Changes in the prostate gland in servicemen with post-traumatic stress disorder: a comparative analysis

OBJECTIVE. To study the changes occurring in the prostate gland in combatants, arising under the influence of posttraumatic stress disorder.

MATERIALS AND METHODS. The study included 100 participants who consented to be examined. All of them were divided into five equal groups. The first four groups included participants of military operations depending on the time that had passed from participation in combat operations (the main group). The fifth group (the comparison group) included servicemen who did not take part in combat operations. The groups were divided as follows: Group 1 (n = 20) - the time from the moment of participation in combat operations was up to 6 months; Group 2 (n = 20) - the time from the moment of participation in combat operations was 7-13 months; Group 3 (n = 20) - the time from the moment of participation in combat operations was 14-20 months; Group 4 (n = 20) - the time from the moment of participation in combat operations was 21-27 months. Comparison group - 20 men. Men aged 30-35 years old, without chronic and/or acute prostate diseases, which is confirmed by documents, without wounds or contusions, were selected for the study. The average time of participation in combat operations was from 6 to 8 months. All participants underwent ultrasound examination of the prostate and culture of its contents.

RESULTS. According to the study, it was found that group 1 and group 2 subjects showed an increase in prostate size compared to the data obtained in the comparison group. In group 3, there was a decrease in the size of the prostate gland, but its dimensions were larger than in the comparison group. In group 4, all sizes were consistent with the results obtained in the comparison group. Based on these data, it can be assumed that those examined in groups 1, 2 and 3 showed signs of acute prostatitis. When examining the microbial landscape of prostate juice, it was found that in the 1st and 2nd groups there was an increase in the number of microorganisms, which then gradually decreased, and in the 4th group began to correspond to normal values.

DISCUSSION. The presented study confirmed that post-traumatic stress disorder (PTSD) has a negative impact on the prostate gland in combatants, as manifested by an increase in its size, which can be considered as a manifestation of congestive prostatitis. The development of prostatitis can be associated with several factors. The first and main reason is the lack of a normal and regular sex life, which leads to stasis. Another cause may be changes in hormonal background associated with increased testosterone levels in the blood, which can affect the prostate tissue, causing it to enlarge. The third reason, which can also cause the development of prostatitis, is a decrease in immune defense. This is indirectly confirmed by the changes in the microflora obtained from the examined different groups. At the same time, in all examined patients qualitative changes in microflora were not revealed, microbial landscape is represented by microorganisms characteristic for normal microflora, changes in quantitative composition were noted, but no microbial associations characteristic for manifestation of bacterial prostatitis were revealed. 

CONCLUSION. Post-traumatic stress disorder triggers a multifactorial mechanism causing the development of acute congestive prostatitis.

1. Zuykova A. A., Potemina T. E., Kurochitskaya L.E., et al. Stress-related disorders of the reproductive sphere in combat participants. Bulletin of the Medical Institute “Reaviz”: rehabilitation, doctor and health, 2019, No. 3, pp. 141–144 (In Russ.)].

2. Sharypova N. V. The state of sexual function in men under the influence of a traumatic stress factor. Modern problems of science and education, 2015, No. 4. URL: https://science-education.ru/ru/article/view?id=21058 (date of request: 02/05/2025) (In Russ.)].

3. Kolov S. A., Sheichenko E. Yu. Changes in the level of neurosteroid hormones in combat veterans with post-traumatic stress disorder. Reviews on clinical pharmacology and drug therapy, 2010, Vol. 8, No. 1, pp. 47-48 (In Russ.)].

4. Kolov S. A., Sheychenko E. Yu. The significance of hypothalamic-pituitary-adrenal system dysfunction in psychopathology among combat veterans. Social and Clinical Psychiatry, 2009, No. 3, pp. 74–79 (In Russ.)].

5. Zaytsev A. A., Barabash L. V., Levitsky E. F., et al. Restorative treatment of chronic prostatitis in participants of armed conflicts. Bulletin of Siberian medicine, 2009, No. 4 (2), pp. 118–123 (In Russ.)]. doi.org/10.20538/1682-0363-2009-4(2)-118-123.

6. Kalyuk A. N. Methods of bacteriological investigation of conditionally pathogenic microorganisms in clinical microbiology. 1991 (In Russ.)].

7. Masljakov V. V., Pavlova O. N., Pronina E. A., et al. Dynamics of microflora condition in patients with acute bacterial prostatitis exposed to combination therapy. Bulletin of the Medical Institute “Reaviz” (Rehabilitation, Doctor and Health), 2022, Vol. 12, No. 3, pp. 60–67 (In Russ.)]. https://doi.org/10.20340/vmi-rvz.2022.3.CLIN.2.