Generally speaking, chronic prostatitis is mostly found in young and middle-aged patients between the ages of 20 and 40, and the clinical manifestations are:
1, pain or discomfort symptoms: can be manifested as pain and discomfort in the perineum, groin, small abdomen, posterior urethra, lumbosacral region, anus, testicles, penis and other parts.
2, urinary tract symptoms: frequent urination, incomplete urination, urine dripping, painful urination, burning urethra, urinary urgency, difficulty in urination, etc. Sun Ming, Department of Urology, Jiangmen Central Hospital
3, sexual and reproductive symptoms: a little thin, milky, watery or thick discharge from the urethra at the end of urination or during stool, or accompanied by seminal emission, premature ejaculation, hemorrhage, ejaculation disorder, decreased sexual desire, etc.
4, mental symptoms: there can be fatigue, depression, memory loss, loss of self-confidence, etc.
Diagnosis of chronic prostatitis.
1, clinical symptoms, physical signs, anal examination;
2, routine microscopic examination of prostate fluid, leukocytes ≥ 10 / HP, lecithin vesicles significantly reduced, etc.;
3, urine routine to exclude urinary tract infection;
4, chlamydia, mycoplasma examination, etc. if necessary.
Prostatitis is generally recommended to take comprehensive treatment
1, drug treatment.
Choose sensitive antibiotics, commonly used antibiotics such as fluoroquinolones, such as levofloxacin and lomefloxacin, etc. After the diagnosis of prostatitis, antibiotic treatment is generally maintained for at least 4 to 6 weeks, during which a phased evaluation of efficacy can be carried out. If the efficacy is unsatisfactory, other sensitive antibiotics may be used instead. alpha-blockers may improve urinary symptoms and pain. Botanicals, NSAIDs and M-blockers can also improve related symptoms. (Intraprostatic antibiotic injections are not recommended as a treatment)
2. Prostate massage
The actual prostate massage can promote the emptying of the prostate ducts and increase the local concentration of drugs, relieving the symptoms of chronic prostatitis patients, and combined with other treatments can effectively shorten the course of the disease. (Acute prostatitis patients are prohibited prostate massage)
3, biofeedback therapy
This is a non-invasive and optional treatment.
4. Heat therapy
The main use of the heat generated by a variety of physical means to increase the blood circulation of the prostate tissue, accelerate metabolism, is conducive to anti-inflammatory and eliminate tissue edema, relieve pelvic floor muscle spasm, etc.. There are reports of heat therapy using microwave, radiofrequency, laser and other physical means via urethral, transrectal and perineal routes. It has a certain effect of relieving symptoms in the short term. (Heat therapy is not recommended for unmarried and infertile people)
5. Health education, psychological and behavioral counseling.
Patients with chronic prostatitis should abstain from alcohol and spicy stimulating foods; avoid holding urine, sitting for a long time, pay attention to keeping warm; strengthen physical exercise; maintain a regular sex life; hot water sitz baths help relieve painful symptoms.
6. Spiritual psychotherapy.
The chronic prostatitis patients with combined depression and anxiety, according to their condition, can choose to use antidepressants and anti-anxiety drugs while treating prostatitis. These drugs can partially improve the patient’s mood disorder symptoms and physical discomfort and pain.
The clinical progressiveness of chronic prostatitis is not clear and is generally not sufficient to threaten the life and vital organ function of the patient, and not all patients with chronic prostatitis require treatment. The goal of treatment for chronic prostatitis is mainly to relieve pain, improve urinary discomfort symptoms and improve quality of life, and the evaluation of treatment effectiveness should be based on symptom improvement.