directly cause erection (blood supply to the penis during sexual excitement).

Main disorder:

  • Premature ejaculation or vice versa Excessive sex - caused by inflammation of semen or scars due to inflammation;
  • Eliminate orgasm - also related to inflammation of the seeds;
  • Pain during ejaculation - related to the inflammatory process in the output pipes of the prostate gland that sperm is released.

Violate fertility

When changing the properties of the prostate, as a result of inflammation, the following changes in sperm are observed, reducing fertilization (fertility) of a man: fertility):

  • The reduction of sperm pH on the acid side - because with prostatitis, the acidic products of pathological oxidation begins to accumulate in secret.The acidic environment is extremely destroyed for sperm causing their determination and even death;
  • Angle of sperm - sperm paste is mainly to the head - which is related to the change of chemical properties of the secretion;
  • Asthenospermia - Reducing sperm's ability to move - is closely connected to the change of pH on the acid side and violates the production of prostate lecitin cars, ensuring the important activity of sperm.

Urethritis

In some cases, prostatitis is combined with chronic urethritis, which is manifested by the small mucus from the urethra (mainly after prolonged urine maintenance).

Prostatitis and sexual disorders

The question "Does prostatitis cause helplessness?"That is the cause of experts' disputes for decades.

Under the influence of sex stimulation, with the full saturation of the Androgen body in the formation of the cortex and under the cerebral cortex of the brain, a neurological signal occurs, transmitted to the center of the erection in the spinal cord, from the bodies of the bodies.In this process, there is no role of prostate.

Ejaculation and orgasm occur with the full stimulation of special receptors in the area of the semen that the exit tubes of the flow of the prostate, along with the receptors are responsible for the departure of the nerve promotion for the cortex in which the orgasm feeling is formed.

The process of causing inflammation in the prostatitis (prostatitis) can lead to the failure of the seeds and therefore, as a potential violation of a man, so premature ejaculation and orgasm echoed.The impotence in chronic prostatitis is related to pathology with the level of damage to the prostate nerve apparatus.This form of powerlessness (nerve impotence) is a typical example of a consequence phenomenon, when the presence of pathological impulses with organs is affected by the inflammatory process, leading to irradiation of the process of stimulating sexual and post -dyslation.One thing for sure, although not leading, the role is played in the pathogenesis of neuritoreceptor, are also some inhibitors of the testes androgenic activity of the testes and the sensitivity to the centers of the hypothalamus and the pituitary gland.

At the same time, there was an idea that in the Russian Federation there were prostatitis and re -appointed its role in developing erectile dysfunction.

Diagnose

The doctor's mission is to detect the inflammatory process in the prostate gland, the determination of the pathogenic pathogen of the disease and assess the weakened prostate function.In 1990, Stamey wrote that prostatitis was a garbage basket for clinical ignorance due to the variety of methods used, diagnosis and treatment.At the same time, a number of simple and clinical tests and laboratories allow accurate diagnosis, allowing you to start appropriate therapy.

Putic rectal survey of the prostate

A lot of information.The process of inflammation can be assessed by evaluating the shape, border, size of the gland, the presence of compressed and (or) softening, pains.The main signs of prostatitis: Increase or decrease the size, inconsistency of consistency, the presence of compression and softening focus, time, pain.The 80% of pancreatic cancer was discovered through a rectal study that showed it.We can say safely that this research method will always be used.

Check by microscopes secretion of pancreatic glands

It should be remembered that the increase in the number of white blood cells in secret does not always indicate the prostatitis, because the methods of getting the secret in the massage process do not guarantee that the content of the urethra and bubbles will not fall into it.At the same time, with clear signs of prostatitis, the secret of prostate can be normal.This is explained by the focus of inflammation, the presence of a part of the output pipes, or closed or closed.

Research on prostate excretion

Representing secret studies of prostate secretion) allows you to determine the presence of an inflammatory process in prostate and part of its functional capacity.This is the main method to diagnose and monitor the treatment of chronic prostatitis.The secret of the prostate can be tested by light microscopes without drawing or using special dyeing methods.In addition, the secret of the prostate can be tested or tested bacteria by the polymerase chain reaction method to detect pathogens in it.Get a secret with prostate massage.A secret issued from the urethra is collected in a sterile test tube or on a clean object glass for research.Sometimes the secret of the prostate from the urethra is not followed.In such cases, the recommended patient immediately stood on his feet.However, if, it is impossible to have a secret, this often means that he has not entered the urethra, but in the bladder.In this case, the centrifugal of washing liquid is released from the bladder after the prostate massage is checked.

  • Lipoid particles (lecitin body) - a specific product of normal physiological excretion of the gland epithelium of the prostate gland.Give a secret view of a milky look.Typically, secret is rich in lecitin cereal.The reduction of their number, along with an increase in the number of white blood cells, shows an inflammatory process, a tumor;
  • Amyloid body - layer (starch), body, with lugol solution is dyed purple or blue, like starch;
  • Amyloid bodies are a secret of the gland condensation, oval and layer structure, like a tree.They are not normal, their findings show the stagnation of the secret in the gland, possibly with Adenomas, chronic inflammatory processes;
  • Erythrocytes can be single.They fall into a secret due to the result of the energy massage of the prostate.Their increase is observed in inflammatory and neoplasms.
  • The decrease in epithelium in large quantities is observed when starting with inflammatory processes and with tumors, then there is often defect with protein and fat degeneration of epithelial cells.Great macrophages can be seen with the stagnation of a secret, for a long time of the current inflammatory process;
  • Betthera crystals are a day crystal formed during cooling and drying the mixture of male gonads (prostate juice with sperm salts) from sperm salt and phosphoric.With Azopermia and strongly manifests the oligozoospermia, the Betthera crystals are formed quickly and in large quantities;
  • Red syndrome - A stagnant syndrome is observed with adenoma gland.There are many macrophages, there are diverse cells such as foreign body and amyloid body;
  • Symptoms of ferns are a symptom of the crystallization of a secret -a form of sodium chloride crystal falling depends on the physical properties of the prostate secret.The study of symptoms is done by adding a drop of chloride's 0.9% chloride solution to the secret of the prostate results when seeing more after drying under the light microscope.In healthy breeding men, the crystallization of the prostate secret is characterized by a typical phenomenon of fern leaves (3+).Androgenic failure or the presence of prostatitis for different levels of violations about the structure of crystals according to their absence.

Bacterial studies of parts of urine and pancreatic excretion

The urethra, including PCR diagnosis

Diagnosis of serum (ELISA) causes urinary tract infections

The reaction of the fluorescent immunity (coral reef) is straight and indirectly

Identify antibodies with well known antigens.

Determine PSA (prostate antigen) of serum

The US urology organization recommends going through an annual rectal survey on prostate, accompanied by PSA for all men over 50 years old, and with prostate cancer for blood relatives in a male line.There is still a discussion about having a dog right after checking the prostate's finger on each rectum.Recent studies cannot confirm the presence of a significant increase in the content of PSA right after checking the finger.Therefore, the level of PSA can be determined by receiving reliable results and after the pancreatic survey.

Test four times

To diagnose chronic prostatitis, the 4 glass tests have been proposed, based on the comparative bacterial evaluation of the urine, approximately equal to a part of the urine, obtained before and after the prostate massage, as well as its secrets.

The diagnosis of prostatitis is set by ten times the microorganism concentration in the secret of the prostate compared to their content in the urine (1, 2 and 3 parts) and the increase in the number of polymorphic white blood cells> 10-16 in the viewpoint of light.Or increase the number of white blood cells more than 300x106/l when they calculate them in the counting chamber.Lecitine bodies, a product of the normal secretion of the prostate epithelium, should cover the microscope's field density (5-10 million in 1 ml).The amyloid body in the secret of the prostate is found in significantly smaller quantities.In men of adulthood, they can be found 1-2 in the field of vision.

Biochemical blood test

Immune and hormonal records (as directed).

Ultrasound, trusie

Ultrasound diagnosed prostatitis with abdominal sensor and time (Trust).

Urofloometry

Treatment of prostatitis

Comprehensive treatment of patients with chronic prostatitis should include:

  • Comply with the general regime, diet, sexual hygiene, as well as attract sex partners with the presence of an infectious agent;
  • select effective drugs to inhibit infections;
  • Increase the overall reaction of the patient's body and the microbiological immunity to the drug to the drug;
  • enhance the flow of excretion and activate the local repair process in the center of inflammation;
  • Hygiene of infection groups in the front and afar organs;
  • improve microcirculation in the prostate and pelvic organs;
  • The appointment of funds, enzymes and vitamins;
  • Adjust hormonal disorders;
  • Antispasmodics appointment;
  • the appointment of analgesics and anti -inflammatory drugs;
  • use sedation and drug transformation;
  • adjust neurological disorders with local analytical drugs;

Prostate massage

Prostate massage- A medical procedure is used to diagnose and sometimes treat chronic prostatitis.The first massage of the prostate was described by Posner in 1893, and since 1936, it has been put into O'Conory's urinary practice.However, in 1968, after describing Meares and Stamey, a test of prostatitis diagnosis, the viewpoint of the cause of the disease has changed and massaged when a treatment procedure has been removed from the list of measures in many instructions to treat prostatitis in developed countries.

But from the mid -90s of the 20th century, many doctors related to the diagnosis and treatment of prostatitis began to pay attention to the inefficiency in some cases of antibacterial treatment proposed and used Alpha blockers, making them use in this forgotten method.

Basically, the prostate massage is currently being used as a diagnostic process to get prostate excretion (excretion of prostate excretion) - for micro research (cultural) and given before and after the massage test (test before and after detection).Massage.Massage is a medical procedure and must follow it a previous trained expert.The massage is done after urinating, and when discharged from the urethra after washing preliminary with the isotropic sodium chloride solution, especially necessary in the case of checking bacteria of the secret.Prostate massage is done through the anus, as the prostate is close to the rectum tube and is only available for research.First, they massage one, then the other ratio of the prostate with the movements of the finger from the periphery to the central groove along the output pipes, trying not to touch the bubble bubble.Massage is completed by pressing the center of the center from above.A secret issued from the urethra is collected in a sterile test tube or on a clean object glass for research.Sometimes the secret of the prostate from the urethra is not followed.In such cases, the recommended patient immediately stood up if he could not have a secret, which means that he is not in the urethra, but in the bladder.In this case, the centrifugal of washing liquid is released from the bladder after the prostate massage is checked.

Prostate massage for medical purposes (repetitive massage) is officially recommended by the Russian Federation of the Russian Federation as a treatment procedure for chronic prostatitis.Prostate massage is widely used to treat prostatitis in countries in Southeast Asia, China and some European countries.Some urinary doctors Severmerican and Canada also recommend the use of massage in combination with antibiotic therapy in the treatment of some forms of prostatitis.In essence, the effectiveness or ineffectiveness of the actual prostate massage is not done.There are a number of conflicting studies, in one, performed by Egyptian doctors, there is no difference in a group of patients, some of which are massage in combination with antibiotic therapy and simply antibiotic treatment, performed by US researchers and evidence treatment.

Supagans use massage for therapeutic purposes that the main effect of using it is the drainage of the prostate tubes - that is, releasing them from pus and dead cells.Another effect is an increase in blood flow in the prostate, helping to improve the penetration of antibiotics into it and activate the local immune process.

In world literature, there are very little data on complications related to prostate massage.In 1990, Japanese doctors described the genital organs, and in 2003, German doctors had permanent hemorrhage after the prostate massage with the development of lung embolism (bleeding).There is a study that after massage, PSA level (prostate antigen) temporarily increased.The massage is contraindicated in the acute inflammation of the prostate gland (acute prostatitis), with acute urethritis, orchiditis, prostate cancer.Massage is not recommended for prostate calcinates and prostate adenoma.In general, it is recommended that the prostate massage is recommended 2 or 3 times a week.

Physiotherapy procedures

Any physical therapy procedure (prostate massage, heating, etc.) in acute prostatitis is contraindicated.

The use of physical therapy procedures in the complex treatment of prostatitis in order to directly directly affect the prostate of physical agents to normalize functional and pathological changes, as well as use electrophoresis drugs into the prostate tissue.

The use of physiotherapy methods based on the platform of drug therapy gives much better results than separate treatment.The following methods to affect the prostate have become popular and prove their effectiveness:

  • Shockwave therapy;
  • Stimulating the electrical pancreas to the current is prepared with TID or rectal electrodes;
  • Thermal therapy in different versions (including high frequency temperature);
  • Magnetic therapy;
  • Microwave microwave technology;
  • Laser therapy.
  • Mullet and phonetic ultrasound therapy;
  • Microclism.