What is prostatitis

What is prostatitis?
Prostatitis is a common disease in urology, which occupies the first place in the group of male urology patients under 50 years old. Prostatitis is divided into four categories and five types, namely acute bacterial prostatitis, chronic bacterial prostatitis lesbian vibrator rose toy , chronic pelvic pain syndrome (inflammatory and non-inflammatory), and asymptomatic prostatitis. Non-bacterial prostatitis is far more common than bacterial prostatitis.
II. Clinical manifestations of male prostatitis
Chronic prostatitis can show similar clinical symptoms realistic dildo , collectively known as prostatitis syndrome, including pelvic and sacral pain, urination disorders and sexual dysfunction. Pelvic and sacral pain is extremely complicated. Pain is usually located in the pubis, lumbosacral and perineum. Radiation pain can be manifested as urethra, spermatic cord, testes, groin and medial ventral pain. Radiation to the abdomen is similar to acute abdomen, and radiation along the urinary tract is similar to renal colic, often leading to misdiagnosis. Urination interference is characterized by frequent urination, urgency, pain, dysuria, bifurcation of the urine line, post-urination, increased frequency of nocturnal urination, milky secretion from the urethra after urination or defecation. Occasional concomitant dysfunction, including decreased libido, premature ejaculation, ejaculatory pain, impaired erection and impotence. The above symptoms can be caused by prostatitis or other diseases of the genitourinary tract.
III. Prostatitis examination
1. Four cups test
Specific method: before collecting urine, tell patients to drink more water, and patients with excessively long prepuce should flip the foreskin. After cleaning the penile head and urethral orifice, the patient urinates and collects 10ml of urine; continue to urinate about 200ml collect midstream urine 10 ml; and then stop urination, massage the prostate, collect prostatic fluid; finally collect urine 10ml. Through the comparison of the number of bacterial colonies in the above samples, we can distinguish whether there is prostatitis or urethritis.
two。 Check the white blood cells of prostatic fluid
The content of leukocytes in the sediment of normal prostatic fluid should be lower than 10 times of the microscope. If there are 10 white blood cells / visual field in the prostatic fluid, the height of prostatitis can be prostatitis, especially the fat macrophages found in the prostatic fluid. However, the number of white blood cells in the prostatic fluid of some patients with chronic bacterial prostatic fluid may have visual field, while in some normal men, the number of white blood cells in the prostatic fluid is "10 / visual field."
3. Other
Bacteriology or white blood cell examination of urine before and after prostate massage is also a relatively simple method, and can even replace the above four-cup test. This method is especially suitable for the treatment of prostate antibiotics.
IV. Treatment of prostatitis
First of all, it is necessary to carry out clinical evaluation, determine the type of disease, choose treatment according to the etiology, psychotherapy and regulatory life should run through the whole treatment process.
1. Antibacterial treatment of prostatitis
Known urinary tract pathogens are the basis for the selection of antibiotics. Rare pathogens or symbiotic bacteria found in the genitourinary tract cannot be identified as pathogenic pathogens. If patients with non-bacterial prostatitis have signs of bacterial infection, they are ineffective after general treatment and are also treated with antibiotics. The selection of antibiotics should pay attention to the prostate blood barrier between prostatic acini and microcirculation, which hinders the passage of water-soluble antibiotics and greatly reduces the therapeutic effect. Some bacteria secrete glycoprotein matrix, which prevents antibiotics from getting close to bacteria. At present, in the presence of glandular stones love egg , stones can become a refuge for bacteria.
two。 Prostatitis anti-inflammatory painkillers
Non-steroidal anti-inflammatory drugs can improve symptoms, generally use anti-inflammatory oral administration or suppositories, traditional Chinese medicine use anti-inflammatory, heat-clearing, detoxification, soft drugs also have a certain effect. Allopurinol can reduce the concentration of uric acid in the whole body and prostatic fluid. In theory, as a free radical scavenger, it can also remove reactive oxygen species and reduce inflammation and pain.
3. Physiotherapy for prostatitis
Prostate massage can empty concentrated secretions in the prostate tube and infection in the area of obstruction of the drainage gland, so prostate massage can be performed every 3 to 7 days with antibiotics. Prostate physiotherapy uses a variety of physical factors, which is conducive to relax the prostate, posterior urethral smooth muscle and pelvic floor muscle, enhance antibacterial effect, and relieve pain symptoms.
4. Receptor antagonist
In patients with prostatic pain, bacterial or nonbacterial prostatitis, the tension of the smooth muscle of the prostate, bladder neck and urethra increases, and the increased urethral pressure leads to the reflux of urine to the prostatic duct, which is an important cause of prostate pain, prostatic calculi and bacterial prostatitis. Application is of great significance to prevent the recurrence of infection. A longer course of treatment should be used to make receptor antagonists have enough time to regulate the function of smooth muscle and consolidate the curative effect.
5. Surgical treatment of prostatitis
Chronic bacterial prostatitis can be used for surgical treatment. Prostatectomy can be cured, but use it with caution. Because prostatitis usually involves the peripheral zone of the gland, electroresection of the prostate (TURp) can achieve the purpose of treatment of TURp prostate stones and bacterial infections near the prostate duct, which is helpful to reduce the reinfection of peripheral zone lesions. Chronic bacterial prostatitis can lead to recurrent urinary tract infections and infertility.