Prostatis is an inflammation of the prostate gland (the body of the genital and reproductive system) and the process of physiological functions as a result of this process.
Rolling
According to various sources, the prostatitis is 35-40%, according to some authors, 70% of men aged 18-50.Representative diapers and leaders are the leader among the urological pathology in the development of the disease and at the same time.
Classification
There are many classifications of prostatitis, so a very unique terminology.The most common is the classification of prostatitis proposed by the US National Health Institute (NIH) in 1995:
| Category | Description |
| Category I | Acute bacterial prostatite |
| Category II | Chronic bacterial prostatitis |
| Category III | Chronic abacterial prostatitis |
| Category IIIA | Inflammatory Chronic Pelvic Pain Syndrome |
| Category IIB | Syndrome of non-metallow chronic pelvic pain (prostatinia) |
| Category IV | Synimptomatic inflammatory prostatitis |
This classification of the prostatitis is the absence of clinical signs, leukocytes and microorganisms or lack of microorganisms, prostate, discharge and urine.
Category I
Acute bacterial prostatiteThe prostate gland is expressed with sharp infectious inflammation with all related signs:
- increased amount of leukocytes in urine;
- Having bacteria in urine;
- Signs of infection (increased body temperature, symptoms of intoxication).
Category II
Chronic bacterial prostatitis- The number of relevant symptoms and leukocytes and bacteria is accompanied by an increase in the number of prostate, ejaculation and the secret of urine.
Category III
Chronic pelvic pain syndrome (ktr)- The leading clinical symptom is more than 3 months pain syndrome for the lack of pathogenic microorganisms in the secret of prostate, ejaculation and urine in the secret of prostate massage.The separation of III and III B is the presence of a growing number of leukocytes.
Category III A
Inflammatory Chronic Pelvic Pain Syndrome- It is characterized by the presence of pain and prostatite symptoms and after the prostate massage, the secretion of pathogenic microorganisms of pathogenic microorganisms of pathogenic microorganisms, a large amount of leukocytes in the secretion of pathogenic microorganisms.
Category III B
Non-metallic syndrome of chronic pelvic pain- It is characterized by pain syndrome and the symptoms of the prostatitis, there is no increase in the number of leukocytes and is not discovered by the standard methods of prostate, ejaculation and pathogenic microorganisms in the mystery of the prostate massage.
Category IV
Synimptomatic inflammatory prostatitis- The lack of symptoms of the prostatitis, the disease, during the histological examination of prostate tissue samples in connection with other reasons, was accidentally discovered during the histological examination of the prostate tissue.
Prostatitis diagnosis
The symptoms of the prostatitis are extremely different, but they can be combined into several groups.
Pain syndrome
As a result of blood supply, the inflammation or spasm of the prostate, the oxygen hunger of the cloth tissue, as a result, organizations affect the nervous ends of pathological oxidation.The prostate innervation is associated with the pelvic floor, penis, scrotum, testicles, rectum innervation - painortionalization is a variable.The following pain symptoms are most common:
- Anxiety or pain in Perineum - mostly physical power, sexual intercourse, sexual attacks appear after the alcohol;
- Hot potatoes sensation in the rectum;
- Pain (anxiety) in testims - patients are described as "pain", "twist", and are related to various inciting factors;
- Concerns, rubber and pain in the urethra - mainly the secrecy of the prostate on the acid side is associated with the PH's turn.The sour secret of the prostate is irritating on the mucous membrane of the urethra, as a "burning", more "burning", part of the secret or sexual intercourse, is squeezed into the lumen of the urethra.
Urinary disorders syndrome
It is associated with the presence of prostate and sac, as well as the participation of prostate muscles with the urinary act.Dysuria can be accompanied by the following manifestations:
- Distance urine - often urine (happens up to 3 times per hour) sharp and sudden calls (non-tolerable) and smaller parts);
- The feeling of the bladder is incomplete - feeling that the urine is stuck in the sidewalk after the urinary act;
- The weak or intermediate flow of urines - this can also be attributed to the "last drop" sign - after the urinary act of the channel, a drop of urine is still being released, despite all the efforts of the patient.
Disruption of discharge and orgasm
Seeds, which send signals to the structures of the brain, formed by the surface, orgasm, the Seed of Seeds to Send Send Send to Sender Tubercle (Killigique) Prostatitis.The prostatitis does not lead to a direct structure (blood supply to pen per penis in sexual awakening).
Basic disorders:
- Prior to premature discharge or contrary, excessively stretched sex - due to an inflammatory process due to seminal tubercle or itching;
- Deleted orgasm - Seed is also associated with inflammation of Tubercle;
- During the ejaculation, pain - the sperm is associated with an inflammatory process in the exit channels of the prostate released.
Fetus break
When changing the prostate properties, the following changes are observed in the sperm, reduce the ability to fertilize the man (productivity):
- A reduction in the sperm pH on the pickle, the prostate inflammation of the prostate begins to assassinate the acidity of acting.The acid environment is extremely destructive for sperm, which causes immobilization and even death;
- Sperm's anglulation - mainly associated with the change of phsychochemical characteristics of the secretion of spermatozoa, mainly;
- Astenospermia - a decrease in sperm mobility - the pH of the pH of the pH of the pH of the pH of the pH of the pH of the pH, which ensures the vital activities of the sperm, is closely linked to the violation of the production of prostate lecitin.
Urethroopostatitis
In some cases, the prostatitis is combined with chronic urethrit, which is combined with chronic urethritis, which shows itself with the least mucous inflammatory discharge from the urethra (mainly after a long urine.
Prostatitis and sexual disorders
"Cause the prostatite impotence?"This is the reason for the disputes of experts for decades.
Under the influence of sexual incentives, the formation of cortical and subconnia region of cortical and subconnia, in the formation of a cortical and subconnival region, or in the spine, or recreation (vascular and sinusoid), the nerve signal occurs when it comes to smooth muscles of the cave of the penis.During this period, the prostate gland has no role.
Ejaculation and orgasm, prostate flow speeches, the same receptors in the region of seminal tuber, the same receptors are responsible for the separation of the nervous impulse of the orgasm sensation sensation.
In the prostate gland, the inflammatory process (prostatitis) seed tubercle and as a result of a person's potential, so it can cause a premature discharge and counterparcation orgasm.Impossibility in chronic prostatitis is pathogenically related to the degree of damage to the nerve apparatus of the prostate gland.This is the form of impossibility (neuroreceptorism), when a pathological impetuation with the affected organs affected by the inflammatory process, when the process of sexual function, which causes the sexual function and the latter unit.In a certain way, the neuroreceptor plays a role in the pathogenesis of neuroreceptorism, as well as the sensitivity of testicular activities and hypothalamus and paths of pharmacies.
At the same time, there is an opinion in the Russian Federation on the re-appointment of both the prostatio hyperdiagnosis and the role of erectile dysfunction.
Diagnosis
The doctor's task is to identify the inflammatory process in the prostate, determining the possible pathogen of the disease and an appraisal of the prostate gland.In 1990, Stamey wrote that the prostatitis was "garbage basket for clinical ignorance" due to the terms used, diagnostic and treatment.At the same time, several simple and clinical and laboratory tests allow you to properly make a diagnosis, it also allows you to start the appropriate therapy.
Putik Rectal Study of Prostate Cloth
A very informative way.An inflammatory process can be tried by evaluating the contours of cloth, contours, sizes, compression and (or) the fact that the emollient and pain.The main signs of the prostatitis: increase in size or decrease, consistency heterogeneity, compression and softening focus, softening, pain.80% of pancreatic cancer speaks for himself in the fact that the rectal was found through a rectural investigation.We can always say that this research method will always be used.
Microscopic examination of the secretion of the pancreas
There is no increase in the number of hidden leukocytes, because the methods of acquiring a secret during massage, do not guarantee that the urethrents and seed bubbles do not guarantee the wastewater and seed bubbles.At the same time, the secret of the prostate, which is the open signs of the prostatitis, can be normal.It is explained by the inflammation focus, explained or closed, part of the exit channels.
Study of the secretion of the prostate gland
Prostatic Excretion-EPS) Hidden studies allow to determine the existence of an inflammatory process in the prostatical gland and partial functionality.The main method of diagnosis and monitoring of the treatment of chronic prostatitis.The secret of the prostate can be inspected using light microscopy without painting and using special spot methods.In addition, the secret of the prostate gland, can be exposed to a bacteryological examination or examination by polymerase chain reaction method for detection of pathogens.Get a mystery with prostate massage.A mystery released from the urethra is gathered in a sterile test tube or a clean object for research.Sometimes the secret of the prostate gland from the urethra is not monitoring.In such cases, the patient is recommended to reach their feet immediately.Nevertheless, it was not possible to buy something secret, the more it means that he did not enter the urethra, but in the sac.In this case, after the massage of the prostate gland, the sentry liquid released from the bladder is investigated.
- Lipoid grains (Leciitin objects) - a particular product of the normal physiological secretion of the glorious epithel of the prostate gland.Gives a secret milk appearance.Normally, it is rich in mystery, Lecitin's grains.The decrease in their number, an inflammatory process, a tumor, along with the increase in the number of leukocytes;
- Amyloid objects - a solution of Lugol, a solution of Lugol (starch), stains in purple or blue as a starch;
- Amyloid objects are a concentrated secret of the cloth, there is an oval shape and a layer of layer that looks like a tree trunk.They show a stagnation in the diaper who can be with normal, adenomas, chronic inflamed processes;
- Erythrocytes can be single.As a result of the energetic massage of the prostate gland, they are in mystery.Their growing amount is observed in inflammatory processes and neoplasm.
- The descending of large quantities of epitheles is observed in the head and tumors, then there are often disability with protein and oily degeneration of epithelous cells.Macrofhajs can be seen with the stagnation of a secrecy of the current inflammatory process;
- Batthera crystals are a day crystals that form a sperm with a sperm with a sperm and a sperm mixture with sperm and phosphorus sperm).Oligozoospermia, azoospermia and sharply stated, is formed quickly and in large quantities of Batthera crystals;
- Redealical syndrome - stagnation syndrome is observed with a cloth adenoma.There are abundance of macrophics, there are many-germinate cells such as foreign bodies and amyloid objects;
- Fern's symptom, a symptom of a mystery crystallization depends on the physical features of a form of a form of a form of sodium chloride crystals.The study of the symptom is carried out by adding a 0.9% sodium solution with more than 0.9% of chloride after drying under a light microscope.In healthy men in the reproductive age, the crystallization of the prostate secrecy is characterized by a typical event of the Fern leaf (3+).The presence of androgenic failure or prostatitis gives a variety of different degrees to the absence of crystals.
Bacteriological research and pancreas secretion of urine
PCR Diagnostics, including Uretra Smear
Serological diagnosis of agents (elisa) causing urinary tract infections
Immunofluorescence (Rif) reaction is flat and indirect
Identifying the antibodies well-injected antigens.
Determination of Blood Serum PSA (Prostate -Specific Antigen)
The American Foundation for Urological Diseases Recommends a PSA and a PSA for all men over 50 years of prostate gland, and with prostate cancer for blood relatives for a man's line.There is still a discussion about getting a dog immediately after the finger examination of the prostate gland per rating.The latest studies could not confirm that the PSA's content was immediately after a finger examination.Thus, PSA levels can be determined after the purchase of reliable results and pancreatic survey.
Four tests
In order to diagnose chronic prostatitis, 4 glass tests were offered a comparative bacteriological assessment of the prostate gland, as well as in terms of the urinary piece of prostate gland.
The diagnosis of the prostatitis, increasing the number of microorganisms in the count of microorganisms (1, 2 and 3 sections) of the urine and the number of polimorphe-nuclear leukocytes, 10-16 light microscope (increases 200 times).Or in the counting room the increase in the number of more than 300x106 / l in the calculation chamber.The lesitine bodies must cover the microscope in a tight section of the prostate gland, the microscope microscope (5-10 million in 1 ml).The amyloid bodies in the secret of the prostate are found in a significant amount.In men in adults, they can find 1-2 in terms of them.
Biochemical blood test
Immunological and hormonal profile (according to indicators).
Ultrasound, trusie
Ultrasonic diagnosis of prostatitis by belly and transcrectal sensor (trust).
Urofloolometry
Treatment of prostatitis
The comprehensive treatment of patients with chronic prostatitis should cover the following:
- In addition to involving sexual partners with the presence of a diet, diet, sexual hygiene, as well as the presence of an infectious agent;
- selection of effective drugs to suppress infection;
- The acquisition of immunobiological tolerance of the general reaction and microorganisms of the patient's body;
- Enhancing the excretion of excretion and activation of local restorative processes in the spotlight of inflammation;
- sewer of infection focus in previous and distant organs;
- Improving microcirculation in prostate diaper and pelvic bodies;
- Assignment of general strengthening funds, enzymes and vitamins;
- Correction of hormonal disorders;
- Assignment of antispasmodic;
- Assignment of analgesic and anti -infulamal medications;
- To take soothing and changing drugs;
- regulation of neurotrophic disorders by local analytical drugs;
Prostate massage
Prostate massage- a medical procedure used to diagnose and sometimes used for chronic prostatitis treatment.The first massage of the prostate was described in 1893 by Posner, and since 1936, O'Conory's urological experience was widely presented.However, in 1968, after the description of Meares and Stamin, a scene test for the diagnosis of the prostatitis, and a therapeutic procedure was removed from the list of events in many guidelines for the treatment of prostatitis in developed countries.
However, in the mid-1990s, many doctors participating in the diagnosis and treatment of prostatitis and use of the use of antibacterial therapy and alpha-blockers, and the use of alpha-blockers, led to use this forgotten method.
Basically, the prostate massage is currently used as a diagnostic procedure for prostate secretion (specified in prostatical secretions) - microscopic (cultural) and before the massage test (advance and later postmaster testing -ppmt).to massage.Massage is a medical procedure and should perform a previously trained specialist.If the urine after the urine, and in case of a bacteriological examination of the mystery, in the event of an isotonic solution of sodium chloride, which is especially necessary, in the event of an isotonic solution.Prostate massage is carried out through anus, because the prostate diaper is close to the rectum bulb and only is available for research.First, they massage, then, then try not to touch the seed bubbles, other than the proportion of the product, the diaphes of the product.Massage is completed by pressing the center of the central dwarf.A mystery released from the urethra is gathered in a sterile test tube or a clean object for research.Sometimes the secret of the prostate gland from the urethra is not monitoring.In such cases, it is recommended that if the patient is not possible to get hidden, it is recommended to reach your feet immediately, it means that it is not in the urethra.In this case, after the massage of the prostate gland, the sentry liquid released from the bladder is investigated.
Prostate massage (repeat massage) for medical purposes is officially recommended as a therapeutic procedure for a chronic prostatitization by the Russian Federation.Prostate massage is widely used for the treatment of prostatitis in Southeast Asian countries, China and some European countries.Some Severmerikan and Canadian Urologists recommend the use of massage with antibiotic therapy in the treatment of some forms of some prostatitis.In fact, the assessment of the effectiveness or massage of the prostate was practically implemented.There are several contradictory research, in one group of Egyptian doctors, while others were a group of antibiotic therapy and an antibiotic therapy, in a group of prostatitics, the combination of antibiotic therapy was a significant development.
Supporters of the massage use for therapeutic purposes, the main influence of the use is the drain of prostate channels - I.E.They are releasing water from water and dead cells.Another impact is the increase in blood flow in the prostate gland, which improves the influence of antibiotics and activates local protective immunological processes.
There is little information about complications related to prostate massage in world literature.In 1990, Japanese doctors described the genitals (quarter) in 2003 and in 2003 were constant bleeding after the prostate massage with the development of the lungs.After the massage, the PSA (Prostosospecific antigen) level has a temporary investigation.Massage, acute urethritis, orcid, prostate cancer is contraindicated in a sharp inflammation of the prostate gland (acute prostatitis).Massage is not recommended for calculating prostate and prostate adenoma.Recommended prostate massage 2 or 3 times a week is generally recommended.
Physiotherapy Procedures
Any physiotherapy procedure (prostate massage, warming, etc.) in acute prostatitis is mostly contraindicated.
In the complex treatment of the prostatitis, the use of physiotherapy procedures, normalize both functional and pathological changes, as well as directly affects the prostate gland of physical agents for electrophological management.
Use of physiotherapy methods in the background of drug therapy gives better results in separate.The following methods affect the prostate gland have been widespread and proved their effectiveness:
- Shock wave therapy;
- Electric stimulation of a pancreas with modulated currents with TID or rectal electrodes;
- Thermotherapy in different versions (including height therapy);
- magnetotherapy;
- Microwave microwave technology;
- Laser therapy.
- Transmission ultrasonic therapy and phonophorez;
- Microclisms.