prostate Examination

August 12, 2017 17:50 | Diagnosis Of Disease

As with most chronic diseases, diseases of the prostate you are for themselves the best defense against prostate diseases.If you can help detect the disease at an early stage, you have all the chances of successful treatment.How to do it?For this purpose it is necessary to have regular prostate check .

No established opinions about when to start checking.If not marked prostate disease and you do not see your family history at the symptoms of these diseases, then to 40 years old is not necessarily audited annually.

However, if you're over 50, you should consider that it is reasonable to take annual prostate examination and continue to do so forever.That will include routine check will depend on your age, a doctor's opinion on the family history of the disease and test results.

Most men undergo a prostate check, together with a general medical examination.In addition to the usual procedures of the medical examination and analysis, such as measuring blood pressure, listening to the lungs, you can pass

some or all of the following procedures.

Digital rectal examination - the easiest, most intuitive and most common method for determining prostate diseases.However, for many men, it is one of the most vexing medical examination procedures, as they feel a sense of embarrassment and discomfort.This is understandable, but for all that the procedure is painless and quite bearable.Understanding the need of this research will allow easy enough to cope with the internal discomfort.

procedure is performed in the following order: Before the procedure the doctor puts his hand on a special glove and puts on his finger grease.Then you are asked to bend forward - perhaps lean hands on the table - and the doctor gently introduces lubricated finger into your rectum.

Since the prostate gland is located directly in front of the rectum, the doctor can feel it with your finger back surface.If the gland is enlarged in size, you may have a benign prostatic hyperplasia (BPH).If iron is sensitive to touch, it may be a symptom of prostatitis.Moreover, 70 to 85% of cancer developing on the outer gland portions.In the early stages they are often palpable nodules or as a seal.If the doctor has found something you like, it does not mean that you have cancer, but the doctor may suggest you do more tests.Some other reasons can cause symptoms such as, for example, prostate infection or formation of small iron pebbles.

during rectal examination the doctor inserts a lubricated treated a gloved finger into your rectum and probes the back wall of the prostate, identifying the possible increase of the prostate, its sensitivity, the presence of cones and seals.

number of studies in recent years proves that men do not undergo regular inspection, more likely to die from prostate cancer than members of this group, undergoing regular screening.Scientists believe that timely rectal exams can save lives 50-70% of men.

Other health care organizations establish a different age at which a man is desirable to undergo rectal examination.Summing up the recommendations of the most authoritative Russian and international organizations, we can say that if a man does not belong to the group with increased risk of prostate disease, he recommended regular check-ups with 50 years;if there is a real risk of the disease - is 40 years old.

This analysis reveals abnormalities in the composition of the urine, which may indicate the problem.If the number of white blood cells in the urine above the norm, you may have an infection of the prostate or urinary tract.

Increased urinary red blood cells can indicate inflammation of the prostate and possibly cancer.Other diseases, such as bladder problems, or inflammation of the urethra can also cause blood in the urine.By , if you have BPH, the normal urine test will help confirm the diagnosis.

small amount of blood is taken from a vein in the arm, and is analyzed to determine the levels of total and free prostate-specific antigen (PSA - PSA) in the blood serum.This antigen is found in prostatic secretions, which is part of the sperm, making it liquid.However, a small amount of antigen in the blood enters and circulates in the bloodstream.If the blood is found elevated PSA content, it may be an indication of prostate inflammation, hypertrophy, or cancers.

Most men pass first test for PSA at the age of 40 to 50 years.In the following sections, we'll talk more about PSA and differences related to the efficiency and informativeness of the test.If the doctor

wary results of the study manual, a blood test or urine test, he may need to examine your prostate gland in detail.This can be done by means of so-called transrectal ultrasound (TRUS).

Ultrasonography - a technique for obtaining an image of the internal organs of your body using ultrasonic waves.This is similar to sonar, only in this case are used high-frequency sound waves that are reflected and absorbed in different ways, depending on the material of the object.Cancerous tissue is thicker and denser than normal, so the nature of the reflection of sound waves changes.During transrectal ultrasound, the doctor inserts into your rectum small treated with special grease probe that emits sound waves.The reflections of these waves are transmitted to a computer and converted into a video image.The procedure completely harmless, although some men find it unpleasant - more ethical than for physical reasons.

If the doctor did not find anything serious, may not need further examination.If the results of ultrasound studies suggest the presence of a tumor, the biopsy is done to confirm the diagnosis.

test for prostate specific antigen (PSA) is applied to the mid-80s as a tool to help detect prostate cancer.From the very first days of application of this test has increased the number of detected cases of the disease.The disease has become increasingly detected in the early stages when it is easier to achieve a cure.

test is conducted as follows: from a vein taken a small amount of blood and sent to a laboratory where it is tested by a special procedure called by immunochromatographic tests.This procedure allows you to determine how much PSA circulates in your blood.

norm considered content from 0 to 4 ng of PSA per milliliter of blood (ng / ml).However, with age, this level tends to increase, so some medically e centers set standards based on age

If your PSA level is higher than normal, it does not mean that you necessarily cancer.Some men with perfectly healthy prostate have elevated PSA.Other factors also can increase your PSA content in the blood.These factors are as follows.

BPH.Most often, an increase in PSA levels result in benign prostate tumors.When the prostate tissue grows, its cells produce more PSA, sometimes exceeding the normal amount in three or even more times.

Prostatitis.Irritation of the prostate during inflammation or infection may cause prostate cells will produce more PSA.

Cancer.Cancer cells develop in the prostate and the PSA.Therefore, above normal PSA in blood may indicate the possibility of prostate cancer.

In addition, there are other factors that can increase PSA levels.

Ejaculation.Ejaculation can cause a temporary increase of PSA in the blood.That is why some doctors ask their patients to refrain from sexual activity for two days before the test to determine PSA.However, in studies published in 1998, it states that the PSA level after ejaculation quickly returns to normal, and does not rise so much as to distort the results of the analysis.The scientists who conducted the study believe that men do not need to abstain from sexual activity before taking a test for PSA levels.

infection of the urinary tract.As prostate infection, urinary tract infection can also cause a rise in PSA levels.

recent treatments of prostate treatment.The procedures used in the treatment of BPH described in detail in the third part of the book, can temporarily irritate your prostate gland, causing inflammation and, consequently, the PSA level going beyond the norm.These procedures include:

prostate biopsy.

Transurethral removal of the prostate.

Transurethral incision.

prostate massage.

The microwave prostate therapy.

Laser prostate treatment.

If you do one of these procedures, wait two weeks to two months before you take a test to determine PSA.During this time, the content of PSA in the blood return to normal for you the level at which it was before the treatment.In addition, the PSA content influence medication used in the treatment of BPH.This - in more detail in Part 3. The main thing is if you are taking these drugs, your doctor should be sure to know about it, to be able to correctly assess the results of the PSA test.

PSA test helps to detect cancer at an early stage, about 75% of cases.In 25% of cases in which men have been ill with cancer, the test may show a normal PSA levels (less than 4 ng / mL).This is one of the drawbacks of the test - about one out of four cases, it can not detect prostate cancer at an early stage, when used alone and not in combination with other analyzes.

Another drawback of PSA testing is that it is not possible to distinguish cancer from other prostate diseases.Only one-third of men with elevated PSA levels prostate cancer patients.In the remaining two thirds of the increase in PSA levels associated with BPH, prostatitis and other problems of the prostate gland.Therefore, to prevent cancer, many men have to undergo additional screening.

I must say that not all doctors, medical organizations and medical institutions agree that the benefits of PSA testing outweigh its disadvantages.

To test advantages include its painless.Regular passage of PSA testing helps identify prostate cancer long before there will be any symptoms.Often this analysis determines the cancer before it has spread beyond the prostate.Localized tumors are much easier to treat, and it frequently can be completely cured, the cancer has already spread to other organs and tissues.According to the materials of Russian researchers, nearly 18% of PSA tests reveal developing prostate cancer, even in cases where ultrasound and digital research did not give reason for concern.

Prostate cancer can develop in different ways.Sometimes the tumor grows very slowly and is still within the prostate and sometimes quickly spreads to other organs.If the PSA test helped identify the time you have a severe form of cancer, it may have just saved your life.

PSA test can not be absolutely, all 100% reliable, as, indeed, any other medical research.In 25% of cases where the test does not detect prostate cancer in male patients, it could give rise to a false sense of security and a wrong idea about the state of your prostate.And among men with elevated PSA levels approximately two-thirds have to go through further unnecessary in such cases, useless and expensive diagnostic procedures.

Another question is whether the test will lead to unnecessary treatment.If you have a very slow growing form of cancer, you can live with it for years and it will not cause you any trouble.For some people it is very difficult to accept.When they learn that have cancer, they are trying to get rid of it by surgery or radiation therapy.These treatments may produce side effects, including impotence and incontinence.As a result of treatment can lead to a decrease in overall quality of life of men who could live a healthy, fulfilling life.

Finally, while is not known whether early diagnosis and treatment of prostate cancer will save your life.In 2002, Swedish scientists of studies have been published: in a group of men, whose average age was 65 years, the surgical treatment of prostate cancer at an early stage, it has reduced the number of deaths.However, over the next six years, the mortality rate for various reasons was the same among those who were treated, and those who did not receive.

So whether you should undergo a PSA test today?

unequivocal answer to this question is no.Many medical associations and conferences offered to all men after age 50 undergo annual PSA test and rectal examination.And men whose relatives suffered from cancer of the prostate, it is better to start regular screening at age 40.

Regarding how long you need to be surveyed, the majority of experts agree that the inspections must be continued throughout life.Many men over 70 years manage to keep good health and lead a full life.They can live for at least 15 years, respectively, they need an annual PSA test.

Most physicians believed that men should have full information about the advantages and disadvantages of various methods of diagnosis of cancer of the prostate and the PSA test should be available for all those who consciously choose this type of diagnosis.Doctors understand that this test is still not perfect, but the point exists in the medical community regarding any of neoplastic diseases can be summarized as follows: "It is better to smash et d than nedobdet".In the case of cancer of any localization vigilance will not be too much, especially when you consider that the analysis is not traumatic and painful.

To briefly summarize the existing opinion, the "Solomonic decision" as follows:

test for prostate specific antigen (PSA), as well as digital examination should be carried out in parallel to all categories of men who are at risk for age and family history.The combination of these two methods may minimize the risk of the disease and improve the quality of his diagnosis.

Researchers continue to look for more advanced and specific diagnostic method for determining prostate cancer to reduce or eliminate those shortcomings that are not deprived of the PSA test.Developments are conducted in the following areas:

test "free PSA".PSA exists in two forms: PSA bound to blood proteins and unbound PSA, called free.Currently, a PSA test measures the total PSA (bound and unbound) in the blood.However, the researchers found that the cancer usually causes an increase in levels of a protein associated with the PSA, while BPH is associated with an increase in the content of free PSA in the blood.

test for free PSA indicates how much PSA circulates freely in the blood and which is associated with blood proteins.The lower percentage of free PSA, the more likely that the increase in PSA levels caused by cancer.The higher the percentage of free PSA, the greater the chances that the cause of elevated levels of PSA-BPH.

table shows the likelihood of developing cancer based on data about the general level of PSA.


If the total PSA level is between 4 and Jung / mL, it is recommended to test for free PSA for a more accurate diagnosis.The higher percentage of free PSA, the less the likelihood of cancer.



1. For younger men PSA rates may be lower.