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Prostatitis: the inflammation of prostate gland

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Glands are called organs that produce and release substances necessary for life. Glands are divided into endocrine (internal secretion) and exocrine (external secretion).

The endocrine glands, which together form the endocrine system , produce hormones – special bioactive compounds that perform a regulatory and controlling function in the body; acting directly into the circulatory system, hormones with the blood flow are delivered to those tissues to which this hormonal “command” is addressed. External secretion glands, unlike endocrine glands, have excretory ducts, the mouths of which open either into the cavity of other organs (digestive exocrine tissues, for example, release degrading enzymes into the gastrointestinal tract), or outside (for example, mammary or sweat glands). It should be noted that some organs perform both exocrine and endocrine functions – the pancreas, in particular, belongs to the glands of mixed secretion.

The prostate gland is one of the key exocrine organs of the male reproductive system (this anatomical structure is absent in the structure of the female body). The prostate gland is located under the bladder, weighs 20-25 grams, resembles a chestnut tree with approximate dimensions of 20x30x40 mm and a volume of 25-30 cm3. The histological composition includes the glandular tissues proper, smooth muscle (due to which the gland can contract and relax), as well as the connective tissue shell-capsule and stroma (base, scaffold for accommodating functional parenchymal cells). The most important anatomical nuance is that the initial section of the urethra, the urethra, passes through the prostate gland. In the medical aspect, it is also important that the prostate gland is adjacent to the large intestine,

The widely known synonymous name “prostate” is derived from the ancient Greek word meaning “standing before”, “guardian”, “protector”.

The functions of the prostate are usually divided into secretory and motor functions (sometimes a barrier function is also distinguished, since the gland really stands “on guard” of the upper urinary tract). The secret of the prostate is the most important auxiliary component of sperm, if the main component is the spermatozoa maturing in the testicles. The biochemical composition of the prostatic secretion is very complex and not fully understood, as, indeed, the functioning of the gland as a whole (there is reason to consider it a gland of mixed secretion). It is known, however, that prostatic secretion contains enzymes, immune factors, energy-supplying compounds (glucose, fructose), vitamins, organic acids, thinning components, etc. Mixing during ejaculation with the secret of the seminal vesicles and cooper glands, the secret of the prostate forms seminal fluid (seminal plasma), the liquid fraction of sperm,

The main motor function of the prostate is that during erection, the gland completely blocks (squeezes) the lumen of the urethra passing through it, which excludes the mixing of even minimal amounts of urine into the final fertilizing ejaculate and, normally, prevents reflux – sperm reflux in the opposite direction, i.e. e. into the bladder.


Any person who is more or less familiar with the principles of constructing medical terminology does not need to translate the word “prostatitis”; even without knowing exactly, we can confidently assume: prostatitis is an inflammation of the prostate. Indeed, this is the name of a group of inflammatory diseases of the prostate gland.

Prostatitis is one of those universal problems, the severity and relevance of which are directly proportional to the degree of development of civilization. Of course, men also suffered from prostatitis in ancient times, but today almost everyone faces acute infections of the urogenital area in their youth, and up to 80-85% of men over 40 years old have chronic prostatitis. Moving further and further away from the natural, natural modus vivendi, we literally doom ourselves to diseases of this kind.


The reasons

Prostatitis is almost always an infectious and inflammatory process caused by bacteria. The phrase “almost always” is used here because in some cases the pathogen cannot be identified (meaning – with routine, standard laboratory diagnostics); this, however, does not mean that the pathogen does not exist in reality. One way or another, non-bacterial prostatitis, namely viral, protozoal, fungal (candidiasis) and, possibly, autoimmune, are much less common and less studied.
The vast majority of prostatitis is thus due to bacterial infections. The range of potential pathogens is unusually wide and is represented mainly by opportunistic microflora, although gonococcal, staphylococcal, Trichomonas and other prostatitis with aggressive pathogens are also common. In chronic prostatitis, as a rule, a polymicrobial infection is detected.
Risk factors are also very numerous; it can be said that they are more dangerous and harmful than the pathogens themselves, since they create a universal predisposing soil for the development of most androurological diseases.

The “main killer” of the male genitourinary sphere is stagnation. Whatever stagnates (urine, blood in the microcirculation system, sexual secretions), it is always very risky, because it is stagnant nutrient media with the temperature of the human body that are ideal for bacteria, which, in the course of their evolution, have perfectly learned to colonize and develop such media as a medium. habitation and rapid reproduction.

In turn, chronic stagnation in the tissues of the prostate is caused by a number of factors: general physical inactivity, rare and irregular sex life, tight-fitting underwear and tight jeans, “sedentary” professions, and many others. Separately, it should be said about the factor of civilization: on a conscious level, we no longer notice to what extent our world is oversaturated with sexually exciting, invocative stimuli, ranging from lightly veiled erotica to outright pornography. Recalling the film with Sharon Stone and Michael Douglas that made a splash at the time, we note that the instinct is, of course, the main one, and the theme is eternal, invariably interesting, beautiful, never boring, and most importantly, it sells well. However, women’s fashion and a provocative style of behavior, the stubbornly imposed cult of sex appeal in advertising, cinema, the Internet, etc.,

Other, no less dangerous risk factors include promiscuity, any acute and chronic infections (not only urogenital), a tendency to constipation, intoxication (especially alcohol and drugs), as well as hypothermia, overwork, lack of sleep and rest, poor unbalanced diet, transferred surgery and any other conditions and conditions that weaken the immune system. Exacerbations of prostatitis are greatly facilitated by cycling, equestrian sports, vibration and other factors of traumatization of the perineum.


In the dynamics of acute inflammation of the prostate, as a rule, several stages can be traced: from catarrhal (initial acute inflammation of the mucous membranes) and follicular (purulent-vesicular inflammation of individual lobules) to parenchymal, when the inflammatory process spreads to the entire glandular tissue and stroma. Accordingly, in the initial phase, pain and increased urination, cramps and burning in the urethra, false urges, “shooting” pains in the groin, often radiating to the coccyx and anus, are noted. The body temperature rises, the progressive swelling of the prostate gland increasingly reduces the lumen of the urethra, which leads to urinary retention (ischuria). With the further absence of medical intervention, the symptoms of general intoxication increase, the pain syndrome becomes sharp and intense, the pains often become pulsating, not only urination is difficult, but also defecation. Blockade of the urethra can result in life-threatening acute urinary retention.

Due to the purulent discharge, the urine loses its transparency; the properties of sperm change: it becomes abnormally liquid or thick, jelly-like lumps appear, an unpleasant smell and taste – which is immediately noted by couples who practice or prefer oral-genital sex.

Chronic prostatitis proceeds, in principle, with the same symptoms, but in a much more erased, and often in an asymptomatic form. Quite typical are cases when prostatitis is detected during an examination of a man who does not present any complaints, whose wife suffers from a chronic urogenital infection and has been treated for it for years – often in such families the need for simultaneous examination and treatment of both partners is ignored.


Of particular note is the psychosexual aspect of the problem: many patients with prostatitis develop a whole bunch of depressive neurotic disorders, including general hypochondriacal fixation, psychogenic erectile dysfunction or fear of impotence, anxiety, avoidance of sexual intercourse, cancerophobia, inferiority complexes, etc. On the other hand, there is also a backlash: a complete denial of problems (contrary to objective data) and a categorical refusal of treatment.

Meanwhile, prostatitis, both acute and chronic, including its asymptomatic and asymptomatic forms, can lead to very serious complications, such as prostate abscess, sepsis, infection of the higher and lower organs of the genitourinary system, urethral stricture , as well as male infertility, in relation to which prostatitis is one of the leading causes. It should also be taken into account that any chronic inflammation dramatically increases the risk of degenerative-dystrophic, hyperplastic and malignant neoplastic processes.


With the right – attentive and rather wary – approach to the examination, the diagnosis of prostatitis is not a particularly difficult problem. The standard set of measures includes the study of complaints and anamnesis, rectal digital examination of the prostate, ultrasound in various modifications (according to indications), uroflowmetry and other studies of urodynamics, as well as a number of mandatory laboratory tests (blood, urine, semen, prostate secretion). If malignancy is suspected, a biopsy is performed.


Therapy of prostatitis is always complex and cannot meet any universal scheme, since the clinic and pathomorphology of this disease depend on many purely individual factors. Based on the results of bakposev and / or serological testing, means of eradicating the identified infectious agent or polymicrobial infection are prescribed – powerful broad-spectrum antibiotics, antimycotics, immunomodulators, antiviral drugs, etc. Anti-inflammatory and analgesic palliatives are used as needed.

Physiotherapeutic procedures (laser, ultrasound, electromagnetic techniques, various baths, microclysters, etc.) play an important role. The question of the need for the “famous”, once prescribed to almost every patient, finger massage of the prostate is currently controversial; in some cases, such a massage is absolutely contraindicated.

In contrast, it is strictly necessary to normalize lifestyle and diet (especially if there is a passion for spicy and other irritating foods), as well as the elimination of all patient-dependent risk factors.



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