Chronic prostatitis (CP) is one of the common diseases and high incidence among young and middle-aged men, with an incidence of about 5% to 8%, accounting for about 1/5 of urological male outpatients. The actual diagnosis is difficult due to the fact that the pathogenesis is not completely clear, the clinical typing is complex, and the duration of the disease is long and recurrent, so there are many diagnostic and therapeutic misconceptions in the clinic, resulting in poor clinical outcomes.
A. The concept of chronic prostatitis and prostate hyperplasia is easily confused
The actual fact is that there are often patients, and even doctors, who confuse the two. 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. The main cause of chronic prostatitis is a chronic infection or inflammation of the prostate gland, the main etiology is infection or chronic congestion resulting in inflammation, clinical manifestations of urinary tract irritation (urinary frequency, urinary urgency, etc.) and/or pain symptoms (pain or discomfort centered on the perineum, etc.), the age of onset is generally sexually active young and middle-aged people. Prostatic hyperplasia, commonly known as prostatic hypertrophy, is a disease of the lower urinary tract obstruction caused by the physiological degeneration of the prostate gland in elderly men under the effect of androgens, with clinical manifestations of lower urinary tract obstruction symptoms (urination difficulties, such as hesitation, weakness of the urinary line, prolonged urination time, dribbling after urination, incomplete urination) and/or irritation symptoms (urinary urgency, frequency, nocturia, urinary incontinence, etc.). Older men above the age of 50 years, the diagnosis of prostatic hyperplasia is generally not considered below the age of 50 years. The two are not necessarily linked, prostatitis does not directly cause prostatic hyperplasia, prostatic hyperplasia can be secondary to prostatitis from urinary retention and other factors combined with urinary tract infections, and currently there is an increasing trend of geriatric prostatitis.
The actual fact is that there are misconceptions in the diagnosis of chronic prostatitis and countermeasures
1, ask the medical history is too simple
The history may be an important clue to the diagnosis of CP and must be taken seriously. The actual history of the symptomatic person is not collected by the non-specialist, and even a few symptoms such as frequent urination, dripping white urine, perineal pain alone will diagnose CP, nor do they pay attention to the NIH-CPSI symptom score. In fact, many medical histories may be important clues for CP. Men rarely present with simple urethritis, such as a history of recurrent urinary tract infections may be chronic bacterial prostatitis (CBP). Those with a history of smut should give high priority to the possibility of post-STD prostatitis. It is also important to note the history of spousal illnesses such as mycotic vaginitis and trichomoniasis, and the male partner should be further examined. The actual fact is that you can find a lot of people who have been in the business for a long time.
The actual fact is that the actual fact is that the particulars of the actuals are not really a lot of.
The actual fact is that you will find a lot of people who are not able to get a good deal on a lot of things. In the case of chronic pelvic pain syndrome (CPPS), the gland is full, slightly large and soft, and the pressure pain is not significant. Of course, anal examination is contraindicated when acute prostatitis is considered (fever, painful urination, increased blood count, etc.). The examination should also pay attention to the presence of swollen and painful nodules in the epididymis, absence and bead-like changes in the vas deferens, the presence of varicose veins in the spermatic cord, and the presence of foci of infection in other areas such as the mouth and skin. All these can provide clues for CP diagnosis and differentiation.
3, over-reliance on clinical symptoms or laboratory, ultrasound and other results
The most important thing is that the prostate is not only a part of the body, but also a part of the body. The true significance of WBCs and bacteria in special prostate specimens is controversial. It is generally believed that the number of WBC in prostate fluid does not directly correlate with symptoms and is of limited value in the selection of medication. For the exact diagnosis of chronic prostate typing and differential diagnosis, it is more recognized that the Meares-Stamey four-cup localization method should be actively carried out, and this method can distinguish bacterial prostatitis from bacterial cystitis and urethritis. In fact, ultrasonography is not specific for the diagnosis of prostatitis and is related to the ultrasonographer’s experience, so prostate ultrasonography should not be used instead of prostate fluid examination.
4, differential diagnosis thought limitations, easy to misdiagnose and mistreat
There are often clinical cases of bladder cancer and rectal cancer misdiagnosed as CP, because bladder cancer may show symptoms of urinary tract irritation, but when the occupying lesion is not obvious, it is often misdiagnosed as CP; rectal tumors compressing the prostate gland may also show symptoms similar to prostatitis. Therefore, in diagnosing the disease, we should think openly and pay attention to differentiate from the following diseases: vesiculitis, seminitis, interstitial cystitis, proctitis, bladder neck fibrosis, urethral stricture, bladder tuberculosis, prostate cancer, superficial bladder tumor, lumbar spine disease, enthesopathy and even rectal cancer. You should do the relevant examination to avoid misdiagnosis and misdiagnosis.
The actual fact is that there are misunderstandings in the treatment of chronic prostatitis and countermeasures
1, do not choose to use anti-infective drugs
The actual fact is that you can find a number of different types of products and services that are available in the market. This is important for the choice of treatment, especially if you need to use anti-infective drugs. 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. It is generally believed that sulfonamides, quinolones are ideal, such as cotrimoxazole, levofloxacin, etc.; for mycoplasma, chlamydia caused by the choice of doxycycline, azithromycin, roxithromycin, etc.. Of course, anti-infective drugs are also effective for some non-bacterial prostatitis, about 10% efficient, in this case, can be short-term, trial anti-infective drugs, such as ineffective can be immediately discontinued.
2. Lack of evidence in the use of proprietary Chinese medicines, resulting in unsatisfactory efficacy
Nowadays, there are more varieties of proprietary Chinese medicines available for clinical treatment, which have better efficacy in improving symptoms, but there is also the phenomenon of blind use without identification, which is especially common among non-Chinese medicine practitioners. The choice of Chinese medicine must be based on evidence-based treatment in order to achieve the desired effect. When the clinical manifestations are frequent and astringent urination, burning and itching in the stem, yellow and red urine or cloudy semen, swelling and pain in the lower abdomen, perineum, testicles, lumbosacral, and even blood in the urine. In severe cases, if the patient has fever and chills, and if the coating is yellow and greasy, the patient is generally identified as having damp-heat congestion and obstruction, and the patient can usually use retention tablets, Ning Ju Tai capsule, prostate tablets and wild chrysanthemum suppositories. If the disease is prolonged, with residual dripping after urination, astringent urine, yellow red and hot, sometimes cloudy semen, accompanied by lumbar and knee weakness, dizziness, insomnia and dreaminess, seminal emission. Or with irritable heat in the five hearts, dry mouth and dry tongue. If the tongue is red and less coated, the evidence is generally identified as yin deficiency and fire, and Zhi Bai Di Huang Wan can be used; if the disease is prolonged and weak, with lumbosacral pain, tiredness and fatigue, depression, constriction of the abdomen, lack of warmth in the hands and feet, frequent and clear urination, incomplete dripping, inability to perform yang, and overflow of seminal clouding with labor, and the tongue is light and thin coated, the evidence is identified as kidney yang deficiency, and Ji Sheng Kidney Qi Wan and Dios Z Fen Qing Wan can be used; if the disease is prolonged, with frequent urination, residual dripping after urination, and overflow of seminal clouding with labor Overflowing, with painful swelling in the perineum and abdomen, aggravated by labor. The head is heavy and sleepy, the face is scaly and less florid, dull food, palpitations and spontaneous sweating, the tongue is light and fat, the moss is white and greasy, you can use Ginseng and Atractylodes Pill, Dioscorea Z Fenqing Pill, etc. ……
3, ignore the psychological factors
The majority of scholars believe that more than 80% of chronic prostatitis patients will have some kind of psycho-psychological problems, of which 20% to 50% of patients may behave very seriously. The pathogenesis may be anxiety, depression, fear, tension, etc. through the mental-neurotransmitter-nerve loop, causing posterior urethra and bladder neuromuscular dysfunction, plant nerve dysfunction, resulting in increased double receptor excitability, further causing bladder urethra dysfunction, pelvic floor muscle spasm, urethral high pressure in the prostate department, urinary reflux, thus causing and aggravating the condition. Psychological factors in chronic prostatitis may be both the cause and the result of the pathology, both of which interact with each other and lead to further aggravation of the condition. 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. Guide the patient to understand the nature of the disease, eliminate the patient’s doubts, establish confidence in overcoming the disease, make the patient realize that some symptoms are caused by their own excessive anxiety and are only migratory, and establish a good doctor-patient relationship so that the patient has a sense of trust in the doctor, encourage the patient to properly arrange work, life and study, and divert the patient’s attention to achieve the elimination of mental burden and better promote the patient’s recovery from the psychological and The patient should be encouraged to make proper arrangements for work, life and study, and to divert the patient’s attention in order to eliminate mental burden and better promote the patient’s complete psychological and physiological recovery.
4, the efficacy is determined solely on laboratory tests
The actual fact is that the actual number of prostatic fluid leukocytes is increased, but some of them are due to the increase in the excretion of the original pus cells in the glandular ducts, which can’t be considered as aggravated condition. The NIH-CPSI can be used as a tool to objectively assess the change in symptoms of chronic prostatitis (CP) patients.
The prognosis and care misconceptions and countermeasures
The most important thing is that you can get a good idea of what you’re looking for. The actual fact is that the majority of the patients are not paying attention to the daily care after the improvement of the condition, sedentary cycling, drinking alcohol or eating spicy, or the sexual life is irregular and so on to make the condition repeated. The actual fact is that most of the chronic prostatitis can be cured with proper treatment, but you must pay attention to daily care to avoid recurrence. In addition to the clinical medication, it is important to educate patients about the preventive health care of chronic prostatitis.
1, physical exercise, enhance physical fitness, improve the ability to resist disease.
2, avoid sedentary, long time cycling, driving, compression of the perineal prostate department.
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4, to prevent constipation, keep the bowels open.
5, when the conditions, regular prostate massage (acute prostatitis should not), no conditions can be appropriate regular masturbation sperm discharge.
6, regular sex life, both to avoid frequent sex or sexual impulses, but also to avoid abstinence for too long or forceful sperm not ejaculate.
7, avoid unclean sexual intercourse, eliminate extramarital sexual intercourse, to prevent sexually transmitted diseases. The actual fact is that you will find a lot of people who are not able to get a good deal on a lot of things, but you can also do abdominal massage, anal exercise, warm water baths and other physical therapy to assist.
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.