Examination of the prostate: its role in the diagnosis of gland diseases

2045

The term “prostate” (Greek pro - in front, in front; histanai - to stand) was first mentioned by the Greek physician Herophilus, who lived in the 6th century. BC. Herophilus used the word to describe the arrangement of organs in relation to the bladder, rather than as a definition for the prostate gland (PG) , which he described as "the spongy tissue near the neck of the bladder." As part of the male reproductive system, the prostate was first described and depicted by Andreas Visalius, first in his Anatomical Tables, and then in the fundamental work On the Structure of the Human Body (Fig. 1-2).

Figure 1-2. The genitourinary system in “Anatomical tables”. Andreas Visalius (1538)

In the middle of the 16th century. Ferri and Lacuna were the first, independently of each other, to associate acute urinary retention with prostate disease, and the first statement about prostatic hyperplasia as a cause of bladder outlet obstruction was made by the French physician Jean Roland only in 1649.

Examination of a patient with prostate diseases must begin with an interview, a thorough collection of complaints and anamnesis, on the basis of which a preliminary diagnosis can be established. To compile an adequate medical history, you should pay special attention to the duration of the disease, the condition of the urinary tract, previous operations and manipulations on the urinary tract, and find out what treatment has been or is currently being carried out. During the conversation, the nature of pain, urination disorders, macroscopic changes in urine, sexual dysfunction, etc. are assessed. Concomitant diseases are specified. In this case, special attention is paid to conditions that can lead to urination disorders (multiple sclerosis, parkinsonism, cerebrovascular accidents, stroke, spinal cord diseases, diseases and injuries of the spine, diabetes mellitus, alcoholism, etc.). In addition, the patient’s general condition and the degree of his readiness for possible surgical interventions are assessed.

Prostate diseases typically manifest with lower urinary tract symptoms (LUTS) . It should be noted that there is significant variability in patient complaints associated with the nature of the individual assessment of discomfort caused by urination disorders.

The difficulty of objectively assessing the severity of symptoms has led to the need to develop various systems to unify the calculation and monitoring of lower urinary tract symptoms associated with various prostate diseases over time. Numerous questionnaires have been proposed over the past decades, the first of which were developed by Boyarsky in 1976 and Madson and Iversen in 1983. In 1992, the American Urological Association (AUA) created the Measurement Committee to create an optimal questionnaire for the quantitative assessment of symptoms and quality life of patients with prostate hyperplasia.

The result was the American Urological Association Symptom Index - AUA-SI (or IPSS) and the International Continence Society Questionnaire (1CS-BPH) .

The main questionnaire currently recommended for widespread use by the International Advisory Council on Prostate Hyperplasia under the auspices of WHO is the International Prostate Symptom Score (IPSS) with the Bother Score (BS) associated with urinary disorders. (previously - the question of quality of life - Quality of Life - QoL).

Since its official presentation in 1992, this questionnaire, translated into Russian at the Urology Clinic of the MMA named after. THEM.

Sechenov, is intended for making a diagnosis of prostatic hyperplasia (PH) and determining the impact of this disease on the quality of life, as well as for choosing a treatment strategy and assessing its results.

Table 1-1. International Prostate Symptom Score IPSS/BS (QoL)

Until recently, it was difficult to assess the symptomatology of patients with chronic prostatitis. The difficulty lay not only in comparing the severity of symptoms in different patients, but also in assessing the frequency of their occurrence, severity of manifestations, and dynamics over time in a particular patient. This is clearly demonstrated in most studies published over the past decades and devoted to the problem of treating prostatitis. Without a standardized approach to the interpretation of symptoms, the results of the treatment were assessed extremely subjectively and it was not possible to compare the effectiveness of different methods.

As a result of a multicenter study conducted by the US National Institutes of Health (1999), a questionnaire was developed to objectify the symptoms of chronic prostatitis, which is also used to assess and subsequently monitor the effectiveness of treatment - the Chronic Prostatitis Symptom Index (NIH-CPS1) (Table 1- 2).

Table 1-2. NIH-CPSI Chronic Prostatitis Symptom Scale

It has been proven that the condition of a patient with prostatitis can be adequately assessed by scoring the symptoms of pain or discomfort (taking into account localization, frequency, severity), urination disorders, as well as the impact of these symptoms on the quality of life of patients. Nine separate questions, formulated in a form that the patient can understand, capture all the important information. The compactness of the questionnaire allows most patients to fill it out within 5 minutes, and the doctor to quickly obtain the necessary information. The full characteristics of the pain syndrome are reflected in the answers to four questions and are expressed in the range 0–21. Symptoms of urinary dysfunction are assessed in the range of 0–10, while the impact on quality of life is determined in the range of 0–12. Each of these sections can be examined in isolation or all three values ​​can be summed to produce an overall NIH-CPSI score (range 0-43).

To determine the state of sexual function of patients before, during, and/or after therapy, a brief questionnaire is used to assess sexual function - Brief Sexual Function Inventory (BSFI) (Table 1-3).

Table 1-3. Brief Male Sexual Function Questionnaire BSFI

To determine daily diuresis, the ratio of daytime and nighttime diuresis, as well as the volume of each urination, a simple recording method - “Urine Diaries” - is successfully used. In them, patients for 3-5 days note the time, quantity and nature of the fluid taken, the time of micturition and the volume of urine excreted.

The data from the above questionnaires simplify the identification and analysis of patient complaints, make it possible to quantitatively assess the symptoms of the disease, and obtain a summary objective characteristic of the entire variety of clinical manifestations of the disease in a particular patient, expressing them numerically. They are very effective for monitoring the condition of patients over time and assessing the results of therapy.

Digital rectal examination (DRE) is a subjective diagnostic method, the effectiveness of which depends on the experience of the doctor. Its advantages are ease of implementation, safety and relatively low cost. TREATMENT of the prostate gland and seminal vesicles is carried out with the patient in the position on the side, back or standing with the torso tilted 90° forward. The examination is carried out wearing gloves through the rectum with the index finger of the right hand, previously lubricated with Vaseline (Fig. 1-3).

Figure 1-3. Palpation of the prostate gland

The examination of the seminal vesicles is carried out with the patient in a squatting position, on a chair or stool, when the patient sits on the finger of the examiner's hand. In healthy people, the seminal vesicles are not detected; in case of damage, they are felt above the prostate gland in the form of a round and stringy compaction (Fig. 1-4).

Figure 1-4. Methods for digital rectal examination of the prostate: a - e position of the patient on the right side, b - on the back, c - in a half-bent vertical position; d — position of the patient when examining the seminal vesicles

When inserting a finger into the rectum, the tone of the anal sphincter, the presence of hemorrhoids, and the condition of the rectal wall are assessed. When palpating the prostate, the size of the gland, its symmetry, consistency, soreness, the condition of the surface of the gland, the surrounding tissue and the median groove are determined.

Normally, the prostate gland is painless on palpation, elastic in consistency, with a smooth surface, clear contours and a median groove.

In case of prostate cancer, it can be determined by:

• asymmetry of the prostate gland;
• the presence of areas of rocky or woody density (knots or infiltrative areas);
• fusion of the gland with surrounding tissues;
• palpable seminal vesicles;
• infiltration of paraprostatic tissue.

With prostate stones - crepitus. With pancreatic hyperplasia, there is usually a uniform increase in size, the median groove is smoothed. Acute inflammation, in addition to an increase in the size of the prostate, is characterized by its sharp pain; with the formation of an abscess, fluctuation can be detected. Based on the results of a physical examination in combination with the collection of complaints and anamnesis, indications for the use of other diagnostic methods are determined - laboratory, radiation, instrumental. SOUTH. Alyaev

Published by Konstantin Mokanov

Source: https://medbe.ru/materials/predstatelnaya-zheleza/diagnostika-zabolevaniy-predstatelnoy-zhelezy/

How is a prostate examination performed?

Sooner or later, men experience problems in the genitourinary system. As a rule, there are no characteristic symptoms and it will not be possible to make a diagnosis based on complaints alone. A comprehensive prostate examination will be required, which consists of several stages. We will tell you how to diagnose pathologies in this organ in men.

Types of tests for prostatitis

First of all, the man is sent to donate blood for bacteriological and biochemical tests, as well as to donate urine for the same studies. Based on the results, the doctor will be able to evaluate the following parameters:

• leukocyte count;
• the presence of blood in the urine;
• hemoglobin level in the blood and other indicators.

With prostatitis, there will be an increase in leukocytes in the urine and blood several times, a decrease in hemoglobin levels, and the presence of pathogenic microflora. Other changes are also possible, such as blood in the urine. These disorders indicate an inflammatory process in the prostate, hyperplasia and even prostate cancer.

History taking

Anamnesis refers to information about the patient that helps to accurately diagnose and prescribe effective treatment. This is an important stage that begins at a doctor’s appointment and helps to identify the causes of the disease through some questions.

Most often, the doctor tries to obtain the following information:

• when did the first symptoms appear?
• after what situation did the problems begin;
• whether you have had sexually transmitted diseases in the past;
• whether there was prostatitis before treatment;
• what is the situation with intimate life, does the man use condoms, how often does he change sexual partners;
• whether the patient is being treated with anything and whether medications were prescribed to the patient;
• whether there are chronic diseases, not necessarily in the genitourinary system.

To record the information received, questionnaires or special computer programs can be used. In this case, the doctor can analyze the information and draw preliminary conclusions about the causes of the disease and its characteristics.

Rectal examination

A rectal examination may be performed at your appointment. We are not talking about prostate massage, which is prohibited at this stage due to the high risk of complications, but about palpation of the organ through the wall of the rectum using a finger.

Sequence of rectal examination:

1. The man lies on his side, bending his knees and pressing them to his chest.
2. The doctor applies Vaseline to the anus and carefully inserts a finger into the rectum.
3. With slight pressure, he palpates the prostate gland, paying attention to its size, consistency, and condition.

If during a diagnostic procedure a secretion is released from the urethra, it is collected in a container and sent for examination. They do not do a special massage - there may be stones, sand, purulent foci in the prostate, and strong impact can cause complications.

Sometimes a man gets an erection during manipulation. This condition is normal and is not something to be ashamed of.

If during the examination a man complained of pain or the doctor did not like the condition of the prostate gland, the patient is given a referral for further examination. As a rule, blood and urine tests are required, as well as TRUS and, in case of suspected prostate cancer, CT or MRI. Let's talk about these methods in more detail.

Study of prostate secretion

Another study that is carried out after rectal massage and taking prostate juice. Normally, it is sterile, does not contain red blood cells and pus particles, and the number of lecithin grains is not reduced.

Doctors pay special attention to the following parameters:

• the color of the secretion – with prostatitis it can be yellow, with cancer – reddish;
• viscosity – increased in pathologies;
• number of leukocytes (normally no more than 10);
• lack of red blood cells;
• the number of lecithin grains is normally more than a million.

Chlamydia, gonococci and other pathogens can also be detected in the secretion, in which case a diagnosis of “bacterial prostatitis” can be made. If pathogenic and conditionally pathogenic microflora are not detected, there are no signs of inflammation, but the man complains of pain in the perineum and legs, the diagnosis will be abacterial prostatitis.

If an STI is suspected, a man will be sent for PCR blood diagnostics. Using this method, it is possible to detect even hidden infections, so it is preferable to a smear from the urethra.

CT scan

Computed tomography allows you to take a series of x-rays in different planes, and then process them using computer technology to obtain a three-dimensional image of the organ. In the case of prostate pathologies, this is practically the only opportunity to exclude oncology and more accurately prescribe treatment.

The examination is carried out in the following sequence:

1. A catheter is inserted into the man's vein, through which a contrast agent is administered.
2. The man lies down on his back on his own.
3. He holds his breath, after which the scanning begins.

The duration of the study is no more than 15 seconds; when diagnosing suspected prostate cancer, several approaches may be required. The event does not cause any painful sensations, however, some men note a feeling of heat throughout the body and increased heart rate - this is a consequence of the injection of a contrast agent into a vein.

TRUS of the prostate

Another instrumental examination, without which it is impossible to make an accurate diagnosis, is based on ultrasound irradiation of the prostate through the wall of the rectum. As a result, a two-dimensional image of the organ appears on the monitor screen, and its condition can be assessed and foci of inflammatory processes can be identified.

TRUS consists of several stages:

1. The man takes off his clothes and lies down on his side on the couch.
2. The uzist, putting a condom on the ultrasound probe, moves the device into the rectum.
3. During certain manipulations, it examines the surface of the prostate gland.

The procedure is usually not painful, but if a biopsy is necessary, it may be uncomfortable. The duration of the diagnosis ranges from 20-40 minutes.

Other methods of examining the prostate may also be used. Most often, they are necessary to exclude diseases that have a similar clinical picture or if the results of the methods described above cannot be interpreted.

You might be interested

Source: https://prostatits.ru/prostatit/obsledovanie-prostaty.html

Prostate Exam: What to Expect in a Doctor's Office

The most unpleasant, but quick and painless part of the examination is the examination of the prostate gland through the rectum, which can provide important information to the doctor.

As the first step in evaluating a patient who has been referred to a doctor because of symptoms of BPH, your doctor will ask you in detail about your urinary and reproductive complaints and previous medical conditions.

In order to choose the right treatment, it is important to know the patient's other problems, determine possible preliminary surgical interventions and medication habits, so when talking with the doctor, you should not listen to any complaints!

An important element of the subsequent medical examination is a thorough examination of the abdomen, which allows the examining physician to check the bladder. If you need to have an ultrasound of the prostate gland in Volgograd, then contact the Medical Center for Immunoprophylaxis "MCI"

Prostate examination: unpleasant, but not painful

A physical examination of the prostate gland is performed through the rectum (digital rectal examination). This occurs when the patient bends upright or lies with his legs elevated. These positions make it easier for your doctor to examine your prostate through the rectum. The test is simple, quick and, although unpleasant, not painful.

The information value of a prostate examination is very important for a doctor: you can make tactile conclusions about the size of the prostate gland and the existing disease (BPH, chronic prostatitis, prostate cancer). Of course, digital rectal testing alone is not sufficient for further diagnosis, and further research is needed.

What can be inferred from the blood test results?

Blood collection always occurs. The result provides general information about the patient's condition, may be caused by certain diseases, or provides important information about kidney function.

Determination of the amount of a specific protein, prostate specific antigen (PSA), is important for the study of prostate disease.

PSA is produced only by prostate cells in the body, and its concentration in the blood is proportional to the size of the prostate.

However, the study is not specific to BPH and may have higher levels in other prostate diseases.

PSA may be elevated in case of inflammation of the prostate gland, its infectious condition, cancer, even after ejaculation. Certain treatments (such as transurethral resection of the prostate) and certain medications can lower the amount of PSA in the blood. PSA comes in two forms, free and bound, and it is important for your doctor to know the amount of both.

Other tests: Urine examination

Because BPH causes confusion when voiding urine, a urine dipstick or laboratory test is also required for diagnosis.
Measuring urine flow is a simple method of determining maximum urine flow rate and average flow rate. There is a urinary flow curve, the shape of which provides important information to the urologist, although decreased urine flow may be caused by other diseases of the prostate and bladder or urethra. The test doesn't hurt.

An important test is to determine the amount of urine remaining in the bladder after urination, which is done using an ultrasound device. The amount of residual urine can also be determined by catheterization if the image cannot be safely characterized for any reason during an ultrasound scan.

Prostate ultrasound also makes the prostate visible, its size and its finer structure. The practitioner may also notice other conditions, such as those suspected of prostate cancer. Ultrasound examination of the abdominal cavity: kidneys, bladder and small prostate.

Source: https://medinses.ru/zdorove-muzhchinyi/obsledovanie-prostaty-chto-mozhno-ozhidat-v-mediczinskom-kabinete.html

You are invited to have your prostate examined by a urologist.

At the first visit, the doctor collects information about the course of the disease. He needs to find out when the symptoms of the pathology first appeared and how often they occur. In addition, the doctor finds out whether the patient has ever experienced problems with the genitourinary system, and whether there have been cases of similar diseases in close relatives.

At the first examination, the urologist may perform a rectal examination of the prostate gland.

If there are complications or suspicion of them, he will refer the patient for blood and urine tests, additional studies such as ultrasound, computed tomography and magnetic resonance imaging, etc.

In some cases, an organ biopsy is performed to determine the presence or absence of cancer.

All of these procedures are necessary in order to make the correct diagnosis and prescribe the correct treatment. There are several different prostate diseases that have similar symptoms. However, the approach to their treatment can differ radically. In the most difficult cases, surgery is prescribed, during which the tumor and, possibly, the prostate gland are removed.

The most commonly diagnosed urological diseases in men include prostatitis, which is caused by bacterial infections or congestion.

The second place is occupied by hyperplasia, accompanied by the proliferation of prostate tissue.

Such a change does not threaten the patient’s life, but as the gland enlarges, it can lead to urinary retention, inflammation of the kidneys and urinary tract.

Unfortunately, these days, urologists are increasingly identifying oncopathology of the prostate, the danger of which is the occurrence of metastasis to other organs.

At the last stage, many treatment methods are ineffective and patients are prescribed maintenance treatment.

All these diseases are usually accompanied by similar symptoms, characterized by the appearance of pain in the perineum and an unpleasant sensation during ejaculation. Discomfort is also possible when emptying the intestines. Decreased potency is observed in many patients with prostate dysfunction.

In the future, after studying blood and urine parameters, the strategy may change.

In case of acute prostatitis, self-medication is unacceptable, since the disease can quickly develop into a chronic stage, in which therapy is longer and less effective.

Independent attempts at treatment are also dangerous due to the possibility of the formation of a purulent focus in the tissues of the gland, which can lead to a sharp deterioration in the patient’s condition and cause a septic complication.

Thus, at the first signs of changes in the prostate gland, accompanied by urinary retention or incontinence, a burning sensation, and problems with erection, you should consult a doctor.

DETAILS: Clinic of urology and andrology in Moscow.

You should also visit a urologist if your urine smells unpleasant or its color changes. Red color of urine may indicate the development of an inflammatory or oncological process.

Initial examination

At the initial appointment, the urologist collects information about genitourinary diseases and troubling symptoms. It is advisable to inform the doctor about cases of prostate disease in relatives, if any. You may need information about medications you are taking, any allergic reactions you have to medications and latex-based products.

If there are complaints of pain and other symptoms of changes in the prostate, and the doctor has discovered any compactions or an increase in the size of the gland, further research is prescribed, including blood and urine tests, prostate juice, and ultrasound (ultrasound), magnetic resonance imaging tomography (MRI).

If neoplasms in the gland are detected using tomography or ultrasound, a biopsy is performed. This diagnostic measure is necessary to determine the nature of the tumor and draw up a scheme for further therapy.

Such research methods are necessary to make an accurate diagnosis, since many prostate diseases have similar symptoms, but the approach to their treatment differs significantly. Sometimes, with severe growth of gland tissue, which is possible even with benign hyperplasia, surgical treatment is required.

Why is a prostate examination performed?

Examinations carried out regularly, even in completely healthy men, make it possible to diagnose diseases in the early stages. After all, pathological processes in the organ are often asymptomatic.

One of the main methods for diagnosing diseases is digital rectal examination (through the anus). The method is recommended as a mandatory procedure for clinical examination of men over 50 years of age. It is simple to perform and can be carried out in almost any medical institution.

It is important! A rectal examination and PSA test are not reliable enough - the doctor can only make an assumption about the presence of pathology.

Only a biopsy can reliably determine the development of a malignant tumor.

Rectal examination method

A rectal examination is a procedure that few men agree to without any problems. At the same time, urologists carry out it as carefully as possible. The patient experiences a minimal level of discomfort. Before carrying out manipulations, the doctor must have a conversation with the patient, telling the course of further actions.

DETAILS: Relieving inflammation in urology

A urologist performs a rectal examination on a patient in the knee-elbow position. The latter can also lie on his side, tucking his knees to his chest.

The specialist, wearing a latex glove, lubricates one finger (usually the index) with Vaseline, and then inserts it into the rectum.

The patient at this moment needs to relax as much as possible, otherwise, in addition to an unpleasant sensation, he will experience pain in the anus.

By feeling the prostate gland, the specialist determines its size, shape and degree of surface elasticity. At the end of the examination, the urologist performs several elements characteristic of massage procedures. His actions lead to the release of a secret, which is then sent for analysis.

The appearance of pain indicates an inflammatory process in the prostate gland. This symptom indicates the presence of acute or chronic prostatitis, which is in the acute stage. In the latter case, scars may be detected on the soft surface of the organ.

Also, pain during palpation occurs in the presence of kidney stones. Prostate adenoma is detected provided that both lobes of the organ have increased symmetrically to each other. At the same time, the consistency of the organ also changes uniformly.

Uneven contours, high density of the prostate gland and uneven consistency - all this indicates the possible formation of cancerous tumors. Mostly, such tumors arise near the borders of the organ, causing its edges to become uneven. At later stages of cancer, both lobes of the gland become asymmetrical relative to each other.

A urine test is prescribed for patients who have signs of dysfunction of the prostate gland or other organs of the genitourinary system.

Exceeding the normal level of leukocytes in the urine may indicate an infectious disease of both the gland and the bladder or kidneys.

If blood cells are detected in urine, the question of the presence of prostate inflammation or neoplasm is raised. Hematuria can also appear with problems with the urethral canal.

An increase in its value may indicate an inflammatory process, adenoma or prostate cancer.

High antigen values ​​do not always indicate a serious disease of the gland, which is why additional diagnostic methods, for example, ultrasound, are so necessary.

This method allows you to detect even the smallest neoplasms and changes in the prostate. The most reliable study is using an ultrasound machine, the sensor of which is inserted rectally. The method is more accurate and informative compared to the diagnostic method, when the doctor assesses the condition of the organ using ultrasound through the abdominal wall.

If a tumor process is detected in the prostate, a biopsy is required. This procedure is carried out by inserting a thin needle into the gland tissue, from which a group of cells is taken. After puncture, the material is sent to a histological laboratory, where the nature of the neoplasm is determined.

DETAILS: Types of kidney stones description photo

In some cases, the patient is additionally prescribed an MRI. This method allows you to detect very small tumors, which are not always easy to identify using ultrasound. Tomography helps determine the location of the tumor and its structure.

Mechanism of digital rectal examination

The procedure is short, does not require preliminary preparation, and takes only a few minutes.

Note! Examination of a healthy organ is painless!

• the examination can take place in one of three positions: in an inclined position, standing, lying on your side (knees pressed to your chest), in a standing position with emphasis on your knees and elbows;
• the examination is performed using a finger: the doctor puts a glove on his hand and lubricates the index finger with a special gel;
• The gland is palpated, the doctor will announce the results immediately after the examination.

Peculiarities

• There is some discomfort, but the examination is not at all dangerous and occurs without pain. A nagging pain may be felt if the prostate is enlarged;
• there may be an urge to urinate (the desire to urinate);
• performance after the examination is completely preserved.

During the examination, the diagnostician receives a huge amount of valuable information about the processes occurring in the organ, based on its shape and the relative mobility of the gland. Further appointments and tests are based on the findings of this examination: ultrasound, digital examination, biopsy, PSA analysis.

Necessity of inspections

Preventative prostate examinations are extremely important for both younger men and older patients. It is important to remember that with age, the risk of developing hyperplasia or cancer increases many times over. The chances of curing prostate cancer are high if the disease is detected at an early stage.

An advanced oncological process is very difficult to treat. Prostate cancer is dangerous due to the appearance of metastases in other organs. The tumor in the initial stage is removed surgically. BPH may also require surgery if it begins to put pressure on the urinary tract and cause problems with urine flow.

There is no need to be afraid or worry if your doctor has prescribed various procedures to improve prostate function. Rectal massage, laser therapy, herbal baths - all this helps prevent congestion in the gland and the development of prostatitis. It is important to remember that untreated prostatitis can also cause glandular hyperplasia.

Source: https://urologportal.ru/kateter/takoe-rektalnyy-osmotr-urologii/

Methods for examining the prostate gland

It is advisable for women to undergo a preventive examination with a gynecologist once every six months. It is advisable for men to visit a proctologist once a year. This is the only way to detect many diseases of the reproductive system in time. Some of them occur frequently, cause complications, and pose a threat to life.

They are difficult to treat if they appeared a long time ago and your health is in poor condition. Oncological diseases cannot be treated at all at the fourth stage; irreversible processes occur. You will have several years to live after diagnosis.

Regular visits to the proctologist and preventive examinations will help detect prostatitis in time.

Examination by a doctor

By visiting a proctologist once a year or every six months, you can notice deviations from the norm in time and stop the development of the pathological process. Regular mantu tests and annual fluorography have improved the situation with tuberculosis. Prostatitis and prostate cancer can also be eliminated with the help of preventive examinations.

Any doctor conducts an examination at the first appointment. It is necessary to collect anamnesis, clarify the clinical picture, and make appropriate entries in the outpatient card. Inspection is an ancient and effective method of research. You can always count on him. Technology and medical equipment cannot yet replace it.

It is used when mass examinations are carried out - within the framework of a military medical commission, for example. The equipment will not withstand the load of a large flow of people, and queues will appear.

Soon funds will be needed to purchase new equipment - two or three copies instead of one.

This is a super task even for a private clinic, where services are expensive and theoretically there are reserve funds in the budget, thanks to which you can purchase the necessary medical equipment and allocate space for it.

The examination method is used by a family doctor. Many people choose to call a family therapist at home. This is better than going somewhere again, for example, with a fever. The family doctor knows the medical history of all family members.

He knows everything about such a risk factor as hereditary predisposition (sometimes this is important), improves the quality of diagnosis and treatment. A person may not be aware of the health problems of his grandparents, but the doctor will be privy to all the secrets.

While maintaining medical confidentiality and without violating the rules of ethics, he will be able to provide timely, relevant assistance.

The proctologist also conducts an examination at the appointment. It involves a digital examination of the prostate gland. With its help, you can detect deviations from the norm in structure, dimensions, and functioning. Palpation is performed through the rectum.

Self-examination

Self-diagnosis and examination of the prostate gland using palpation can provide the necessary information. True, the probability of error is higher. The doctor has access to a comparative analysis, he has more experience, even if he graduated from university yesterday and this is his first day of work.

The person himself may not notice minor deviations. However, inflammation can be determined, there is no doubt about it.

It appears in the initial stages, with prolonged stagnation of prostate secretion, if any negative factors influence the tissue of the gland, it can be the cause of the appearance of adenoma or its symptom.

When palpating the intestines, pain will become noticeable at the location of the gland if its tissues are inflamed. There should be no pain if everything is normal with the gland. Prostate massage is one of the therapeutic procedures and is not associated with pain.

Feeling the intestines must be done carefully; sudden movements can cause discomfort, because there are nerve endings in the rectum. If you are in a hurry or nervous, palpation will only be associated with negative emotions, which should be avoided.

Part of the diagnosis, examination, rectal examination sometimes becomes the reason for the formation of a sharply negative attitude towards preventive measures in general. They are not mandatory, they are completed voluntarily.

You cannot allow negative emotions to dominate logic and the instinct of self-preservation. This is a common medical procedure - important, necessary. It will help maintain men's health.

In this case, the prostate will be easy to palpate. It will move slightly and will be as close as possible to the intestinal walls. Diagnostic results will be more accurate.

Half an hour before the start, you should drink about a liter of liquid to achieve the desired effect.

It is also advisable to take a bath using antimicrobial agents. In particular, you can add a decoction of herbs.

A digital rectal examination of the prostate gland must be carried out wearing medical gloves and using a gel lubricant. The finger should be inserted into the anus, relaxing the sphincter muscles.

The prostate is located at a distance of 4-6 cm from the entrance to the large intestine. It resembles a hard bump with an uneven surface.

Deviation from the norm is:

• the size of the prostate becomes larger than a walnut;
• the difference in the size of its shares;
• discomfort in this area when pressed.

If these deviations are detected, you need to contact a specialist to clarify the situation and get medical help. These are signs of illness, perhaps, but there is a possibility that palpation was performed incorrectly and its results could not be interpreted. If a person independently examines the gland for the first time, there is a high probability of problems with interpretation.

Important. You can conduct a self-examination of the prostate before a visit to a specialist, a week or two before, and compare the results.

Laboratory research

Finger examination is the main, but not the only diagnostic method. You may need to submit the following biological material to the laboratory for testing:

These are the main tests. Optional, but allowing to avoid subjectivity on the part of the doctor when assessing the patient’s condition.

Urinalysis is part of the examination

A urine test will tell you about your health status and show whether there is an inflammatory process. One of the reasons for the appearance of pathological changes in prostate tissue is inflammation in the organs of the genitourinary system. This is important to remember. Its symptoms will also not be immediately noticeable by a person; a urine test is necessary to detect them.

This analysis talks about the formation of stones that appear in various organs due to impaired water-salt metabolism. Often they can be detected by abnormalities in a general urinalysis.

Bacterial inflammation sometimes leads to deterioration of the gland. Not only a general analysis is prescribed, but also a urine test for culture. It will become clear what microorganisms we are talking about.

Blood test

A complete blood count determines the level of hemoglobin. This indicator will tell you about oxygen metabolism, acid-base balance and more. The erythrocyte sedimentation rate will show whether there is an inflammatory process. A PSA blood test is needed to diagnose prostate cancer.

This is a specific study. But if a person himself decides to undergo an examination, he will probably want to take it first. Cancer is a dangerous, common disease, a serious threat. It is better to take both PSA and general analysis.

Not only oncology should be noticed in time.

Characteristics of prostate juice

A study of prostate juice will allow you to assess the condition of this particular organ. The acidity of the environment, the level of leukocytes, the presence of epithelium and macrophages, the presence of atypical cells and more are assessed. The secretion is obtained by massaging the gland during the examination.

A study is ordered when abnormalities are detected. Also prescribed to ensure the absence of pathological processes. This study does not cancel the previous ones, as they are no less important.

Important. Without blood and urine tests, it will be impossible to find the causes of functional or structural disorders. A comprehensive diagnosis is needed.

Additional diagnostic methods

Hardware examination of the prostate allows you to obtain more accurate, reliable information. Ultrasound will help detect and assess the degree of tissue inflammation and gland deformation.

Computed tomography, uroflowmetry, biopsy are more specific methods for examining the prostate gland area.

The doctor writes out a referral when a preliminary diagnosis needs to be confirmed or refuted or clarified.

Uroflometry is needed to assess urination rate and urine volume. The time to reach the maximum flow rate is determined. It will become clear whether the functions of the genitourinary system and prostate are impaired.

A biopsy is performed under anesthesia and is needed when a tumor or cyst is diagnosed. Examination of prostatic cells makes it possible to determine whether the neoplasm is malignant or benign.

Computed tomography is a more modern method than ultrasound. With its help you get a very clear image. It is taken before starting radiation therapy, so metastases will be visible. Ultrasound does not provide such clarity, but it is advisable to see metastases. They are the cause of relapses in cancer and require careful attention.

Important. Radiation therapy is an effect on metastatic cells, not only on the tumor, while healthy areas are not affected.

Conclusion

Many new methods of treating diseases of the male genitourinary system exist in our time. Prevention remains a priority. It is better to control the situation, respond in a timely manner to a threat to life and health, than to deal with constant discomfort, complications, and consequences.

Prostatitis, if it goes into a chronic stage, will have to be treated long and hard, with more effort. In some cases, it is necessary to remove the gland altogether - the situation is too dangerous, this is the only thing that will help.

If you start taking your health seriously and attentively, this can be avoided.

Source: https://myzhelezy.ru/smeshannoj-sekretsii/polovye/obsledovanie-predstatelnoj-zhelezy.html

Diagnosis of prostatitis: laboratory and instrumental methods

Acute and chronic prostatitis occur in one third of older men. This pathology is accompanied by the development of unpleasant symptoms associated with impaired urine outflow and intoxication syndrome.

Early diagnosis of prostatitis allows doctors to select the necessary treatment and prevent the development of complications of the disease. To diagnose inflammation in the prostate gland, various diagnostic procedures are used: laboratory and instrumental.

It is important to note that only the attending physician, who can give a professional assessment of the results and prescribe effective therapy based on them, should interpret the tests.

About the disease

Doctors know well how to diagnose prostatitis in the initial stages of its development. First of all, men need to know the possible symptoms of the disease and, if they are identified, immediately seek medical help. Main clinical signs of pathology:

• Discomfort and pain in the perineum and scrotum. The pain syndrome can radiate to the rectum, lower back and legs;
• dysuric disorders in the form of frequent and painful urination;
• all symptoms intensify during sexual intercourse.

If these symptoms are detected, you should contact a medical institution for diagnostic measures and treatment.

With late visits to doctors and attempts at self-medication, prostatitis can quickly progress, complicated by dysfunction of the kidneys and organs of the male reproductive system.

Diagnostic methods

An accurate diagnosis should be made by a urologist. The specialist carefully conducts a clinical examination, selects the necessary laboratory and instrumental diagnostic procedures that allow assessing the condition of the prostate gland.

It should be noted that diagnosing prostatitis in men does not present great difficulties for doctors. An experienced specialist makes a diagnosis during the initial examination and collection of complaints, since the symptoms of the disease are specific.

However, differential diagnosis should always be made with inflammatory lesions of the pelvic organs and benign prostatic hyperplasia, which may have similar clinical symptoms.

Source: https://prostatitaid.ru/prostatit/diagnostika-2.html