Prostate (prostate gland) disorders are among the most common men diseases. Every second man over 50 years suffers from them.
The most common prostate diseases are benign prostatic enlargement (benign prostatic hyperplasia), prostate cancer, acute prostatitis (prostate inflammation), chronic prostatitis, chronic non-bacterial prostatitis (prostatodynia / vegetative urogenital syndrome) and others. You can find specialists in prostate treatment collaborating with GMG here
The following diagnostic and therapeutic methods are used in Germany for prostate diagnosis and treatment:
Classification of pathologies is based on similar features of manifestations. All possible diseases of the prostate gland in men are nominally divided into 4 groups:
The following list of diseases consists of the most common ones. Most of them can be successfully treated in the early stages.
Prostate gland diseases in men may occur both singly or in combination with other illnesses. In the latter case diseases result from infections of other organs: cystitis, urethritis, vesiculitis, etc.
The causative agents of the disease can be viruses, bacteria, fungi, mycoplasma. They penetrate the urethra, lymphatic vessels, rectum or urinary tract.
There are many external factors that create favorable conditions for the development of the inflammatory process:
No man can avoid age-related changes in the prostate tissues. It increases in size and squeezes the urethra. The risk of oncological diseases grows rapidly.
In old age, preventive treatment is required, even in the absence of any negative symptomatics.
Prostate diseases in men are always accompanied by urogenital organs disorders and sexual dysfunction.
Clinical implications are similar to the symptoms of many pathological processes, therefore, the differentiation of diseases requires high-quality comprehensive diagnosis.
General symptoms that require getting urgent medical help:
During the first visit of a medical institution the doctor conducts a patient intake - he asks about the way of life, chronic illnesses, period of first symptoms occurrence and their character, medication intake.
After the patient intake physician conducts a visual examination using the palpation method. Based on the data collected, at the physician's discretion, additional laboratory and instrumental examinations are prescribed:
Preventive examination will not include a whole range of measures. When prostate diseases are in question, only comprehensive diagnosis will give an accurate result.
Prostatitis is most commonly detected in men aged 45 years and older. More than 50% of males are vulnerable to this disease.
Prostatitis is divided into:
Acute prostatits is triggered by the immunity decrease of the prostate gland as well as in the whole organism. This factor causes penetration of pathogenic microorganisms into the body that leads to the development of the inflammatory process. Chronic prostatitis occurs due to a variety of reasons. It can be easily triggered by the penetration of pathogenic microorganisms.
In addition, the disease occurs due to:
About 90% of patients complaining of prostate gland problems are diagnosed with chronic non-bacterial prostatitis. Today, unfortunately, doctors can not find the true causes of this pathology.
It is assumed to be triggered by:
In case of acute prostatitis the patient notes the following symptoms:
The danger of bacterial chronic prostatitis is that the pathology can be present for several years without a clear clinical picture: the man does not feel any discomfort.
In most of the cases symptoms of this disease are manifested during the recrudescence period and are as follows:
Similar symptoms are typical for chronic non-bacterial prostatitis.
There are several main reasons for the formation of prostate gland stones:
If you do not get rid of prostate gland stones as soon as possible, they tend to grow gradually. Enlarged masses violate the integrity of the ducts, which leads to urine leakage. As a result, the patient experiences severe pain when emptying the bladder.
The main diagnosis method is palpation of the prostate gland. The physician examines the affected organ and detects seals indicating the presence of the disease. However, in some cases, the prostate does not change its structure.
To confirm the diagnosis it is necessary to conduct ultrasound and X-ray examination. An ultrasound specialist detects stones, with dimensions often exceeding 3 mm.
In 70% of cases X-ray is ineffective, because some calculi are not displayed on the image. For accurate diagnosis of the disease, it is necessary to undergo CT (Computer Tomography) or MRI (Magnetic Resonance Imaging) of the pelvic region.
Treatment of prostate stones can be conducted in 3 ways:
A disease-causing infection penetrates the gland through the blood. Then, tuberculosis tubercles appear in the affected organ, and merge forming infiltration centers. The next stage is the caseous necrosis formation, sometimes accompanied by the abscess process. Purulent discharge often falls into the urethra, causing a sharp pain attack.
Strong immunity - is the key to healthy body, where pathogens can stay for a long time without giving any signs of their presence. Bacillus Kochii is no exception. Bacteria enter the body by inhalation and may penetrate any organ hematogenously. As medical practice shows, in 20% of cases it's the prostate gland, ovaries or seminal vesicles.
The main way for tuberculosis infection to invade body is contact with the patient, namely:
Sometimes it is enough to be present during an emotional conversation with a patient in order to become infected with tuberculosis.
Ways of the prostate gland's tuberculosis infection:
The initial stage of prostate tuberculosis is asymptomatic. First signs, namely, painful sensations in the perineal region, observed in 40% of patients and indicate the growth of inflamed lesions. The doctor can identify the disease after rectal examination.
As a rule, the first symptoms of prostate tuberculosis appear when the urethra, bladder or testicles are involved in the pathological process. The further spread of the infection is the cause of characteristic fistulas formation.
Sometimes prostate tuberculosis causes the decrease in the quantity and quality of sperm, which over time can lead to infertility.
In the later stages of the disease development, the prostate gland becomes firm to the touch, and visually shriveled. At this stage, half of the male patients suffer from impaired urination.
Diagnostic measures involve several methodological studies: palpation of the prostate, x-rays, a number of tests. As a result, an enlarged gland is detected, sometimes thick to the touch.
Urine analysis allows to determine the localization of tubercule bacillus, in our case - in the prostate gland. But this method cannot detect the cause of the disease.
If the inflammatory process is localized in the center of the prostate, the disease cannot be diagnosed by palpation. Alternative methods should be resorted to.
More specific data can be obtained after bacteriological analyses. In this case, the problem is that infectious microorganisms of the male urinary system develop very slowly and in small groups.
The final diagnosis can be made after the secretion examination for the presence of pathogenic bacteria, although transrectal biopsy is considered the most efficient method. A course of treatment can be prescribed on its basis.
Tuberculous prostatitis therapy is a debilitating long-term process. Sometimes it is possible to stick to traditional medical treatment only, although the option of surgery is also probable.
Drug treatment takes at least a year. In the future, support therapy must be practiced for three years. Tuberculosis is considered cured when no infectious bacteria causing the gland disease is detected in the blood and semen.
Chemotherapy is a popular treatment for prostate tuberculosis. In this case, the rectal injection of chemicals (isoniazid, rifampicin, ethambutol) is combined with the dimexidum injection into the rectum. The latter is necessary for better drugs absorption by the prostate tissues.
Lymphotropic chemotherapy is also commonly used. During the procedure antibiotics are injected into the lymph system. It normalizes the gland functioning, and also increases the effect of treatment up to 90%.
Surgery is an extreme measure in the treatment of tuberculous prostatitis. The patient is prescribed the two-week course of chemotherapy before the procedure can be performed.
At first, to diagnose benign gland enlargement, it is usually needed to define patient’s individual symptoms with the help of a specially developed anamnesis form. It is highly important to point at all previous diseases (surgeries, diabetes, neurological diseases, accidents and injuries, disk prolapse). Only when the doctor is aware of all the features of your disease history, can he figure out the prognosis or offer treatment.
The next step is usually rectal test, performed digitally, aimed at finding out the main characteristics (size, form) of gland, as well as diagnosing any inflammations (painful sensation when pressuring) and potential prostate carcinoma signs(indurations in the gland). Alongside with lab tests (PSA, bacteria presence, blood admixtures, cancer cells), it is also possible to carry out uroflow-metry; it’s a technique for urine stream measuring, which helps to determine urination flow rate. Other ways of diagnostic examination, preceding adenoma treatment:
Treatment methods in Germany are indicated according to symptoms and concomitant disorder signs. Therapy of adenoma, includes conservative methods (above all, phytotherapeutic drugs). In case the symptoms have not diminished, it is advisable to use medicines, which are aimed at down-regulation of hormone generation, etc.
Surgical treatment of benign adenoma hyperplasia in Germany can be performed by means of different surgical operations. Among them is prostate extraction via urethra or open surgeries.
Doctors of German clinics have different surgical techniques at their disposal, which allow conducting transurethral surgical operations. Open surgery is recommended in case of large tumors or various complications. Among the most common operations are:
There are new methods being investigated and implemented in Germany. One of the is water stream therapy (WIT), an experimental method which helps to destroy adenoma tissue with the use of water-air-filled balloon. This procedure minimizes the risk of damage of healthy prostate tissue.
To secure our patients’ safety and health we use only reliable and established methods and help to find best clinical centers.
In terms of relative frequency prostate cancer yields only to lungs and stomach cancer. Pathology characterizes malignant lesion of organ tissues. Long asymptomatic development leads to late diagnosis - at 3-4 stages. Despite the gradual rejuvenation of the disease, the risk group is headed by men over 60 years old. There are 4 histological forms: adenocarcinoma - 90% of all cases, squamous, transitional-cell, undifferentiated cancer.
The first 2 stages symptoms are similar to signs of adenoma, prostatitis. The occurrence of dull pain in the ribs or spine indicates the lesion metastasis.
At the last stage, anemia, weight loss, cachexia, and swelling of the lower limbs are noted. Treatment involves surgery, chemotherapy, radiation therapy.
During the first two stages, it is advisable to conduct a radical treatment - prostatectomy, means the removal of the gland, seminal vesicles, part of the urethra, and bladder neck. Subsequently, impotence and urinary incontinence are possible. Radiation and chemotherapy are used in the later stages in order to prolong the patient's life.
As a rule, there is no urgent need for men with prostate enlargement to perform prostate surgery. Therefore, most people can calmly weigh the advantages and disadvantages of such an intervention.
Ultimately, there are several reasons for deciding on an operation:
Prostate surgery does not completely remove the prostate in all patients. However, this is reduced so that it no longer presses on the urethra and bladder. Small instruments are used for this purpose, which are guided through the urethra to the prostate. There, tissue can be removed or the urethra dilated. These procedures are called minimally invasive operations in medicine.
In contrast, an open surgery involves an incision in the abdominal wall in order to be able to access and operate the prostate. However, this procedure is only comparatively rarely necessary, for example if there is a large enlargement of the prostate.
In rare cases, benign enlargement of the prostate can mean that the person affected can no longer urinate or can urinate only very little because the urethra is pressed off the prostate. In this case, the bladder needs to be emptied using a catheter. Following this, surgery is also common.
Surgery is also inevitable for prostate cancer, the most common cancer in men. The prostate, including the two seminal vesicles, is completely removed. This procedure is called radical prostatectomy.
TURP. The so-called transurethral resection of the prostate - also called TURP for short - is the standard surgical procedure. During this procedure, the surgeon inserts a resectoscope, i.e. a thin tube, into the urethra and pushes it forward to the prostate. In addition to a small camera, this thin tube also contains an electrical wire loop. With this, the prostate tissue can be removed mechanically. Since the loop is heated at the same time, the blood vessels can close again very quickly. The resectoscope also has valves that can be used to rinse the removed tissue. A TURP procedure is performed either under outpatient anesthesia or general anesthesia and takes around 90 minutes. After the procedure, the patient has to wear a bladder catheter for a few days and plan a hospital stay of two to seven days.
In addition to the TURP, there are other surgical procedures, which are also standard treatments and have comparable results and consequences to a classic TURP. Which includes:
The transurethral incision of the prostate (TUIP) has also proven itself as a prostate operation. There is no removal of prostate tissue, but relief of the urethra. For this, the surgeon makes one or more incisions at the transition between the prostate and bladder neck. This creates space for the narrowed urethra, which brings relief to the patient.
The advantage of this procedure is that some side effects are less common. However, a TUIP is only suitable for patients in whom the prostate is not enlarged too much. In addition, the procedure may have to be performed again after some time.
Prostate treatment with the use of Green Light laser is effective for fighting benign prostatic hyperplasia (BPH) with minimal traumatization of healthy tissues. Photoselective vaporization provides instant relief of the disease symptoms, improves urine outflow significantly, as opposite to the standard transurethral prostatic resection (TURP). This type of laser prostate surgery requires less time and provides quicker recovery. There are minimal side effects. Compared to other minimally invasive methods, this technology doesn’t require catheter installation during recovery period. A special light source that emits green laser impulses is used for the photoselective gland cell vaporization. As a rule this prostate laser surgery in Germany is made in the outpatient settings, surgical centers or polyclinics.
The cost of such treatment in Germany starts from 6.000 Euro.
Green Light laser acts on the growing prostate tissues by vaporizing the targeted cells. The laser impulses for the surgery are generated by a special fiber-optic lightguide inserted into an ordinary cystoscope. The impulses of green laser are directed on hyperplastic prostate tissues.
Green Light laser removes prostatic obstruction quickly and precisely, removing the hyperplastic prostate tissue almost unbloodily. The average duration of such surgery is less than 60 minutes.
Photoselective vaporization by a green laser (PVP) in Germany: major advantages:
Heidelberg clinic is a specialized center, which uses attenuated methods of prostate diseases treatment. It provides such mild treatment methods as prostate non-bioptic diagnostic to determine the risk of prostate cancer, synchronous elastography to study tumor changes in tissues, choline PET, high-intensity focused ultrasound ablation in case of prostate cancer, Greenlight-laser ( TCR-laser), as well as diode laser Evolve by Biolitec for gentle treatment of benign prostatic hyperplasia, thermotherapy using microwaves, transurethral needle ablation and prostatitis treatment by magneto therapy, using therapeutic device NeoControl.
Surgical prostate treatment methods are:
The center of prostate treatment offers medical and surgical treatment of prostate diseases. The surgical methods, used for prostate treatment in the center in Frankfurt-am-Main, include thermotherapy (hyperthermia, thermotherapy or thermoablation and other laser methods), transurethral resection of prostate (as an alternative to removal of prostate through laparoscopy). The clinic also uses an endoscopic method of treatment by means of laser system Greenlight.
An important aspect of work of the center is carrying out preventive studies aimed at early diagnosis of prostate cancer. Such studies include ultrasound, analysis of the urine for signs of inflammation and blood in it, a test for diagnosis of bladder cancer and others. The highest diagnostic accuracy of prostate cancer is observed, when using a comprehensive study, which consists of a digital rectal examination and test for prostate-specific antigen (PSA).
The center offers the latest diagnostic and therapeutic possibilities. The range of services of prostate treatment, provided by “Nymphenburg” in Munich, includes diagnostic and treatment of all prostate diseases:
The main aspects of prostate treatment center Berlin-Mitte are diagnostic and treatment of prostate cancer. The range of services in this area includes: