Urological massage what is it. General idea of urological massage and its correct implementation Urological massage is done once a year
If a man has problems with the prostate, it can be psychologically difficult for him to start treatment. Such a useful procedure as also often causes fear. But you don’t need to give up professional massage: this is one of the most effective methods of therapy that will help prevent serious health problems.
The essence of massage is to provide an impact on the nerve endings of the gland.
This helps her secrete an inflamed or stagnant secret, with which pathogenic substances leave the body.
Stagnation can occur as a result of, or various diseases.
The best result in the treatment of prostate diseases is achieved by the appointment of complex therapy. Along with massage, other procedures are carried out, medications are prescribed.
It is better to conduct sessions with a specialist who is well acquainted with the anatomy of the gland, types and. When the doctor constantly palpates the gland, he sees how the patient feels, whether to continue the prescribed treatment or whether it needs to be corrected.
Before starting the course, you will have to visit the doctor again, who will determine at what stage he is inflammatory process, appoint a date for the procedure and, if necessary, prescribe medications.
Immediately before the session itself, you need to empty the intestines. It is not recommended to take laxatives for this purpose, since they irritate nerve receptors and worsen the intestinal microflora.
It is better to put a medium-sized enema with chamomile decoction half an hour before the procedure. In addition, about two hours before the procedure, you should drink a liter of water. If the bladder is full, it will swell and put pressure on the gland. As a result, the prostate will receive enhanced stimulation.
How is a prostate massage done by a urologist?
In the medical center, this procedure is as follows. The specialist inserts a finger into the anus to affect the prostate. Most often, it is located at a distance of 3-5 cm from the anus.
Direct prostate massage
When the gland is found, the doctor begins to gently massage the right and then the left area. The strength of the impact depends on the sensations of the patient, but gradually the intensity increases. The massage continues for about 2 minutes.
The position of the patient in this case can be any: standing, lying, on its side. Most men prefer to lie down on the couch on their right side.
At the end of the procedure, the doctor slightly presses on the center of the gland and carefully draws it from top to bottom along the groove located in the middle. Now the patient can cope with a small need, after which the urinary canals are disinfected for him.
Does it hurt or not?
Many men refuse to undergo massage sessions because they are afraid that it will hurt.
Feelings during the procedure are really not the most pleasant, but a good doctor will try not to cause pain and minimize discomfort.
In addition, it gives an excellent effect and allows you to get rid of, which can poison a person's life for a long time. Sometimes this way of treatment even gives pleasure.
How to make free at home?
Patients are often interested, or trust it close person, for example, if the wife massages her husband's prostate.The procedure has too many contraindications that the patient may not be aware of. If you still decide to massage yourself, you should consult with your doctor.
A home session can be done on the couch or in. The sequence of actions is the same as for a professional procedure. Massaging movements should be soft. To increase blood flow, at this time you need to relax as much as possible.
In time, home massage takes longer - about half an hour, but the first few times the time can be reduced to 15 minutes.
What ointments and traditional medicine can be used for prostatitis?
In the treatment of prostate diseases, both and time-tested are actively used.
Good feedback patients received such means as, Vishnevsky's ointment,. From traditional medicine can be recommended, a decoction of chestnut,.
Ointment Finalgon
In addition, patients who have undergone a course of prostate massage are prescribed medicinal herbs, for example, in the form of alcohol tinctures.
They help restore immunity and destroy pathogenic organisms in the prostate gland. Therapy with plants such as chamomile, yarrow, is considered quite effective and useful.
Contraindications
There are many indications in which prostate massage is prohibited. This is a tumor in the rectum, pyelonephritis, impaired urination.
Any urological diseases in severe forms are almost always contraindications.
Alternative therapeutic methods of influencing the male organ
In addition to the usual massage, you can influence the prostate with the help of special devices. They are of several types:
- vibration massager. This is the most gentle way to treat prostatitis. The gland is massaged thanks to vibrations that are safe for the body;
- an electrical stimulator that acts on the gland with an electric current;
- apparatus for exposure to laser radiation.
There are other alternative methods of influence, even such unusual ones as hirudotherapy.
Treatment with leeches is now considered one of the most effective ways to combat inflammation and congestion in the prostate. It is believed that leeches are very useful for both arterial and venous blood supply.
Related videos
Where is it better to do prostate massage - at home or with a doctor? Pros and cons of each method in the video:
A good result from prostate massage is almost always noted. Even if it is difficult for a man to overcome the psychological barrier, for the sake of curing the disease, it is worth reconsidering your attitude.
– This is an organ located next to the bladder.
He is responsible for the development of the secret, which is integral part ejaculate, and it also regulates the state of the output tract of the bladder during an erection.
Congestive and inflammatory processes are possible in the gland, which can develop and lead to a number of diseases.
Prostate massage allows you to avoid this, with its help the work of the organ improves, its tone increases, blood flow and the outflow of secretions increase.
What is prostate massage? It . It is carried out by massaging movements with a finger or a bougie (a medical instrument in the form of a rod). The movements have a funnel-shaped trajectory or describe the shape of the number 8.
Goals
Prostate massage in men is carried out with four goals:
- A stagnant secret becomes a fertile environment for the reproduction of pathogenic bacteria that provoke inflammation of the gland. Therapeutic massage eliminates stagnation, and the normalization of blood circulation in the body improves the flow of drugs.
- disease diagnosis. A urologist, using palpation of the prostate gland, can establish the fact of its inflammation and take a secret for analysis.
- . One of the main causes of impotence is circulatory disorders in the pelvic region, and prostate massage can improve it. Normalization of the secretion outflow prevents the development of infertility.
- improving sex life. The prostate is a very sensitive organ, if you stimulate its nerve endings before and during sex, then the duration of sexual intercourse will increase, and it will bring more pleasure to a man.
Carrying out options
There are 2 ways in which prostate massage is performed, photos of the procedures are attached. or with the help of a bougie. If prostate massage with hands can be done at home, then only a urologist can use the bougie.
Urological massage of the prostate on the bougie is carried out according to the following algorithm:
- An antiseptic is injected into the urethra to prevent infection.
- Then the bladder is filled with an antiseptic.
- An instrument is inserted into the urethra and fixed.
- The doctor massages the penis along its entire length.
- A minute later, the bougie is removed from the canal.
Your attention to the pictures of prostate massage option 1:
The urologist can also massage with a finger. The digital stimulation algorithm is slightly different:
- It is desirable that the bladder be filled, but not necessarily with an antiseptic.
- The patient can take three positions to choose from: be on bent legs and arms on the couch, be standing with legs straight and back tilted, or lie on his side, pulling his legs to his stomach and facing the doctor.
- The doctor puts on a glove and lubricates the finger with an oily liquid (Vaseline).
- When massaging the male prostate, a finger is inserted into the rectum by 4-5 centimeters - this is where the lower edge of the prostate is located.
- The prostate gland is massaged with stroking and light pressure movements. In dense areas, the pressing force increases.
- The procedure lasts 2-3 minutes. The frequency is once every two to three days, the duration of therapy is approximately four weeks.
Photo of prostate massage in men option 2:
REFERENCE! Before the procedure, an enema is given and a shower is taken. This is necessary to cleanse the intestines and improve its patency.
Prostate massage treatment can be done at home on your own or with the help of a partner. Since the procedure is complex and dangerous if performed incorrectly, it is better to entrust the massage of the prostate gland to an experienced person. The partner should massage according to the same algorithm as the urologist performs the procedure. In order not to make a mistake, it is better to stimulate the prostate half-heartedly, avoiding strong pressure.
Self stimulation is more difficult compared to other options. There is a simplified version of it - indirect massage. To carry it out, you need to make rhythmic compressive and unclenching movements of the sphincter. The effectiveness of this procedure is not as high as that of a direct massage, but it is very easy to carry out.
Self-massage with a finger is best done in the bathroom. To do this, lie down in it and spread your legs to the sides. A glove is put on the hands, lubricated with petroleum jelly, a finger is inserted into the anus and massages the gland.
Prostate massage ends with the emptying of the bladder. Along with urine, fluid is released from the urethra during prostate massage. By the nature of the secretions, one can judge the state of the organ. A healthy prostate secretes a transparent secret with a white tint. The yellow color of the secret speaks of purulent processes.
A huge number of male problems arise due to congestion in the prostate gland. Only by accelerating these processes, it is possible to ensure the healthy activity of the gland. Among such preventive procedures is urological prostate massage.
What is urological massage
Urological massage should be done by a specialist. This is one of the varieties of therapeutic massage, which is performed by a urologist and promotes the outflow of excess fluid from the gland.
There are several professional techniques for such a procedure, each of which stimulates a certain part. If the procedure is carried out correctly, a man experiences improvements in his sexual life, pain during urination disappears, and his general health improves.
Preparation for the procedure
For massage, you need to free the rectum. It is also necessary to stop eating a few hours before the treatment procedure. But it is worth drinking water, because the bladder must be filled.
Urological massage has a number of contraindications, which include temperature fluctuations, an acute form of prostatitis, as well as prostate thrombosis, tuberculosis of the gland and oncology. In addition, if the cause of erection problems is not established, then massage is also not allowed.
Indications for the procedure
Urologists prescribe prostate massage after the following diagnoses:
- Inflammatory processes in the testicles, seminal vesicles and prostate.
- Spermatorrhoea.
- Problems in antibiotic therapy.
- Urethritis.
This procedure helps to expand blood vessels, reduce congestion, and restore microcirculation.
For the procedure, the doctor must wear sterile medical gloves. The patient lies on the couch in a position on the right side and bends the knees under him. The knee-elbow or squat position is also suitable, as the pelvic muscles relax. Everything is individual, the position is selected based on their comfort for the patient.
The doctor starts the procedure from the right half of the gland. She is more sensitive. Massage consists in a combination of light stroking movements and point light pressure in the right places. Pressure occurs first in the peripheral areas, and then the doctor moves closer to the center of the gland. Lastly, the specialist acts on the central groove.
If everything is done correctly, at the end of it a secret will be highlighted. It is important to note that urological massage is not considered a one-time procedure. It consists of at least 10 sessions, in each of which the effect on the gland is enhanced. Only in this case the result will be noticeable.
Be sure to trust the procedure to be carried out only by a highly qualified specialist, otherwise you can harm your health.
Massager
The urological prostate massager was invented specifically for those who are embarrassed to go to the doctor. This is a small device that will successfully help you perform all procedures at home and without a sterile room. The massager consists of a working part, a pulsating mechanism, a connecting tube, and a pumping device.
The mechanism of action is very simple - a man just has to squeeze the muscles of the anus at the required frequency. To do this, you need to insert the prepared massager all the way into the anus and squeeze the injection mechanism. Gradually, an indicator of 200 mm / Hg appears on the pressure gauge. Art. After that, the massager is considered ready for work. All that remains for the representative of the stronger sex is to periodically resist the internal pressure with the muscles of the anus. As a result, a therapeutic prostate massage will be carried out.
The procedure should be no more than 10 minutes, this is the optimal exposure time.
After finishing work, you need to open the locking mechanism, squeeze out all the air, and then slowly pull the device out of the anus.
In addition to the urological massager, there are many types of prostate massagers.
Self massage
If there is no opportunity and desire to go to the urologist, it is worth carrying out the procedure yourself. It is important to consult with a specialist before this, since an incorrectly performed exposure can lead to disruption of the prostate. For self-massage, you need to fill a warm bath with water. Lie on your back, raise your legs to the side walls, relax your body.
It is necessary to put on a medical glove on the hand, and be sure to lubricate the finger with a cream with sufficient fat content. Insert the finger to the depth of the location of the prostate gland, about 5 cm. As a result, the patient will feel the bumps of the gland. They need to be massaged until they harden. Then the pressure should be increased. So move forward gradually until a groove is groped. When painful sensations appear, the pressure should be loosened. Pain, with proper massaging, should not appear.
Finally
Urological massage and what it is known to many. But not everyone wants to go to the doctor to carry out this procedure. And massage will perfectly help those who have chronic prostatitis and related problems in their sexual life.
It is important to contact a specialist in time who is qualified for prostate massage. You can buy a professional massager, but use it strictly according to the instructions.
For the treatment of diseases genitourinary system as an additional measure, urological massage is used. This procedure will help restore men's health and get rid of stagnation of the prostate secretion. If you do not take action on time, then prostatitis can develop into an adenoma, and in the worst case, into a cancerous tumor.
Many patients do not even know what urological is. This procedure is not offered to a healthy patient. Massaging the prostate gland or other organ helps to get rid of circulatory problems and stop the symptoms of inflammatory diseases.
Urological massage is a stimulation of the prostate, cooper glands, seminal vesicles and urethra. It is part of a comprehensive treatment system, thanks to which it is possible to normalize blood flow and lymphatic drainage in different parts of the male organs.
Treatment is prescribed in urology for inflammatory diseases of the genitourinary system after a doctor's examination. The procedure is carried out only by a specially trained masseuse or urologist, andrologist. Independent can provoke the development of diseases, and not their elimination.
Which type is prescribed is up to the doctor to decide. It also determines the duration and number of sessions. This is only an additional measure, the main treatment for prostatitis or other diseases is medication.
Many men find it shameful to go to this type of physical therapy due to the delicacy of the technique. Prostate stimulation requires rectal penetration, which hurts male pride. But the effectiveness of massaging is very high, it is worth coping with psychological barriers and attending sessions.
Therapeutic effect
Stimulation of the organs of the genitourinary system has many advantages. Massaging is used even to treat erectile dysfunction. The procedure is aimed at releasing the secretion of the prostate through the urethra, this helps to eliminate congestion.
The therapeutic effect is as follows:
- increases the effect of drug therapy;
- symptoms are relieved inflammatory diseases;
- normal blood circulation in the pelvic organs is restored;
- sexual desire increases, sexual dysfunction is eliminated;
- reduces pain and discomfort during urination.
Prostate massage can also be a diagnostic tool. The urologist, using palpation, will assess the degree of inflammation of the gland, the presence of neoplasms on the organ. Cysts, benign or malignant tumors are strict contraindications for massage.
Indications for use
Several massage sessions are scheduled at once. One course will be enough for early stage prostatitis or minor inflammation. It is also recommended to additionally conduct healthy lifestyle life to enhance the effectiveness of procedures.
The urological effect on the organs of the genitourinary system is indicated for chronic prostatitis or urethritis in remission. In case of exacerbation of symptoms or relapse of the disease, it is recommended to interrupt physiotherapy procedures. If massage is done at such a moment, the course of the disease may worsen, and the duration of treatment will increase.
Who and where does
Urological massaging can take place right in the doctor's office. Examination of the prostate is done by a urologist, andrologist. Some private offices have qualified massage therapists trained in stimulation techniques.
You can undergo a course of massage treatment at a local public clinic for medical purposes or at a private medical center. The price per session depends on the policy of the clinic, it ranges from 500 to 1000 rubles.
Types of methods
The choice of physician depends on the concomitant disease. Massaging can occur rectally or through the urinary canal. Urethral penetration is performed under a local anesthetic.
Varieties:
- prostate stimulation;
- stimulation of the urethra;
- stimulation of the seminal vesicles and cooper glands.
Each type is indicated for certain diseases. Stimulation of the prostate is prescribed for chronic prostatitis, urethral massage - for urethritis or gonorrhea. Massaging the cooper glands and seminal vesicles helps to influence every organ of the urinary system.
prostate stimulation
Prostate massage requires rectal penetration. It can be performed with a finger, a special sensor or a massager. Such a procedure is prescribed for erectile dysfunction, prostatitis, sexual abstinence and the formation of stagnation in the prostate.
Some patients prefer to carry out manipulations at home. Couples sometimes practice sexual play to treat impotence through stimulation of the glandular tissue. In this case, you need to get accurate recommendations for performing massage from a doctor.
Mandatory preparatory procedures are carried out:
- Purgation. The rectum should be emptied naturally. A cleansing enema with the addition of chamomile decoction will help get rid of all feces.
- Massage is performed with a full bladder. You should drink plenty of water 1 hour before the session. A full urea will help close access to the glandular organ, making the procedure more efficient.
The patient comes to the doctor and lies down on the couch. It is recommended to take a towel and napkins with you. The doctor works in gloves, lubricates the index finger with a special gel that facilitates penetration into the rectal area.
The patient's posture is knee-elbow, lying or standing. A finger or a special sensor is inserted into the anus by only 3-5 cm. The doctor presses on the areas and strokes. Prostate stimulation lasts 1-2 minutes.
The patient after the massage should go to the toilet and urinate. The stagnant secretion of the prostate gland will come out with the urine. If during the procedure a man feels, then the doctor should be informed about this and the massage should be interrupted.
Urethral massage
In diseases of the urinary canal, another technique is shown. Urethral massage is prescribed after trauma and surgical treatment, with gonorrhea infection. Sessions are also prescribed for inflammatory processes in the chronic urethra.
The procedure is performed using a special expander - bougie, which is shown in the photo. This is a metal instrument that is inserted directly into the urethra. The session takes place under local anesthesia. Also in parallel, as an additional treatment for infectious pathologies, a therapeutic antiseptic solution is injected into the urinary canal.
Massage on the bougie is not carried out with hemorrhoids, high temperature patient and viral diseases, benign hyperplasia, in the acute stage of prostatitis and urolithiasis.
Massage of the seminal vesicles and cooper glands
Another method of influencing inflammatory diseases of the pelvic organs is the stimulation of the seminal vesicles and cooper glands. The procedure is indicated for gonorrheal urethritis, prostatitis, infectious diseases of the urinary tract.
Penetration occurs rectally (through the rectum). Massage according to the method is no different from the classical stimulation of the prostate. However, it is required to empty the bladder before the session. The seed sacs are close to the gland. The impact lasts 1-2 minutes, it is recommended to conduct a course of 10-15 procedures.
It is prescribed only by a doctor, depending on the diagnosis. With an exacerbation of symptoms of diseases, it is urgent to interrupt the course. Massage is also contraindicated for neoplasms on the prostate gland of any type.
Technique
Any urological massage helps to stop inflammation in the pelvic organs. After a course of physiotherapy, blood circulation is restored, erectile function returns, and the process of urination is facilitated. Stimulation requires some preparation, and the patient must also know how to do urological massage, what happens after it.
Training
The preparation for the procedure depends on the chosen technique. During a rectal examination, it is recommended to make a cleansing enema, the effect is performed on a full bladder.
Preparatory procedures:
- Prostate stimulation. A cleansing enema is required before the massage. 40-50 minutes before the procedure, you need to drink 1 liter of liquid, but not sweet. A full bladder is needed in order to press the prostate against the rectum and provide access to it.
- Urological massage. Stimulation of the urethra is preceded by taking antibiotics in order to protect the body from possible infection. To reduce pain, you should stop eating no later than 12 hours before the start of the procedure and first give up water and drinks.
- Stimulation of the cooper glands and. You will also need to do a cleansing enema to eliminate stool. Unlike prostate massage, you will need to empty your bladder.
It is also recommended to follow proper nutrition. A balanced diet will help reduce inflammation and strengthen the main drug treatment. Strictly follow the preparation recommendations, otherwise the manipulations will be useless.
The course of the procedure
The execution technique is different. You can get acquainted with each type of massage, and how it is done, in the table.
Type of massaging | Mandatory conditions | Execution technique | Treatment course |
Urethral massage on bougie | Empty bladder, prior and concomitant antibiotic therapy. | A special metal tool is used - bougie. This dilator provides access to the urethra. The device is inserted into the urethra, and massage is performed. The urethra is flushed with an antibacterial solution. If the patient has unpleasant painful sensations, then anesthesia is applied. The movements are strictly translational from the head to the base of the penis. A change in the color of urine, the presence of blood cells in it, unbearable pain are indications for stopping the massage. | The duration of the session is 1-2 minutes, the visit is every other day, 10 procedures are needed. |
prostate stimulation | Empty bowel, cleansed with enema, full bladder. | The patient takes a knee-elbow position standing or lying down. The doctor puts on gloves, lubricates the index finger with gel, kneads the prostate gland. Penetration is only needed a few centimeters. The doctor feels the lobes: he presses harder on hard tissues, weaker on soft ones. The impact can occur with a massager. | The duration of the session is 2-3 minutes, the visit is 7-10 days, the minimum break between sessions is 48 hours. |
Massage of the cooper glands and seminal vesicles | Empty bladder, cleansed intestines. | Massaging occurs rectally, through the rectum. When the Cooper glands are stimulated, the bladder is washed with a weak solution of potassium permanganate or another drug. Stimulation is carried out using the index finger or a special apparatus. | The duration of the session is from 20 seconds to 2 minutes, the visit is every other day, 10 procedures are needed, the minimum break between sessions is 48 hours. |
During the normal course of the procedure, the patient will not feel pain or discomfort. It is worth informing the doctor about the appearance of unpleasant symptoms during or after the massage. Physiotherapy will have to be interrupted and replaced with another method of treatment.
What to do after massage
Immediately after the session, you need to visit the toilet. Regardless of the technique of urological massaging, it is necessary to empty the bladder. Together with the urine, the stagnant secret of the prostate, the accumulated bacteria from the urethra, will come out.
This is a mandatory and only recommendation. After passing 10-15 procedures, it is necessary to take a break for 1 month. After that, you can repeat the course of treatment again. To improve the effect of the procedures, it is recommended to combine massage with drug therapy.
Contraindications and possible complications
Physiotherapy will help the patient eliminate the unpleasant symptoms of prostatitis, as well as facilitate the process of urination and restore sexual desire. But the procedure can be harmful if performed without medical prescription. There are several diseases in which it is impossible to massage the organ of the genitourinary system.
In the list of contraindications to urological procedures:
- neoplasms of any type (benign and malignant) on the pelvic organs;
- proctitis, hemorrhoids, anal fissures and inflammatory diseases of the rectum;
- urolithiasis disease;
- infectious diseases of the respiratory tract;
- high temperature (above 37 degrees);
- exacerbation of inflammatory diseases of the genitourinary system;
- violation of the process of urination in severe form.
Stimulation is performed only by an experienced specialist. If the recommendation is violated, there may be an exacerbation of the symptoms of pathologies accompanied by pain, the appearance of suppuration and the development of cancerous tumors.
Video
Learn more about urological massage from the video.
Has the greatest application. The scientist, physician and philosopher Avicenna, back in the Middle Ages, spoke about the benefits of massage and believed that he was able to prevent suffering from diseases of various organs. Urology is one of the branches of medicine dealing with inflammatory processes occurring in the genital organs (prostatitis, urethritis, etc.) and diseases transmitted through sexual contact.
In the treatment of male diseases, especially prostatitis, urological massage has been considered for more than a hundred years the most effective way. The prostate gland or prostate is the male organ that is responsible for the production of seminal fluid. With age, most men experience inflammation of the prostate gland, caused by sexual abstinence or excesses, infectious disease, wrong way of life, etc.
Urological in chronic inflammation is performed in order to restore blood circulation and remove the affected secret. usually manifests itself with pain and burning during urination. Frequent urination is also one of the signs of an inflammatory process in the gland.
top scores gives massage in combination with local and general treatment (antibiotics, vitamins, physiotherapy, etc.) with a complex form of the disease.
For many men, urological massage is an unpleasant procedure, and for a number of far-fetched reasons, it is considered unacceptable. In fact, experts recommend this method of treatment for a simple reason, there is no more proven method of influencing a number of male diseases. Unfortunately, no drugs have yet been found that could fully replace massage.
Urological massage, as well as a number of other organs (urethra, etc.), increases blood flow in them and leads to a decrease in the inflammatory process, relieves pain and reduces discomfort. The prostate is adjacent to the rectum, the gland is massaged through the anus. It is performed with a full bladder in one of the positions convenient for the patient.
Before starting the massage, the specialist puts on gloves and applies an anesthetic cream or gel to the finger. Inserting a finger into gently presses on the patient's prostate gland. Rough movements can provoke pain in the patient, the urge to urinate and other unpleasant sensations. The appearance of pain during massage should serve as a signal to stop it, usually the correct implementation of this procedure does not cause pain.
At the same time, both lobes of the gland are massaged alternately, movements are directed towards the central groove, without contact with the seminal vesicles. If compacted areas are found in the gland, such areas should be massaged especially carefully. Urological massage should be completed by rubbing the central groove. During the procedure, it is secreted from the prostate through the ducts into the accumulated secret.
At the end of the procedure, the patient must urinate and wash off the secret accumulated in the canal. Such an effect on the prostate gland allows you to quickly remove the inflammatory process and reduce the treatment time. All further procedures should be carried out based on the condition of the prostate: if it is soft, the massage should be weaker than with a compacted gland. The procedure should not exceed two minutes and is performed, on average, once every two days.
Depending on the condition of the patient, the course of treatment can reach up to 15 procedures, re-massage can be started no earlier than after 14 days. A contraindication to prostate massage is: adenoma, and other diseases.
It is advisable to carry out urological massage at home only if there is an experienced specialist. At home, urologists recommend hydromassage using chamomile decoction.