The prostate (prostate gland) is called the second heart of the male body.And this humorous definition is not far from the truth.Despite its small size, the prostate performs a very important function - it gives a man the ability to continue his lineage.With problems with the prostate gland, reproduction, and simply a normal sexual life becomes impossible.Why it is important to know the first symptoms of prostate diseases, what doctor to go to “if suddenly what” and how to prevent the most common diseases - about all this we will tell in our article.
What is the prostate gland for?
The prostate gland is an unpaired organ the size of a walnut, which is located in the small pelvis in men: one side of it is adjacent to the bladder, and the other - to the rectum. The parenchyma (tissue) of the prostate consists of a large number of mucous glands, the ducts of which open into the urethra, and from above this organ is covered with a connective tissue capsule.
Many people think that the prostate gland is involved in the production of sperm. No, male sex cells can only be formed in the testicles. But the prostate performs an equally important function - it synthesizes a special secretion that liquefies the ejaculate (semen released during ejaculation ). It is rich in nutrients, vitamins and even minerals (e.g. zinc).
How does this happen? The sperm produced in the testicles travel through the ejaculatory ducts to the seminal vesicles and then, together with their contents, to the prostate, where they mix with the organ's secretion and are discharged into the urethra.
In addition, the prostate plays the role of a valve - during erection, it blocks the exit from the bladder and prevents the mixing of sperm with urine. If it is removed, retrograde ejaculation occurs - the seminal fluid is thrown in the opposite direction (into the bladder).
The main function of the prostate gland is to participate in the formation of sperm and its secretion. If this organ is removed together with the seminal vesicles, a man will lose the ability to conceive children.
Why can there be problems with the prostate?
Urologists distinguish three main problems with the prostate gland:
- inflammation (prostatitis);
- benign enlargement (hyperplasia/adenoma);
- malignant tumor (cancer).
Each of these conditions has its own causes and triggering factors. For example, prostatitis can be infectious and non-infectious. Infectious inflammation of the prostate is more often caused by bacteria (E. coli, enterococcus, staphylococcus), which get into it in an ascending way (through the urethra) or descending (from the bladder). But the causative agents of the disease can be other microorganisms - viruses, fungi, protozoa.
Infectious prostatitis is acute and chronic, and contribute to the “chronicization” of the disease certain factors:
- Concomitant diseases of the urogenital system (pyelonephritis, cystitis);
- foci of chronic infection, including remote (dental caries, maxillary sinusitis, tonsillitis);
- frequent hypothermia, staying in a humid environment;
- constant physical fatigue and unbalanced diet;
- infrequent urination.
Non-infectious prostatitis occurs due to stagnation of fluid in the prostate gland against the background of violations of venous circulation in the pelvis. This leads to its swelling, incomplete emptying from the secret and, accordingly, violations of the organ.
Stagnation in the prostate is most often associated with:
- sedentary, sedentary lifestyle (chronic prostatitis - the “professional” disease of cab drivers and truckers);
- vibration;
- chronic intoxication;
- prolonged interruptions in sexual activity;
- practice of prolonged or interrupted sexual intercourse.
Benign prostatic hyperplasia (BPH) is a typical age-related disease of men. It is diagnosed in 30% of patients over 50 years of age and 90% over 85 years of age. A single cause of BPH has not been identified to date, although most doctors agree that the prostate begins to enlarge due to hormonal imbalance, which inevitably develops against the background of fading reproductive function.
The risk of DPPJ increases if a man:
- is overweight;
- eats a lot of red meat and fatty foods (this increases the likelihood of “earn” prostate adenoma by 38% and 31% respectively);
- drinks a lot of coffee or drinks containing caffeine;
- suffers from diabetes.
Also matters and heredity - if prostate hyperplasia in the first line relatives, most likely it will be in the man. The disease is also more likely to occur if relatives have been diagnosed with bladder cancer.
The main risk factors for prostate cancer are considered to be:
- Age (on average, this disease is diagnosed at age 70, and only 5% of men were under 60 at the time of diagnosis);
- hereditary predisposition (having a father or brother with prostate cancer increases the likelihood of getting the disease by 2-3 times).
Obesity, excessive consumption of fatty foods and smoking also increase the likelihood of the disease.
Please note: a prerequisite for the development of malignant prostate tumor is the presence of male sex hormones (androgens). At the same time, the relationship between the intake of androgens in adequate doses (e.g. for the treatment of hypogonadism) and the development of prostate cancer (provided the risk of the disease is low) has not been confirmed.
First signs of prostate problems
A very typical sign that there is something wrong with the prostate is urinary problems in men. If they begin to urinate frequently, have to get up to go to the toilet at night, complain of a weak flow (stream) of urine - most likely, the prostate gland has enlarged and it is because of this that difficulties with urination have arisen.
Other manifestations of prostatic hyperplasia:
- urgent urges to urinate and urinary incontinence or, on the contrary, difficulty in starting it - “delayed start”;
- the need to exert effort in the process of urination, intermittent discharge of urine;
- a feeling of incomplete emptying of the bladder;
- urinary retention.
Symptoms of prostate adenoma are difficult to confuse with something, and a preliminary diagnosis can usually be established by any health care provider.
The first signs of acute bacterial prostatitis usually include:
- increased frequency of urination;
- a difficult and painful discharge of urine;
- a burning sensation in the lower abdomen;
- increased body temperature.
In chronic prostatitis, pain and other symptoms are less severe, but men may complain of blood in semen, pain in the scrotum and perineum, the head of the penis, and even the inner thighs. In addition, they are often bothered by a feeling of pressure on the perineum or anus, painful ejaculation, impaired potency and decreased libido.
The prostate and sexual dysfunction are interrelated. With problems with the gland, a full and vivid sex life is almost impossible. And vice versa, irregular, “low-quality” sex, prolonged abstinence inevitably worsen the health of the prostate in men. So there is a vicious circle - and to break it, sometimes you need to make a lot of effort.
Prostate cancer very often proceeds without any characteristic manifestations. The disease can exist in the body for many years and not make itself known at all. Urologists say that men die much more often with prostate cancer than from it.
Please note: Asymptomatic prostate cancer is the most common finding at autopsy. It is found in 30% of deceased men over 50 years of age and 70-80% over 80 years of age.
The first signs of a malignant tumor are indistinguishable from the manifestations of prostatic hyperplasia. Patients also complain of frequent and “nocturnal”, intermittent urination, weak urine stream. And at advanced stages of the disease there is already blood in the urine or semen, there are pains in the ribs and spine, caused by cancer metastases.
How to identify problems with the prostate?
Detecting the disease of this organ is not difficult: if any of the above symptoms of prostate problems appear, you need to see a urologist. He will conduct a clinical examination and the necessary examination, which will allow to establish the correct diagnosis.
Diagnosis of prostate diseases includes:
- palpebral rectal examination;
- ultrasound of the prostate gland (as well as the bladder with determination of residual urine volume, kidneys and other organs if necessary);
- Biochemical blood analysis with determination of creatinine level;
- determination of the level of prostate-specific antigen (PSA) in the blood;
- general urine analysis;
- examination of urethral smear and prostate secretion;
- urodynamic studies (uroflowmetry);
- prostate biopsy;
- MRI of the prostate and surrounding tissues.
At the appearance of “prostate” complaints should not be engaged in self-diagnosis and take a lot of different tests. The scope of the necessary examination is determined by a urologist, taking into account the presumed diagnosis. Early diagnosis is very important: the earlier treatment begins - the more favorable the prognosis, and this is true for all prostate diseases.
Important: A doctor should be consulted as soon as possible in case of fever combined with lower abdominal pain and/or blood in the urine or semen, acute urinary retention (inability to empty the bladder). You should also be aware of “red flags” (prostate cancer warning symptoms), which are weakness, anemia, weight loss and bone pain combined with complaints characteristic of an enlarged prostate gland.
How to treat prostatitis and other prostate diseases?
For acute bacterial prostatitis, broad-spectrum antibiotics (such as cephalosporins or fluoroquinolones) and anti-inflammatory / pain relievers are usually sufficient. Occasionally, a suprapubic cystostomy may be required to drain urine.
Please note: in this condition, urine cannot be discharged with a catheter and prostate massage is not allowed.
In chronic prostatitis, doctors recommend avoiding factors that provoke exacerbation of the disease (in particular, hypothermia). Additionally, non-steroidal anti-inflammatory drugs, alpha-adrenoblockers (they also reduce pressure, so they are ideal for patients with hypertension and “problem” prostate), 5-alpha-reductase inhibitors, prostate massage can be used. If indicated, the urologist may prescribe antibacterial drugs.
An effective method of treatment of chronic prostatitis is regular sex with full ejaculations, it provides excellent drainage of this organ without any drugs.
In benign prostatic hyperplasia, alpha-blockers and 5-alpha-reductase inhibitors, FDE-5 inhibitors (e.g. sildenafil, tadalafil - they not only facilitate urination, but also improve erection) are widely used.
Also urologists use phytotherapy. Traditionally, pumpkin seed oil or dietary supplements based on serenoa extract (Serenoa repens) are prescribed as part of a complex therapy for BPH. However, their efficacy remains controversial, as it has not been proven in controlled randomized trials.
Prostate cancer is a common cancer in men, but it has the most favorable prognosis. In most cases, men with this tumor die from entirely different causes.
Treatment tactic options for prostate cancer:
- watchful waiting (usually in patients over 70 years of age with asymptomatic cancer and low PSA levels);
- active surveillance (PSA control every 3 months, periodic biopsy of the organ);
- radical removal of the prostate;
- radical external or internal radiotherapy.
How to prevent prostate problems?
Prevention of prostate diseases does not require taking medications or supplements. It is quite simple to perform, enjoyable and beneficial for the whole body. To reduce the risk of prostate problems, you need to:
- have sex regularly and do not forget about protection when it comes to casual partners;
- be physically active, move around a lot;
- eat right - limit the use of fatty foods and red meat;
- replace coffee or caffeine-containing drinks with orange or grapefruit juice (preferably freshly squeezed);
- stop smoking. Interesting fact: alcohol in moderate amounts does not affect prostatic hyperplasia, and in excessive amounts - reduces the risk of its development due to a decrease in the level of androgens in the body. But still, it is not worth using alcoholic beverages as a preventive measure;
- avoid hypothermia and occupational hazards (e.g., vibration).
For timely detection of prostate cancer, doctors recommend once every 1-2 years to undergo “male” screening - to determine the level of PSA in the blood. At a moderate risk of malignant tumor development, screening begins at the age of 50, and at an elevated risk - at 40-45 years old.
According to research results, PSA levels can rise 5-10 years before the first clinical symptoms of prostate cancer. This screening method is indispensable in men from high-risk groups (for example, carriers of genetic mutations).
Stay healthy and sexually active for as long as possible!