How to recognize prostatitis

  Prostatitis is one of the common diseases among adult men. Although it is not a direct life-threatening disease, it seriously affects the quality of life of patients. At the same time, its large patient population and high medical costs impose a huge economic burden on public health. As the pathogenesis and pathophysiological changes of prostatitis are not well understood, many physicians find it tricky in the clinical diagnosis and treatment of prostatitis. The actual fact is that there is no clear standard for the understanding of prostatitis, the judgment of the severity of the condition, the choice of treatment methods and the evaluation of the efficacy. The prostate gland is part of the male reproductive system and has the shape and volume of a chestnut, located in front of the rectum and under the bladder, and wraps around the beginning of the urethra, and the prostate gland secretes prostatic fluid that is part of the semen.  Prostatitis is the inflammation that occurs in the prostate gland. Chronic prostatitis is a fairly common, non-life-threatening condition that may resolve on its own in some patients, and not all patients require treatment.  There are three types of prostatitis with clinical symptoms: acute bacterial prostatitis, chronic bacterial prostatitis, and chronic non-bacterial prostatitis. Symptoms of prostatitis include pain in the pelvic region such as the perineum, perianal area, urethra, suprapubic, inguinal, and lumbosacral regions, and urinary symptoms such as frequent, urgent, and labored urination, but they may not be present in every patient. The clinical manifestations of each type of prostatitis also have some respective characteristics.  1, acute bacterial prostatitis: acute attack, accompanied by chills, fever and other systemic symptoms and obvious urinary symptoms.  2, chronic bacterial prostatitis: recurrent symptoms, laboratory tests prove that bacteria from the prostate.  3, chronic non-bacterial prostatitis: the vast majority of prostatitis falls into this category, with no evidence of bacterial infection. The white blood cell count of the prostate massage fluid can be normal or abnormal, and the white blood cell count does not necessarily correlate with the severity of the symptoms.  There is no good evidence that prostatitis is cancerous. Some patients with prostatitis have symptoms of sexual dysfunction such as decreased libido, erectile dysfunction, and premature ejaculation, but there is no evidence that prostatitis directly causes sexual dysfunction. Some patients with prostatitis may have abnormal semen parameters.  A comprehensive treatment approach should be taken for chronic prostatitis. The goals of treatment for chronic prostatitis are primarily to relieve pain, improve urinary symptoms, and improve quality of life. The degree of symptom relief is the main basis for evaluating the effectiveness of treatment for chronic prostatitis. Although there are numerous treatments or medications, none of them can achieve the goal of treating all patients or relieving all symptoms. The treatment of prostatitis should follow medical advice and be followed up on time. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. Hot water sitz baths are beneficial for patients with chronic prostatitis. After the treatment is over, paying attention to the above matters will help prevent the recurrence of symptoms. The actual fact is that you will need antibiotic treatment for acute and chronic bacterial prostatitis patients, and some chronic non-bacterial prostatitis patients can try antibiotic treatment. alpha-blockers, non-steroidal anti-inflammatory analgesics, and botanicals have varying degrees of efficacy in relieving the symptoms of chronic prostatitis.  The traditional method of classifying prostatitis is the international generic prostatitis classification: acute bacterial prostatitis, chronic bacterial prostatitis, chronic non-bacterial prostatitis, and prostate pain.  In 1995, the National Institutes of Health (NIH) developed a new classification based on basic and clinical research on prostatitis at that time: Type I: equivalent to acute bacterial prostatitis in the traditional classification. The onset of the disease is rapid and may present as a sudden febrile illness with persistent and marked symptoms of lower urinary tract infection, elevated white blood cell counts in the urine, and positive bacterial cultures in the blood or/and urine.  Type II: Corresponds to chronic bacterial prostatitis in the traditional classification method and accounts for about 5-8% of chronic prostatitis. There are recurrent symptoms of lower urinary tract infection lasting more than 3 months, elevated white blood cell count in prostate fluid/semen/urine after prostate massage, and positive bacterial culture results.  Type III: Chronic prostatitis/chronic pelvic pain syndrome, equivalent to chronic non-bacterial prostatitis and prostatodynia in the traditional classification method, is the most common type of prostatitis, accounting for about 90% or more of chronic prostatitis. The main manifestation is long-term, recurrent pain or discomfort in the pelvic region lasting for more than 3 months, which can be accompanied by varying degrees of urinary symptoms and sexual dysfunction, seriously affecting the patient’s quality of life; negative urine culture results after prostate fluid/semen/prostate massage. According to the results of routine microscopic examination of prostatic fluid/semen/post-prostate massage urine, this type can be subdivided into two subtypes, IIIA (inflammatory CPPS) and IIIB (non-inflammatory CPPS): Type IIIA patients have elevated white blood cell counts; Type IIIB patients have white blood cells in the normal range. each of the two subtypes, IIIA and IIIB, accounts for about 50%.  Type IV: asymptomatic prostatitis (AIP). There are no subjective symptoms, and evidence of inflammation is found only on examination of the prostate (prostate fluid, semen, prostate tissue biopsy and pathology of prostatectomy specimens, etc.).  The International Prostatitis Collaborative Network (IPCN), after 3 years of clinical application, concluded that the classification method is a great improvement over the traditional classification method and has certain guiding significance in clinical application, but there are still shortcomings that need further improvement.