Analysis of prostate juice is included in the list of studies necessary for the diagnosis of prostatitis and hyperplasia. Microscopic examination of the fluid makes it possible to make a preliminary diagnosis and select optimal scheme treatment.
A study of the composition of prostate juice is indicated for all men over 40 years of age. For preventive purposes, it is necessary to visit a doctor annually and get tested. This will allow timely detection of the onset of a pathological process in the prostate and take therapeutic measures.
Analysis is required for the following symptoms:
- Nagging pain and, as well as in;
- Feeling .
The study allows us to determine at the initial stage of development. The analysis is used to determine a man’s fertility and possible deviations in the composition of seminal fluid, which may lead to problems with conceiving a child.
Collecting fluid for analysis
Prostate juice is released when the organ is touched with fingers. This means that the analysis is carried out by massaging the prostate. The procedure is painless and lasts about 5 minutes.
After finger pressure on the organ, secretion is released through the urethra. This liquid is collected in a sterile container and sent to the laboratory.
In some pathologies, the secretion is not released enough. In this case, the patient must urinate in a special container. The analysis can also be carried out with minor inclusions of juice in the urine.
Preparing for analysis
To obtain reliable results, you must prepare for the test. For about 4-5 days, it is recommended to abstain from sexual intercourse, drinking alcohol and taking medications.
Physical activity may negatively affect the results of the study. It is important to adhere to a gentle diet, exclude fast food, fatty and spicy foods.
In the evening before the test, you should do an enema to cleanse the intestines. Before the massage, the patient must go to the toilet and urinate. This is necessary so that in case of a lack of excreted fluid, it is possible to analyze the first portion of urine immediately after digital exposure.
The study is prohibited for anal fissures, exacerbation of hemorrhoids, or any other disorders as a result of which massage can lead to tissue damage.
In case of infectious diseases, elevated body temperature and fever, the test cannot be taken.
How to understand the result?
Deciphering the analysis of prostate secretions allows you to diagnose a number of diseases.
- If the secreted juice is too small (less than 0.5 ml), acute prostatitis is diagnosed. An increase in the amount of secretion over 2 ml allows one to suspect stagnation of blood in the prostate.
- Normally, the secreted fluid is milky white in color. Yellow and cloudy secretion indicates prostatitis.
- An important indicator is the acidity of the juice. In acute prostatitis, there is an increase in acidity, an alkaline reaction characteristic of a chronic disease.
- An increased level of leukocytes in prostate juice is an inflammation of the organ in the acute stage.
- Normally, red blood cells are completely absent in the secretion, but isolated inclusions are allowed. An increase in this indicator is a dangerous signal indicating cancer or acute inflammation.
- The absence of lecithin grains in juice is chronic prostatitis.
- If gonococci or trichomonas are detected during bacterial culture, gonorrhea and trichomoniasis are diagnosed. Fungal spores appear secretly during a fungal infection of the prostate gland.
- The presence of amyloid inclusions indicates a violation of the outflow of secretions. Amyloid bodies appear with gland hyperplasia.
- Normally, pathogenic and conditionally pathogenic microflora are absent in the secretion. Indicates bacterial prostatitis large number bacteria in juice.
Based on the study, a primary diagnosis is made. Additionally, an ultrasound examination and a number of laboratory tests (blood and urine tests) are prescribed.
Repeated microscopic and bacterial examination of the juice may be necessary for an unspecified diagnosis. Regular testing allows you to evaluate the effectiveness of drug therapy and, in case of unsatisfactory results, adjust the treatment regimen.
Often, deviations from the norm determined by analysis are caused by thickening of the juice due to poor circulation and stagnation of lymph. In this case, massage of the prostate gland is indicated to normalize the outflow of secretions. A repeat analysis is done after several massage sessions.
Analysis of prostate secretions is an important laboratory method for diagnosing prostate pathologies. The secretion produced by the prostate gland plays an important role in ensuring the fertilizing ability of the ejaculate. Pathological processes in the prostate gland have similar symptoms, while deviations of the secretion from the norm are quite specific.
When ordering a study of prostate secretions, a qualified specialist will explain how the material for this test is taken, how the analysis is done, and after it is completed, he will decipher what the result shows.
All men over 40 years of age are recommended to undergo regular prostate secretion testing, even in the absence of any complaints, for preventive purposes.
Indications and contraindications for analysis
The main symptoms that serve as an indication for prescribing an analysis of prostate secretions are pain in the groin and perineum, painful sensations and/or pain during urination, intermittent and/or frequent urination (especially at night), unusual discharge from the urethra. Also, analysis of prostate secretions can be prescribed as part of the diagnosis of male infertility, as well as to monitor the effectiveness of treatment for prostate diseases.
Prostate diseases are registered in approximately 50% of middle-aged and elderly men. Due to its widespread prevalence, all men over 40 years of age are recommended to undergo regular prostate secretion testing, even in the absence of any complaints, for preventive purposes.
Preventive examination of prostate secretions is recommended for men in combination diagnostic measures when planning conception, as well as athletes (in particular, wrestlers and cyclists) and men with sedentary work.
Analysis of prostate secretion is contraindicated for hemorrhoids in the acute stage, rectal fissures, prostate tuberculosis, acute infectious and inflammatory diseases, and fever.
Preparation and delivery of prostate secretion analysis
You can take an analysis of prostate secretions in a public or private clinic, as well as in specialized laboratories that have the necessary equipment for this.
It is necessary to properly prepare for the test of prostate secretions. 5-7 days before the study, exclude excessive physical activity, sexual contacts, visiting a sauna or bathhouse, drinking alcoholic beverages. On the day of the test, a cleansing enema is recommended.
Prostate diseases are registered in approximately 50% of middle-aged and elderly men.
Immediately before collecting the material, the patient’s head of the penis is treated with a sterile cotton swab moistened with saline solution. The man takes a knee-elbow position or lies on his side, bringing his knees to his stomach. The doctor collects prostate secretions into a sterile container specially designed for this purpose after rectal digital massage of the prostate gland. If difficulties arise when collecting biological fluid, you can collect the first portion of urine after the procedure, which contains a small amount of prostate secretion. The collected material is delivered to the laboratory. The results, as a rule, are ready within 1-2 business days after taking the biomaterial for research.
Norms of indicators determined during the analysis of prostate secretions
Norms for prostate secretion indicators are presented in the table.
|
Indicator |
Normal values |
|
Quantity |
|
|
Whitish |
|
|
Reaction (pH) |
|
|
Leukocytes |
0–12 in field of view |
|
Red blood cells |
Absent or single in the field of view |
|
Epithelial cells |
Single in sight |
|
Macrophages |
Not found |
|
Amyloid bodies |
None |
|
Lecithin grains |
Large amount (occupies approximately ½ field of view) |
|
Atypical cells |
None |
|
Fern symptom |
Positive |
|
Spores, mushroom mycelium |
None |
|
Gonococci |
None |
|
Trichomonas |
None |
Decoding the results
Quantity
A decrease in the amount of secretion is observed during the inflammatory process in the prostate gland, an increase is observed during congestion.
Color
An intensely white or yellowish color of the secretion may indicate inflammation of the prostate gland, while a reddish color may indicate an inflammatory or tumor process.
Acidity index
An acidic reaction of prostate secretion may indicate an acute form or exacerbation of chronic prostatitis. In chronic prostatitis, without exacerbation, the reaction of prostate secretion is alkaline.
Despite the high information content of the study, a diagnosis cannot be made based on analysis of prostate secretions alone. It is complemented by other studies.
Leukocytes
An increase in the number of leukocytes indicates an inflammatory process. When deciphering this indicator, it is taken into account that leukocytes can be mixed with prostate secretion as it passes through the urethra.
Red blood cells
The number of red blood cells may increase with prostatitis, a malignant tumor of the prostate gland.
Epithelial cells
An increase in the number of epithelial cells is a sign of inflammation.
Macrophages
Macrophages are found in prostate secretions during congestion and a chronic inflammatory process.
Amyloid bodies
The appearance of amyloid bodies in the prostate secretion usually occurs during congestion.
Lecithin grains
A decrease in the number of lecithin grains indicates a decrease in prostate function and may indicate the presence of prostatitis.
Atypical cells
The detection of atypical cells in the specimen usually indicates a neoplasm in the prostate gland.
Fern symptom
The fern symptom is the name given to the phenomenon of crystallization of prostate secretions. This test carried out by adding a 0.9% sodium chloride solution to the test material and studying the dried preparation under a microscope. Normally, crystallization produces a pattern that visually resembles a fern leaf. The structure of the crystals, as a rule, is disrupted (or there are no crystals at all) in the presence of a chronic inflammatory process in the prostate gland.
Fungal mycelium
Microscopic fungi in the secretion of the prostate gland can be detected with prostatitis.
Bacteria
The causative agents of sexually transmitted infections are not normally found in prostate secretions. Their identification indicates the presence of one or another infectious disease (gonorrhea, trichomoniasis, etc.).
5-7 days before the study, exclude excessive physical activity, sexual contact, visiting a sauna or bathhouse, and drinking alcoholic beverages.
Despite the high information content of the study, a diagnosis cannot be made based on analysis of prostate secretions alone. It is supplemented by other studies: urethral smear analysis, general urine test, bacteriological culture (culture tank) of urine and/or prostate secretion, spermogram, determination of prostate-specific antigen in the blood, etc.
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The prostate gland (prostate) is one of the most important glands of the male body and its genital area. It performs a number of functions, if violated, the process of fertilization becomes impossible.
An indicator of the condition of the prostate gland is its secretion, or, as it is sometimes called,.
Morphophysiological and biochemical characteristics of the secretion
The secretion of the prostate gland is a kind of whitish liquid substance, which, during sexual intercourse, is released into the lumen of the urethra, where it is mixed with the product of the activity of the seminal vesicles and Cooper glands. This is how seminal fluid is formed. Subsequently, sperm join the seminal fluid, and as a result of ejaculation, sperm is released from the urethra; while the secretion of the prostate gland accounts for a third of its volume.
The production of prostate secretion is carried out by the glandular part of the prostate gland, which consists of several dozen hollow tubes that open into the urethra. The removal of secretions to the outside is facilitated by the contraction of the smooth muscles of these glands.
Functional significance of prostate secretion
Prostate juice is, first of all, a kind of protective cushion for sperm that have left the male body. In addition, it is thanks to this secretion that sperm pass through the urethra undamaged.
- The secretion of the prostate gland helps create a neutral environment in the urethral cavity. This is very important because sperm die quickly in an acidic environment.
- makes sperm liquid, thereby facilitating and accelerating its passage through the urethra.
- The biological substances included in the secretion serve as a nutrient medium for sperm.
- The unique composition of the secretion ensures its antimicrobial activity and protection of the genitals from attacks by various infectious agents.
Thus, from the state, quantitative and quality characteristics Prostate secretion directly depends on the state of sperm, which determines the high diagnostic value of prostate secretion analysis.
Normal biochemical composition
Biochemical analysis of prostate juice allows us to determine the presence of the following components: 
- water (the main component, up to 95% of the total volume);
- salts of alkali (potassium, sodium) and non-alkaline metals (calcium, zinc): chlorides, phosphates, bicarbonates, citrates;
- citric acid;
- enzymes (phosphatase, hyalorunidase, fibrokinase, fibrinolysin);
- prostaglandins;
- sugar (fructose and maltose);
- spermine;
- protein structures (immunoglobulins).
Conducting a microscopic analysis of prostate secretion allows the laboratory assistant to detect cellular (leukocytes, desquamated epithelial cells) and non-cellular inclusions (cholesterol crystals, lecithin grains and amyloid bodies).
Diagnostic value of the analysis
Deciphering the results of the analysis of prostate secretions allows you to diagnose the inflammatory process in the tissues of the prostate gland and indirectly determine its functional state. First of all, this study is used to diagnose and confirm the presence of chronic prostatitis. In addition, special techniques make it possible to identify the pathogen infectious process and even determine its sensitivity to different groups of antibacterial drugs.
Often, examination of prostate secretions is carried out using light microscopy by carefully examining a stained preparation applied to a glass slide. In some cases, a bacteriological study of this biological fluid is carried out by applying (seeding) it to a nutrient medium in a Petri dish, followed by creating conditions favorable for reproduction various types microorganisms. This analysis allows you to determine the sensitivity of the infection to antibiotics, that is, to create an antibiogram, which is of great importance for prescribing treatment. This is a very accurate, time-tested diagnostic method, which has only one big drawback: long term carrying out analysis.
Most modern method studies of prostate secretion for the presence of pathogenic microorganisms - polymerase chain reaction. This prostate juice test is carried out using special equipment and gives accurate results.
Method of collecting material for research
The procedure for collecting material for diagnosis gives men a lot of unpleasant sensations, especially if there is an inflammatory process in the genital area. Correct collection of secretions is one of the main factors in the reliability of the resulting analysis transcript.
The manipulation is carried out in a hospital setting by a specially trained specialist. Before the procedure, the man is asked to empty his bladder. Then, if during the inflammatory process a man notices the presence of discharge from the urethra, the urethra is washed with a physiological solution of sodium chloride.
After preparation, a medical worker uses a special technique to massage the prostate gland through the anus. The secretion, which, due to pressure on the prostate lobules, is released from the external opening of the urethra, is collected in a test tube (for subsequent bacteriological examination or polymerase chain reaction, the test tube must be sterile). It is possible to apply the secretion to a glass slide.
If the secretion is not released, it is assumed that it entered the bladder. Therefore, the man is asked to urinate again, the urine is collected and centrifuged. However, such an analysis will show a less reliable picture.
It is important to consider that collecting material by massage is contraindicated in the presence of acute inflammatory processes in the genital organs.
Analysis results: normal and pathological
Decoding the analysis of prostate secretion by assessing its morphophysiological qualities and subsequent microscopic examination is as follows: 
- The normal amount of material is from 0.5 to 2 ml. A decrease in quantity and difficulty often indicates the presence of an inflammatory process in its tissues.
- Color: normally resembles liquid (highly diluted with water) milk. White, yellowish or transparent color may indicate prostatitis.
- The density should be 1.022. Any deviation from these figures indicates inflammatory phenomena.
- The reaction of the medium must be neutral, a slight deviation towards the alkaline side is allowed. Oxidation indicates an inflammatory process and may indirectly indicate a deterioration in the fertilizing qualities of sperm.
- Lipoid bodies (lecithin grains) under microscopy completely cover the field of view; a milliliter of secretion contains more than 10 million. With inflammation, their number decreases significantly, up to complete absence. This also serves as an indirect sign of impaired sperm fertility.
- Leukocytes. When counted with a special device, their number approaches 300 cells in 1 μl of material. If the study is carried out with a microscope with an objective magnification factor of up to 280, up to 10 leukocytes are normally detected in the field of view, and with an objective magnification factor of up to 400, their number is reduced to 5 cells in the field of view. In this case, a complete absence of leukocytes is allowed. With any inflammatory process, there is an increase in the number of leukocytes in the field of view or 1 μl of secretion.
- Red blood cells are normally absent (a single appearance is allowed). An increase in the number of red blood cells may indicate an oncological process in the tissues of the prostate gland or a pronounced change in the prostate due to prostatitis.
- Cells of the desquamated epithelium of the excretory ducts of the prostate gland: normally there can be no more than two of them in the field of view. An increase in this number to 10-15 cells indicates a desquamatous inflammatory process, that is, pathological peeling of the epithelial lining.
- Giant cells are not normally detected; their appearance is associated with a chronic inflammatory process and congestion in the prostate gland.
- Böttcher crystals (inclusions formed when the mixed product of various secretory organs of the male reproductive system hardens and dries). They are not a diagnostic criterion, since both during normal functioning of the prostate gland and in the presence of an inflammatory process they occur in single quantities.
- Pathogenic microorganisms (gonococci, trichomonas) are normally completely absent and are found in prostatitis.
- The mycelium of the fungus is not normally found in the secretion of the prostate gland. Its presence indicates fungal or mixed inflammation of the prostate tissue.
- Conditionally pathogenic microflora (cocci and some types of rods that are constantly present in the body). Can be detected in single quantities; a large number of opportunistic microorganisms indicates the development of nonspecific inflammation.
Additional examination of the secretion includes testing for the presence of the fern sign. The technique is very simple: a drop of saline sodium chloride solution is added to the prostate secretion applied to a glass slide. The preparation is dried and examined using a light microscope. When the physical and chemical parameters of prostate secretion change, sodium chloride molecules precipitate, forming a pattern reminiscent of the imprints of fern leaves.
It is important to remember that one-time obtaining a normal result from an analysis of prostate secretion is also possible during inflammatory processes, since the excretory ducts of the prostate gland can be clogged with viscous secretion. It is especially important to take this into account if, in the clinical picture of prostatitis, the decoding of bacteriological culture or polymerase chain reaction did not show the presence of pathogenic microorganisms.
The patient lies on his side and rests his knees on his chest. Also the most common posture when conducting this method research is knee-elbow.
The urologist, inserting a finger into the rectum, performs a special massage for several minutes, bringing the man to arousal. As a result of this, prostate secretion is released, which enters the semen. Juice in an amount of 1-3 ml is collected in a special sterilized beaker.
If secretion does not occur this way, the doctor, at the end of the procedure, takes an initial dose of the patient’s urine.
By analyzing the secretion, you can obtain reliable results about its work, identify diseases and begin high-quality and effective treatment.
What does it show?
This is an extensive set of laboratory tests that provide the attending physician with information such as:
REFERENCE: The study will help to begin timely treatment under the supervision of a doctor to avoid serious complications and diseases.
Prostate secret: analysis decoding
What will a prostate juice test show? After collecting the secretion, the prostate secretion is deciphered in the laboratory in order to carefully evaluate the morphological indicators, and subsequently carry out microscopic measures. For this, 0.5-2 ml of liquid is enough.
A small amount of secreted juice, as well as a sufficient volume, indicate the presence of any abnormalities in the gland. Prostate secretion should not have a yellowish or reddish color, be cloudy or transparent.
Analysis of prostate juice - transcript:
- The composition of the water is a secret, which should be 96-98%.
- The secretion should also contain salts of calcium, sodium, metals, potassium and zinc.
- Mandatory presence of enzymes and spermine.
- Presence of citric acid.
- Prostaglandin.
- Presence of maltose and fructose.
- Presence of immunoglobulins.
- Presence of various cellular components.
Indications
Macroscopic indications
Microscopic readings
- Lipoid bodies. They give the juice a whitish tint, which is normal. There should be up to 10 million of them in 1mm of juice. In case of any violations, their number is less or they are completely absent.
- Leukocytes in the secretion of the prostate - the norm: with an increase of 280 times - leukocytes should be from 0 to 10, and at 400 the norm is 0-5. If leukocytes are normal in the prostate secretion, they may also be absent. If the number of leukocytes in the prostate juice is higher, this indicates inflammation or the presence of prostatitis.
- Red blood cells. The norm is 1-2 or complete absence. If there are more of them, there is a suspicion of prostatitis or tumors.
- Ductal epithelial cells. The norm is no more than 2. A larger number indicates the presence of a desquamatous process, or pathological peeling of the lining.
- Giant cells. This type of cell should be absent. Their presence indicates stagnant and inflammatory processes.
- Böttcher crystals are formed due to drying or stagnation of products from gland juice. There can only be a single number of them.
- Amyloid bodies- This is an oval-shaped prostate clot. They shouldn't be kept secret.
- Microorganisms. Their complete absence indicates a healthy prostate. When they are detected, a special bacterial culture is done to accurately identify their type.
- Mucus. Normally, prostate juice analysis should not contain it.
- Atypical cells. Their presence indicates the presence
IMPORTANT: If there is a deviation from the norm, immediate treatment is necessary.
The male gland, the prostate, produces a secretion that is a component of sperm. Study of prostate secretion allows the doctor to give the patient the correct diagnosis.
Composition and functions of prostate secretion
The liquid consistency of prostate secretion is explained by the presence of water, which makes up 92-95% of its volume. The remaining 5-8% are potassium, calcium, sodium, zinc salts, chlorides, phosphates, enzymes (phosphatase, hyaluronidase, fibrinase, fibrinolysin), immunoglobulins, sugar (fructose, maltose), leukocytes, epithelial cells, lipoid grains, spermine.
The harmonious balance of all components of the secretion ensures the fertilizing ability of sperm. Any deviation from the norm leads to infertility in a man. After all, it is the secretion of the prostate, which makes up one third of the volume of ejaculate, that provides motor activity and viability of spermatozoa caught in external environment. Including its alkaline environment, it neutralizes harmful effects acidic environment of the vagina.
Microscopic examination of prostate secretion allows us to draw conclusions about changes in its composition and determine the disease.
How is a prostate examination performed?
How to obtain prostate secretion? By massaging the prostate itself. The urologist does it with his finger through the rectal route for 5-7 minutes.
But the process itself must be preceded by serious preparation:
- within a week are contraindicated sexual activity;
- Alcohol, physical activity, and baths should be eliminated in 2-3 days;
- Immediately before the procedure, you need to perform a cleansing enema and urinate.
As a result of all manipulations, liquid should be released from the canal. If this does not happen, then the first portion of urine is collected - the secretion could have entered it through the ducts. But in this case the analysis is not so informative.
How to understand the research results
While exploring the secret male gland take into account macroscopic and microscopic parameters.
Macroscopic parameters when examining secretions
From this point of view, the following indicators are studied:
- Amount of liquid. There should be approximately 3-4 ml - up to 1-2 drops. Both a decrease and an increase in the volume of prostate secretion indicates congestion in it.
- Color. A healthy color is whitish. If some kind of inflammation occurs in the male organ, it changes to yellow or even reddish (with blood impurities).
- Consistency. A healthy man has a thick, viscous secretion.
- Density. The norm is 1022.
- pH reaction. As the disease progresses, the healthy alkaline environment of the prostate secretion may become acidic. This is a sign of acute prostatitis.
Diagnosis of prostatitis: microscopic parameters
An increase or decrease in the number of cells, the absence or presence of bacteria - for this purpose, a study of the prostate secretion is carried out.
Leukocytes: what should be the norm?
Everyone knows from school that an increased number of leukocytes signals inflammation. This means that pathogenic microorganisms have appeared in the body or in a separate organ. The prostate is no exception. Even if they are present in healthy prostate secretion, there should be no more than 0-12 of them in the field of view.
Red blood cells: as evidenced by an increase in their number
There should also be few of them - isolated phenomena in the field of view. An increase in the number of red blood cells indicates serious pathologies in the prostate gland - adenoma and cancer.
Epithelial cells (columnar epithelial cells)
Normally there should be few of them - single cells of columnar epithelium. The abundance of epithelium may indicate inflammation, for pathological peeling of the epithelial lining.
Macrophages: what they indicate
This is another beacon that signals the presence of foreign cells (bacteria, viruses) in tissues. They should not be kept secret by a healthy patient. Their presence indicates inflammation in the male organ.
Amyloid bodies as a sign of prostate adenoma
Also should not be detected in the secretion of a healthy prostate gland. This is one of the signs adenomas.
Giant cells in the prostate secretion
The presence of giant cells is also explained by pathology - chronic inflammation or congestion.
Lecithin (lipoid) grains: meaning
These are healthy cells, of which there should be a lot, because lecithin grains make up 1/2 of the total secretion. A decrease in the number diagnoses male fertility and prostatitis.
Atypical malignant tumor cells
The presence of such cells is a reason to begin treatment for prostate cancer.
Mushroom spores and mycelium
None in normal condition.
Fern symptom (arborization test)
A drop of saline solution is added to the secretion, dried and examined through a microscope. Sodium chloride precipitates and forms a pattern resembling a fern print. But only if the secret is healthy. If not, such a visual effect does not occur.
Gonococcus in the study of prostate secretions
If the patient is healthy, then when examining the secretion of the prostate gland, on the contrary, the signature “not detected” will appear.
Trichomonas as a sign of pathology
Likewise, they shouldn’t exist.
Study of the bacterial flora of the secretion
The bacterial flora of the secretion is also studied. The presence of many bacteria indicates existing and developing pathology.
An example of decoding for bacterial prostatitis
The doctor made a diagnosis. But to confirm, he ordered an analysis of prostate secretions - the interpretation may look different.
Bacterial prostatitis
This disease will be indicated by:
- brown-yellow, cloudy color;
- sweet smell of secretion;
- acidic pH environment - more than 7;
- a large number of leukocytes in the field of view - more than 10 at a magnification of 280;
- a large number of epithelial cells - more than 10 at a magnification of 280;
- single lecithin grains;
- macrophages - 15-18 per field of view;
- amyloid bodies are absent;
- gonococci, trichomonas and fungal mycelium were found;
- microflora - in large quantities.
Chronic bacterial prostatitis
The analysis of the secret will be similar to the first example in almost all positions. Only the color of the liquid becomes reddish before the development of a chronic form of the inflammatory disease - due to the presence of red blood cells in it. Their number can reach 25-30 in the field of view.
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