Prostate Secret Analysis

Laboratory testing of body fluid secreted by the prostate gland - analysis of prostate secretion - is a non-invasive (painless and safe) diagnostic procedure. This analysis allows you to assess the condition of the gland, as well as determine the disease at an early stage.

Since 1968, a four-glass test according to Meares and Stamey has been [1], [2]considered the standard test for the detection and localization of pathogens in the lower urinary tract. About 10 years ago, a simplified test with two glasses was proposed, based on the collection of urine samples before massage to the prostate gland (VB2) and after massage (VB3). [3]

Indications for the procedure of the prostate secretion analysis

The prostate gland is part of the male reproductive system, taking its secret for cytological examination - along with the analysis of sperm and seminal fluid - is performed when examining patients with suspected  male infertility , as the fluid produced by the prostate is part of the sperm. A prostatic fluid containing proteins, enzymes, lipids, amines, metal ions, plays an important role in protecting sperm by reducing the acidity of the urethra. In this case, sperm liquefies, which increases the mobility of male germ cells (sperm) and increases the likelihood of successful fertilization of the egg.

Also, indications for a laboratory study of prostate secretion include the identification of diseases in which men experience  pain in the prostate , pain in the groin and pelvic area, dysuria (pain in urination) and pain during ejaculation. Thus, analysis of prostate secretion helps to diagnose:

• chronic prostatitis;
• prostate adenomas;
• benign prostatic hyperplasia;
• malignant neoplasms (carcinomas).

An additional serological blood test, a bacteriological analysis - a prostate secretion bacanalysis - is necessary in order to confirm or exclude the presence of inflammation or bacterial infection.

That is, a bacteriological study is an analysis of prostate secretion for infections (staphylococci, streptococci, trichomonads, Klebsiella, chlamydia, Escherichia coli, etc.), which allows to determine the causative agents of the inflammatory process.

In addition, with the help of this analysis, the treatment of these diseases is monitored.

Preparation

Preparation for the analysis of prostate secretion consists of:

• in stopping the use of alcoholic beverages - a week before the appointed procedure;
• stop taking antibiotics two weeks before the analysis;
• refusal to visit the sauna, bath and hot baths - at least five days in advance;
• in limiting physical activity - four to seven days before visiting the laboratory;
• in sexual abstinence (within three to four days before the day of the procedure);
• in cleansing the rectum with an enema (in the morning on the day the test is taken);
• in the most thorough hygiene of the inguinal, perianal and gluteal areas.

Analysis is given after emptying the bladder.

Technique of the prostate secretion analysis

How is prostate secretion taken for analysis? To stimulate the production of prostatic fluid, a prostate massage is performed: the urologist lying on the side of the patient performs antiseptic treatment of the gluteal and perianal areas, a gloved finger lubricates the rectum and presses each side of the prostate gland several times, and then the prostatic part of the urethra is massaged from top to bottom.. The secret released from the opening of the urethra is collected in a test tube, and its sample is examined using a microscope, that is, microscopy of the secretion of the prostate is performed  .

How many days is prostate secretion analysis done? Usually, this laboratory test requires no more than two days, although the procedure for obtaining biological material takes several minutes.

Normal performance

Normal indicators of prostatic secretion analysis:

• volume (amount) - at least 3-4 ml;
• turbid liquid of a whitish (milky) color;
• pH in the range of 6.2-6.7;
• cylindrical epithelium - single cells;
• white blood cells - up to 5-10 in the field of view;
• erythrocytes - absent or single;
• amyloid bodies are absent;
• a large number of lecithin grains;
• pathogenic bacteria are absent.

Determining the zinc content in prostate secretion can be a useful test in the diagnosis of patients with chronic bacterial prostatitis or those who may be prone to prostatitis. [4]

Raising and lowering of values

Deviations from the norm include:

• a significant number of white blood cells (more than 10-12 in the field of view);
• increased number of epithelial cells;
• the presence of mucus;
• the presence of sperm;
• the presence of phagocytes (macrophages);
• the presence of giant (multi-core) cells;
• reduction in the number of lecithin grains;
• the presence of the corpuscles of Trousseau-Lalleman;
• the presence of Betther crystals;
• pH shift to the acidic side.

After the deviation is recorded by the cytologist, taking into account the results of the microbiological study, they are interpreted - the interpretation of the values.

So, an increase in the number of leukocytes, macrophages, the presence of red blood cells, as well as a decrease in the number of lecithin grains allows us to ascertain the presence of an inflammatory process. And the identification of specific pathogenic microorganisms during prostate secretion during bacterial sowing gives reason to diagnose bacterially caused inflammation and prescribe antibacterial therapy.