Analysis of prostate secretion: indications for the procedure and sampling technique

• An analysis of prostate secretions is performed to assess the function of the organ.
• And also to identify inflammatory processes (prostatitis) and other diseases.
• The resulting prostate juice can be examined in various ways.
• The basic diagnostic procedure is its microscopy.
• Culture and PCR of prostate secretions are also used if it is necessary to identify pathogens of infectious diseases.
•  

How to take prostate secretion

1. To obtain biomaterial, it is necessary to perform a prostate massage.
2. During this procedure, mechanical stimulation of the ducts is performed.
3. As a result, their contents are pushed into the urethra and released into the external environment.
4. Prostate massage is performed through the anus.

5. Anatomically, the prostate gland is located in close proximity to the rectum.
6. She is close to her.
7. The doctor massages both lobes of the prostate in turn.
8. In this case, finger movements are performed from the peripheral part of the gland to its center.
9. In this way, the contents are pushed out of the ducts.

10. When performing a massage, the doctor tries not to affect the seminal vesicles.

• At the end of the procedure, the doctor presses on the central sulcus.
• After this, prostate juice begins to flow from the urethra.
• The doctor collects it either on a glass slide or in a test tube.
• This depends on the purpose of the study and the type of diagnostic procedure performed.
• When microscopying the resulting material, it is immediately placed on glass, stained if necessary, and examined within a short time.
• To test for bacteria, prostate secretions are placed in a transport medium.
• Then it is sent to the laboratory, where after some time the research results come back.
• It happens that the doctor massaged the gland, but no secretion is released from the urethra.
• This is due to the fact that there is very little of it.
• Or there are mechanical obstacles that prevent fluid from being released into the urethra.
• Prostate juice sometimes enters the bladder.
• In such cases, prostate secretion is determined in the urine.
• After massaging the prostate gland, the man should immediately urinate.
• After this, the urine centrifuge is examined.
• 

Analysis of prostate secretions: preparation

1. In most cases, no preparatory measures are required.
2. With the exception of situations when diagnosing infectious diseases.
3. Then it is necessary to abstain from sexual intercourse for several days before collecting biomaterial.

4. Antibiotics or other antimicrobial agents should not be taken before the patient has been examined.
5. Prostate massage and collection of its secretions are performed after urination.
6. If the doctor sees that there is urethral discharge, it must be removed.
7. To do this, the urethra is washed with saline solution.

8. This procedure is especially important if a bacteriological study of prostate juice is planned.

Indicators of prostate secretion analysis

During microscopy of prostate secretions, many indicators are assessed.

• Some are of little clinical significance.
• Others are decisive in the diagnosis of prostatitis.
• Normally, the volume of prostatic juice is at least half a milliliter.
• The color of highly diluted milk.
• The density should be 1022.
• The reaction is neutral.
• That is, a pH in the region of 7.0 allows deviations of 0.3 in one direction or another.
• The prostate produces lecithin bodies.
• They are also called lipoid grains.
• One milliliter of prostatic juice normally contains at least ten of them.
• Amyloid bodies are detected.
• With a microscope magnification of 400 times, one or two of them come into the field of view.
• If the amount increases, this may indicate stagnation.
• This happens if a man has not had sex for a long time.
• The presence of a small number of leukocytes is allowed.
• These are cells that are markers of the inflammatory response.
• They are responsible for implementing the function of cellular immunity.
• Their number increases in case of prostatitis.

Normally, the number of leukocytes cannot exceed 10 per field of view if a magnification of 280 times is used.

Read also: Blood by PCR

1. When cells are counted, their number does not exceed 300 in 1 μl of prostatic juice.
2. Epithelium may be detected.
3. Normally, its quantity is 1 or 2 cells in the field of view.
4. Individual Böttcher crystals are observed in small quantities.
5. Prostatic juice normally does not contain fungal, bacterial flora or protozoa.
6. The presence of nonspecific flora in the form of single cells is allowed.

Changes in prostate secretion due to inflammation

• We looked at what normal indicators should be.
• Now let's discuss how they change in case of prostatitis.
• First of all, prostatic secretion is taken to diagnose this disease.

Its microscopy can provide indirect information about other pathologies.

But in the diagnosis of prostate cancer, benign hyperplasia, etc. analysis of prostate juice is not very informative.

During the inflammatory process, the changes will be as follows:

• the color may become transparent, often the prostatic secretion acquires a yellow tint;
• the amount of secretion decreases, during prostate massage it is released with difficulty;
• amyloid bodies are not detected;
• the number of lipoid grains is significantly reduced, sometimes they are completely absent;
• the reaction of the prostatic secretion becomes acidic (the pH shift correlates with the severity of the inflammatory process);
• the density of prostate juice changes - it can either increase or decrease;
• a large number of leukocytes is determined;
• the epithelium is found in numbers of up to 15 cells in the field of view of the microscope.

1. The fern symptom may become positive.
2. This is a laboratory symptom.
3. It determines the physical and chemical properties of prostate secretion.
4. Sodium chloride is added to the biomaterial.
5. The preparation is then dried and examined under a microscope.
6. With a positive fermentation symptom, sodium chloride crystals fall out.
7. As a result, the microscopic picture changes.
8. The drug looks like the leaves of the corresponding plant.
9. Sometimes pathogenic microorganisms are detected in the secretion of the prostate gland.
10. It could be gonococci or trichomonas.

• They are causative agents of sexually transmitted diseases: gonorrhea and trichomoniasis.
• If they are detected, an appropriate diagnosis can be immediately established.
• In addition, with nonspecific bacterial prostatitis, a large amount of flora is found in the biomaterial.
• Additional research is required to establish the type of pathogen.
• Often the inflammatory process is caused by associations of microorganisms.

Culture of prostate juice

1. A cultural examination is prescribed for men with suspected prostatitis of bacterial, fungal or protozoal etiology.
2. Most often, inflammatory processes in this organ are nonspecific.

3. That is, they do not arise as a result of sexually transmitted infections, but are initiated by resident flora.
4. This is most often E. coli, less often other microorganisms.
5. Before culture of prostate secretions is performed, sexual abstinence for at least 2 days is required.

6. Then the patient comes to the clinic.
7. With the help of prostate massage, a secret is taken from him.
8. It is then placed in a test tube and sent to laboratories.
9. There, the clinical material is placed in a nutrient medium.

• It is cultivated under conditions optimal for microbial growth.
• If they appear in the prostatic secretion, then colonies appear on the nutrient medium after a few days.
• They can be used to identify the type of bacteria.

Who is prescribed culture of prostate secretion for flora?

The study is used if the patient has clinical or laboratory signs of prostatitis.

Clinical signs include:

• pain in the perineum;
• difficulty urinating;
• erectile dysfunction;
• frequent urge to urinate.

Sometimes prostate culture is recommended based on the results of microscopy of prostate juice.

It may show signs of infection.

This is a large number of bacteria, leukocytes, epithelial cells, etc.

That is, all the signs that are listed above.

Purposes of prostate secretion culture analysis:

• confirmation of bacterial inflammation;
• establishing the type of bacteria;
• determining the activity of the inflammatory process by the number of bacteria;
• assessment of the sensitivity of isolated flora to antibiotics.

Decoding the prostate culture tank

1. The first thing assessed is the presence of bacterial growth.
2. That is, whether colonies appeared on the nutrient medium.
3. If they are not present, the culture tank result is negative.
4. This indicates the absence of bacterial prostatitis.

Read also Analysis of Femoflora

• In addition, bacteria can grow in minimal quantities.
• The threshold value is considered to be 10 to the power of 4 colony forming units or more.
• If the quantitative indicators are lower, this indicates possible contamination of the material.
• Normally, prostate secretion should be completely sterile.
• However, when taken, it passes through the urethra.
• Microorganisms may be present in its distal section.
• But if they grow in numbers exceeding the specified threshold, this indicates inflammation caused by bacteria.
• This patient requires treatment.

Assessment of drug susceptibility in prostate secretion culture

During bacteriological culture, the sensitivity of the isolated flora to antibiotics can be assessed.

This is required to select an effective antibiotic therapy regimen.

1. Sensitivity assessment is not carried out if the isolated flora is contained in quantities less than 10 to the 4th power.
2. Since in this case the diagnosis of bacterial prostatitis is not considered confirmed.
3. If the threshold is exceeded, an antibiogram is issued with the results of the analysis.
4. It indicates which antibiotics have a high degree of effect on the isolated microorganism, which have minimal effect on it, and which have no effect at all.
5. The notation in the analysis looks like this:

• S – sensitive (the doctor will choose one of these drugs to treat an infectious lesion of the prostate);
• I – insensitive (used in high doses, only if it is impossible to use drugs from group S);
• R – resistant (there is no point in prescribing drugs because the isolated bacteria are not susceptible to them).

Conducting a sensitivity test significantly increases the effectiveness of treatment.

Analysis of prostate secretion after treatment of prostatitis

• After treatment of the inflammatory disease, the patient is re-examined.
• Confirmation of its cure is necessary.
• The criteria used are clinical and microbiological.
• The urologist examines the man, evaluates his complaints and objective symptoms.

1. Their absence is a sign of clinical recovery.
2. Then the man takes the tests again.
3. The doctor evaluates changes in prostate juice during its bacterioscopic examination.
4. Repeated seeding is carried out to determine the amount of microflora.
5. If the test results are negative, the disease is considered cured.
6. If they are positive, a repeat course of therapy is necessary.

PCR for STDs of prostate secretion

• Sometimes molecular biological diagnostics are required.
• It allows you to determine the type of pathogen that provoked the inflammation.
• Basically, PCR is prescribed for suspected sexually transmitted diseases.
• Some of them can spread to the prostate gland.
• PCR is a very accurate method.
• It has high sensitivity.
• In the secretion of the prostate, it can be used to detect chlamydia, trichomonas, gonococci or other microorganisms.
• However, it should be borne in mind that when prostate secretion is collected, it passes through the urethra.
• Therefore, when performing high-quality PCR studies, a single analysis of prostate juice for STDs does not confirm the presence of pathogens in this organ.
• They could well have gotten into the biomaterial when passing through the channel.
• To know for sure that the prostate is affected by a certain pathogen, it is necessary to either conduct quantitative tests or simultaneously examine a urethral scraping.

1. Otherwise, the diagnosis will be etiological, but not topical.
2. That is, it will confirm the presence of a certain pathogen in the body.
3. But it does not prove that it is localized specifically in the prostate.
4. Prostatitis caused by an STD is indicated by:

• the presence of pathogen DNA in the prostate secretion in its absence in the urethral scraping;
• the presence of DNA in high concentrations (determined by quantitative PCR).

Analysis of prostate secretions: where to go?

To check the functional state of the prostate, contact our medical center.

We use the most modern laboratory tests to diagnose prostatitis:

• microscopy of prostate juice;
• sowing on flora;
• PCR for sexually transmitted infections.

• We carry out differential diagnosis with other diseases of this organ.
• If the diagnosis is confirmed, you will be able to receive a course of therapy.
• We employ highly qualified urologists and venereologists.
• They will help get rid of the inflammatory process in the prostate.
• To have your prostate secretions analyzed, please contact the author of this article, a urologist in Moscow with many years of experience.

Source: http://intimnyjotvet.ru/diagnostika/analiz-sekreta-prostaty.html

Prostate secret: preparation for analysis, algorithm and interpretation of results

• November 15, 2018
• Prostatitis
• David Omarov

Not many people are familiar with how to prepare for the analysis of prostate secretions.

The prostate gland is a very important male reproductive organ. It produces a secretion, otherwise called prostate juice.

It contains enzymes that are required to reduce the viscosity of sperm. This ensures sperm motility. This function of the gland is far from the only one.

The analysis makes it possible to determine important indicators of a man’s health and the degree of effectiveness of treatment.

Preparation for the analysis of prostate secretions is important. If the meanings are correctly deciphered, it is possible to establish oncology, infertility and obtain all the necessary information about the condition of the main gland in the male reproductive system.

If the doctor directs you to undergo such a study, then you should not neglect this procedure or postpone it until later if you want to maintain the healthy condition of your intimate organs.

The doctor will tell you in detail what preparation is required for the analysis of prostate secretions.

Function of prostate secretion

In the male reproductive system, the prostate gland is one of the most important organs.

It is located in the pelvic area, directly behind the posterior surface of the bladder, and on the other side it is in contact with the rectum, separated by a thin septum. The average size of the gland is three centimeters.

It includes two lobes, each of them is covered with excretory ducts. They are all sent to the prostatic urethra.

In addition, prostate secretion has stabilizing properties for sperm, due to which sperm activity increases. The gland produces two milliliters of secretion per day. It makes up at least 30 percent of seminal fluid.

Nature, therefore, took care of eliminating obstacles to normal fertilization of the egg.

Not everyone knows why preparation is needed for the analysis of prostate secretions.

When is prostate juice examined?

As in any other organ, pathological processes can develop in the prostate. They are most often caused by infections that are sexually transmitted.

Such troubles most often occur to men at a young age, when they are sexually active. Infectious pathogens “settle” in the prostate and accumulate there throughout the entire period of male sexual life. If conditions arise that provoke the activation of infectious pathogens, the process of inflammation begins to develop. Such conditions may be:

• state of stress;
• hypothermia;
• pathologies of the pelvic organs;
• Unhealthy Lifestyle.

The process of inflammation in the prostate is called prostatitis. Its forms differ depending on the source of occurrence: chronic, acute, abacterial, bacterial. The study of prostate secretions makes it possible to determine the nature of the disease and the prognosis of its development.

Symptoms

Analysis is also carried out for the following symptoms:

• decreased sex drive;
• long-term difficulties with conceiving to rule out male infertility;
• erectile disfunction;
• systematic pain in the pelvic area.

There is another significant reason for studying the analysis of prostate secretions, that is, tracking the therapeutic dynamics of the patient's condition.

The biochemical content of the juice becomes an indicator of the ineffectiveness or effectiveness of prescribed medications.

The analysis is carried out to determine infectious pathogens and their sensitivity to drugs, mainly to antibiotics.

Signs of an unhealthy prostate

It is necessary to distinguish the initial signs that indicate disorders of the prostate gland, signaling an urgent visit to the urologist.

With timely detection of a developing disease, you can get rid of it and return to normal in a short time.

Any man who is attentive to his own well-being is able to conduct an initial self-diagnosis and determine that he is beginning to have genitourinary problems. For the prostate gland, the first signs of pathology development are:

• frequent urge to empty the bladder;
• feeling of incomplete urination;
• pain when urinating;
• potency defects.

Self-medication without determining the cause of deviations in a person’s health is pointless.

It is important to eliminate the cause

The use of herbal medicines and special urological exercises also contribute to recovery. However, without eliminating the cause of the disease, all these actions will only relieve symptoms. As soon as the training stops and the drug is discontinued, all the genitourinary problems will return again.

Algorithm for collecting prostate secretions

Often representatives of the strong, who are concerned about their health, ask the question of how to analyze prostate secretions in men? This is done only by massaging the gland. No other method has been found or invented at this time. Men do not like this procedure, but without it it is impossible to get an accurate picture of the condition of the prostate.

After preparing for the analysis of prostate juice, the doctor massages the gland on an outpatient basis. Before starting the procedure, the patient is advised to empty the bladder. The urologist, depending on the weight, build and other characteristics of the patient, chooses the most comfortable position for massage for the person. This is predominantly a knee-elbow position. However, it can be done with legs tucked in, lying on one's side.

After a rectal massage, a small volume of secretion is released from the urethra, which is collected on a previously prepared glass slide or in a test tube. The material is then packaged in a sterile container, formatted and described, and then sent for testing to the laboratory.

It happens that after a massage the juice is not released and goes into the urethra. In this case, the patient is asked to defecate and urine is collected. Subsequently, it is passed through a special centrifuge, due to which the liquid is divided into components.

Preparation for analysis of prostate secretions at a psychological level

For a man, the most unpleasant thing during a urological appointment when taking prostate secretions is emotional discomfort.

The volume of collected secretion can show congestion in the prostate (over two milliliters) or prostatitis (less than one milliliter). Normally - from 0.5 to 2 milliliters.

The procedure is contraindicated for acute types of prostate pathologies, so there will be no pain. It is important to find out in advance how to prepare for the analysis of prostate secretions.

That is why the main preparation of a man for the reception is overcoming his own shyness and emotional state. You need to understand that these unpleasant moments will become assistants in finding the most effective treatment method. Thus, one can hope for quick relief from genitourinary disorders.

A few more recommendations

There are several more recommendations for preparing for the donation of prostate secretions:

• you need to abstain from intimate relationships 2-3 days before the analysis;
• It is prohibited to drink alcohol;
• do not load the prostate gland;
• do not engage in strength exercises, do not carry heavy objects or ride a bicycle;
• Overheating of the prostate area is prohibited, and therefore saunas, steam baths and hot baths are excluded.

The essence of bacterial sowing

The doctor will tell you in more detail about preparing for the analysis of prostate secretions at your appointment. What is this analysis?

By bacterial culture we mean a laboratory analysis of biomaterial, which allows us to identify pathogens and test their sensitivity to antibiotics. Such a study is in demand by gynecologists, urologists, dermatovenerologists, etc. The analysis has two stages:

• Growing bacteria. The biomaterial is placed in favorable conditions for their growth and provided with the necessary nutrient medium. Laboratory assistants observe this process and determine the rate (degree) of increase in the number of bacteria. It is calculated in CFU/ml.
• At the second stage, sensitivity to medications is determined. This is a very important study, since recently there is a serious disorder that significantly complicates all therapeutic methods. This is the resistance of bacteria and viruses to drugs. That is why it is so important to conduct an antibiogram, which allows you to choose an effective drug in a given situation.

The following pathogenic microorganisms grow especially often in prostate secretions:

• staphylococci;
• coli;
• enterococci.

You can also test prostate secretions for sexually transmitted infections. Venereal pathogens are often identified in this way:

• mycoplasma;
• gonococci;
• ureaplasma;
• candida;
• chlamydia, etc.

Where can I take the test?

Many men do not know where to get tested for culture of prostate secretions, as well as what the cost will be.

The duration of bacteriological analysis is from five to seven days. Its results allow us to develop treatment tactics for each case. Bacterial seeding is currently an accessible procedure. It is performed in all urological clinics and dermatovenerological clinics.

Decoding the analysis results

The study of prostate secretions includes two types of tests: bacteriological and microscopic.

In the first process, the structure of cells is studied. To do this, use two viewing glasses, with a drop of secretion placed between them. Bacteriological research is bacterial culture. There is another quite informative test for the so-called “fern symptom”.

It is carried out in this way: a drop of secretion and the same amount of saline solution are applied to the viewing glass. They are mixed and left to dry. During crystallization, a special pattern is formed. If it looks like a fern leaf, we can judge the absence of inflammation in the prostate.

Another drawing confirms the suspicion of prostatitis.

Analysis of prostate secretion allows you to evaluate the following indicators: odor, color, density and collected amount. The absence or presence of pus in the blood is determined.

Native analysis of prostate secretion

In a laboratory setting, a native test is performed: the biomaterial is applied to glass slides, dried in the open air, and then stained with a Gram stain. After this, the laboratory doctor examines the native agent microscopically in all fields of view and counts the number of formed components of the secretion.

The volume of collected material can indicate symptoms of stagnation in the prostate (over two milliliters) or prostatitis (less than one milliliter). The norm is from 0.5 to 2 milliliters, an increase or decrease is a symptom of the inflammation process. Color – yellowish or transparent white.

Lecithin grains - ten million per milliliter of secretion. A decrease indicates the presence of disease. Density is 1.022, pH (acidity) is neutral, 0.7, in both directions it can deviate no more than 0.3. The number of leukocytes is a maximum of ten per field of view.

Trichomonas, gonococcus, and Escherichia coli are absent.

Pyrogenal test

Sometimes bacterial culture of prostate secretions does not indicate an inflammatory process. However, there may be symptoms of the disease. In such an ambiguous situation, the patient is offered a test with pyrogenal.

When such an analysis does not show prostate symptoms, there are two options: narrowing of the excretory ducts and/or several inflammatory foci in the gland. To determine the condition, a biopsy or TRUS is prescribed.

Preparation of prostate secretion must be carried out correctly. Moreover, the collection can be done independently.

Features of self-collection of prostate secretion

Nowadays it is not difficult to carry out microscopic and bacteriological examination. Any large populated area has a laboratory that specializes in performing such tests. The study is paid, but the cost is affordable. To collect the secret yourself, you need:

• learn prostate massage techniques;
• prepare a hermetically sealed sterile container;
• bring the quickly collected secret to the clinic.

After receiving the result, you can visit a urologist. Typically, prostate secretion analysis does not take long.

Source: https://cureprostate.ru/421185a-sekret-prostatyi-podgotovka-k-analizu-algoritm-provedeniya-i-rasshifrovka-rezultatov

Analysis of prostate secretion: what it shows, how it is taken and how it is done, interpretation, deviations and norms

Prostate secretion is a fluid that appears as a result of the activity of the prostate gland and is a component of semen. The secretion ensures the normal fertilizing ability of sperm, so it is difficult to overestimate its importance.

Analysis of prostate secretions

The secretion is 1/3 of the volume of ejaculate. It is necessary to ensure the motor activity of sperm. It is also known that the normal fertilizing ability of cells is preserved only when the secretion composition is normal, therefore, with inflammation of the prostate, the fertilizing ability is impaired.

The secret is 95% water. The rest of them are potassium, sodium, calcium salts, citrates, bicarbonates, phosphates and numerous protein enzymes. In addition, cellular elements are found in the liquid - leukocytes, for example, and non-cellular elements - lipid particles, lecithin grains, amyloid bodies.

The quantitative content of cholesterol crystals and lecithin grains determines the functionality of the secretion, therefore, the greatest attention is paid to determining these parameters, especially when examining suspected infertility.

In addition, the content of citric acid is important - it determines the acidity of the biological fluid and zinc ions.

To analyze the secretion, a minimum amount of 1.5–2 ml is required. This is sufficient for microscopic examination in the laboratory.

What does it show

A study of prostate secretions is necessarily prescribed when diagnosing the following diseases:

• male infertility - there are several types of this disease associated with a lack of sperm count, their shape and motility. The last factor depends most on the composition of the prostate product. If there is a violation in the composition of the fluid, the sperm is deprived of the ability to move in the right direction, but moves chaotically and simply does not reach the target;
• diseases of the prostate gland - inflammation, prostatitis, cancer, infectious diseases of the genitourinary system, and so on;
• analysis is also carried out during treatment to monitor the result of the course.

Prostate secretion is used for microscopic examination to clarify all of the above diagnoses. If an infection is suspected, it is also necessary to conduct a culture test.

Indications

Laboratory examination is prescribed in cases where the patient exhibits the following symptoms:

• pain and cutting sensations during urination - inflammation of the urinary canal often affects the prostate;
• discomfort and pain in the perineum and groin area;
• urinating too often, especially at night;
• urination too often with a low flow density;
• yellow discharge from the urethra;
• frequent - several times a year, infectious diseases of the genitourinary system. In this case, it is necessary to examine the prostate gland;
• decreased potency;
• infertility - it is mandatory to carry out analysis during examination, especially in cases where sperm culture does not reveal the cause of the disease.

Contraindications

The analysis procedure is quite simple, and the examination itself is safe.

However, there are some limitations under which the analysis is not performed:

• anal fissure – makes the procedure extremely painful;
• the temperature is too high - above +38 C, the composition of the secretion changes;
• inflammatory diseases, especially acute ones. Fluid analysis will only confirm the presence of inflammation, but will not clarify the diagnosis;
• acute hemorrhoids – painful sensations make the procedure impossible;
• prostate tuberculosis.

In these cases, they try to limit themselves to sperm culture or use other instrumental examination methods.

Some preparation is required for microscopic examination. There is nothing special about them; the requirements are easily met.

You must stop eating 10 hours before the examination. As a rule, the test is scheduled in the morning, so there are no problems with fulfilling this condition.

• In the morning they do a cleansing enema.
• Before donating the secretion, it is necessary to empty the bladder so that drops of urine do not mix with the secretion of the prostate gland.
• It is forbidden to have sex for 3-4 days before the analysis.
• It is recommended to stop drinking alcohol and visiting bathhouses and saunas 1–2 days in advance.

The patient may need psychological help or a sedative, as a number of men are extremely aggressive about prostate massage. And the latter is an indispensable element of passing the analysis.

Preparation for prostate secretion analysis

Carrying out

The prostate gland is located in close proximity to the rectum. The fluid that it secretes is discharged into the urethra, so the logical question is how the analysis is taken. This occurs spontaneously only during ejaculation. To obtain a secretion for research, a urologist massages the prostate through the rectum.

The procedure is as follows:

• the patient frees the lower part of the body from clothing;
• The patient is placed on his right side, with his legs slightly bent and his hands held near his chest. A knee-elbow position is possible, but, as a rule, it is resorted to in rare cases;
• the doctor, wearing gloves, inserts the index finger into the rectum - 3.5–4 cm, and makes stroking movements on one side and the other. As a rule, 10–15 movements are enough;
• then the urologist presses on the interlobar groove to squeeze out the secretion accumulated in the gland. This is how analysis begins.;
• the fluid is secreted through the urethra and collected on a glass slide.

Sometimes the secretion is not released in sufficient quantities. In this case, the patient is asked to urinate into a test tube so that the required liquid is removed from the canal along with the urine.

The collected liquid is delivered to the laboratory.

How to massage the prostate to obtain secretions

Decoding

Prostate secretions are subjected to several studies:

• visual: measuring volume, determining color, density and acidity;
• microscopic analysis - assessment of the cellular structure of the liquid: the number and presence of red blood cells, leukocytes, epithelial cells, macrophages, and so on;
• bacteriological examination - detection of microorganisms that can cause illness;
• study of the nature of crystallization - the secretion contains a large amount of sodium chloride. When crystallized, salts can take on different shapes, and these shapes depend on the characteristics of the liquid. Normally, the crystallization pattern resembles a fern leaf - quite complex and orderly. The stronger the deviation from the norm, the more chaotic the crystals are arranged.

Norm and deviations

The results of the examination are entered into a table, which helps to decipher them.

Focusing on the norms generally accepted for analysis, it is quite easy to establish the nature of the deviations:

ParameterNorm
Deviations from the norm, possible pathology

Liquid volume	Minimum amount – 0.5 ml, maximum – 2 ml	With prostatitis, a decrease in secretion volume is recorded, and with blood stagnation, an increase
Color	White shade	With inflammation, the color of the liquid will be either bright white or yellow. If there are blood impurities, the secretion takes on a red tint.
Smell	The characteristic smell of sperm	A different smell indicates a change in fluid composition
Density, g cubic. cm	1,022	Any deviation indicates an illness
Secretion pH	7.0, deviation up to 0.3 is allowed	A shift toward an alkaline reaction indicates chronic inflammation, a shift toward the acidic side indicates prostatitis.
Red blood cells	Completely absent or isolated	Present in prostatitis or cancer
Epithelial cells	No more than 2 in sight	Epithelial cells line the ducts of the gland. If their number is increased, this indicates inflammation of the organ. Against the background of an excessively high number of leukocytes, the parameter indicates a malignant formation
Leukocytes	No more than 10 in the field of view at 280x magnification, no more than 5 at 400x magnification	Excessive amounts indicate inflammation
Macrophages	Absent or present in quantities of no more than 2–3	Exceeding the norm indicates an inflammatory process
Giant cells	None	The appearance of cells indicates stagnation or a chronic course of the disease
Amyloid bodies	None	In case of stagnation of blood, seminal fluid, adenoma or hypertrophy of the glands, the corpuscles appear in secretion
Lecithin grains	10 million per 1 ml	With prostatitis, their number decreases significantly
Fern symptom (crystallization pattern)	Saved	Broken or missing
Fungi	None	May be present with prostatitis, but not necessarily
Bacteria	Non-pathogenic microflora is present in small quantities	The appearance of staphylococci, Klebsiella, Pseudomonas aeruginosa, Escherichia indicates infectious diseases

The diagnosis is not made based on the results of a single analysis. For example, too high a secretion viscosity can significantly distort the indicators, so this examination is repeated at least one more time. It is recommended to massage the prostate yourself between two examinations.

Interpretation of the results of a microscopic examination of prostate secretion does not serve as an absolute indicator of a particular disease. However, deviations in the composition of the secretion indicate the presence of some inflammatory or chronic ailments.

The final diagnosis is made after consultation with an oncologist and surgeon.
In the video, the results and interpretation of the analysis of prostate secretion:

Source: http://gidmed.com/urologiya/diagnostika-urolog/laboratornye/analiz-sekreta-prostati.html

Prostate juice analysis and interpretation

If urination is impaired, accompanied by pain in the perineum, there is reason to suspect pathology in the prostate gland, including prostatitis. To clarify the diagnosis, along with instrumental methods, laboratory tests are used, one of which is the analysis of prostate juice (secret) in men.

We'll tell you how it's done, give information about proper preparation, and tell you how to do a preliminary decoding without waiting for a doctor's conclusion.

Why is prostate juice collected?

The secretion of the prostate gland is a transparent and viscous liquid that is produced in the organ to maintain the desired consistency of the ejaculate. The juice consists of more than 90% water; it also contains some trace elements, lecithin grains, epithelial cells and a number of other substances.

The prostate gland is normally sterile and therefore there are no Bactria in its secretion. However, during the inflammatory process, the level of leukocytes will be increased, and in case of infection, various pathogenic or conditionally pathogenic microorganisms will be noted in the analysis. Therefore, laboratory testing of prostate secretions is part of the diagnostic measures.

How to prepare for analysis

Taking prostate juice is an activity that does not require special preparation. However, a man must adhere to certain rules, violation of which may distort the final results.

1. A week before the appointed date, you need to give up sex.
2. Eliminate alcohol for 3-5 days.
3. It is advisable not to visit the bathhouse or swim in the pool for the last week before the study.

Sports activities are permissible, but only under loads regulated by a doctor. This point must be discussed separately and not deviate from the instructions. Otherwise, you will have to take the secretion test again, and the favorable time to start treatment may be missed.

To eliminate infection from the bladder, antibacterial drugs in prophylactic doses may be prescribed 3-4 days before the date chosen by the doctor. Immediately on the day of collection, you need to do a cleansing enema and thoroughly wash the genitals, paying special attention to the foreskin.

How to take a secret for research

Sometimes taking secretions is combined with a four-glass urine sample. In this case, the patient collects the first two portions of urine, 30 and 10 ml each, into containers, then proceeds to collecting prostatic juice.

Prostate secretion can be collected after rectal massage of the gland. To do this, the man becomes “on all fours” or lies on his side. Next, the sampling is carried out in accordance with the following algorithm:

1. The doctor applies Vaseline to the anus and inserts a finger into it.
2. Examines the organ, paying attention to the consistency of the prostate, size, location and other points.
3. With careful movements from the edges to the center, he strokes the prostate gland, while lightly pressing on it.

After a few minutes of such stimulation, secretion will begin to be actively produced, then it will be released through the urethra. The liquid is collected in a container and sent for further research.

With prostatitis, the organ is inflamed, so the procedure can be painful. The doctor's recommendations will help reduce the intensity of the pain, but it will not be possible to completely get rid of it.

You won't be able to collect the secret yourself. It is impossible, without knowledge of anatomy, to feel the prostate through the wall of the rectum and, moreover, to exert the correct influence on it. Therefore, it is better to entrust the manipulation of collecting biological material to a doctor.

Contraindications for analysis

As with rectal massage of the prostate gland, taking prostate juice has a number of contraindications. These include:

• exacerbation of bacterial prostatitis;
• prostate cancer;
• abscess;
• calculous prostatitis;
• acute urinary retention;
• hemorrhoids, anal fissures and other pathologies of the anus.

In this case, manipulations in the anus can cause serious complications, so the diagnosis is made based on other examination methods.

Decoding the analysis results

It is not possible to decipher the results of an analysis of prostate secretions 100%: the conclusion contains a lot of specific terms, plus you need to know all the normal indicators. However, it is possible to make a general conclusion about the pathology in the organ; for this you need to have an idea of ​​the microscopic parameters.

The following are important in deciphering the results:

• volume of secretion and its acidity, smell, density;
• number of leukocytes and erythrocytes;
• presence of bacteria and fungi.

Each factor has its own normal values, deviations from which indicate the development of pathology. In this case, the final result depends on the technical features of the laboratory, which also needs to be taken into account.

If there are no pathologies in the prostate gland, the secretion should meet the following indicators:

1. Juice volume – 0.5-2 ml.
2. Color – light white.
3. Density – 1.022.
4. pH – 7.0.
5. The smell is specific.

The normal indicators of microscopic examination can be found in the table.

Parameter	Value is normal	A comment
Red blood cells	No	Occasionally 1-2 in the field of view is not a deviation.
Böttcher crystals	1-2 units	It is not a diagnostic indicator; it may also be present in the analysis of healthy prostate juice.
Giant cells	No
Lecithin grains	1 million	Completely cover the field of view
Epithelial cells	1-2	No more than two at 400x magnification.
Microflora	Absent	The presence of opportunistic microflora in small quantities is allowed.

Often the presence of pathology can be judged by a change in the color of the juice. So, with prostatitis it becomes light yellow, and with prostate cancer or chronic prostatitis it becomes red.

An increase or decrease in the density and acidity of prostate juice can signal a disease. With bacterial prostatitis, various microorganisms are found - gonococci, trichomonas, fungi.

An increase in the number of leukocytes against the background of a decrease in lecithin grains always indicates the onset of an inflammatory process in the prostate gland.

Conclusion

Analysis of prostate secretion is a necessary measure, the purpose of which is to identify changes in the composition of the fluid. If bacteria are detected, lecithin grains decrease and leukocytes increase, an inflammatory process can be suspected.

However, results alone do not provide a basis for diagnosis. A conclusion can be made only after a full examination, including TRUS of the prostate, urine and blood tests, and a number of other examinations.

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Source: https://prostatits.ru/prostatit/kak-delayut-analiz-sekreta-prostaty.html