Etiology and pathogenesis Only a minority of patients have a history of acute illness, mostly presenting with a chronic, recurrent course. The pathogens are mostly enteropathogenic bacteria, and routine bacteriological examination detects bacteria in only about 20% of patients. Regardless of the presence or absence of leukocytosis in the prostate fluid or the presence of pathogens, patients may have symptoms such as pelvic pain and disrupted urination. Recent studies have shown that urodynamic examination of patients with prostatitis reveals increased pressure in the posterior urethra and that symptoms are reduced or disappear after internal administration of alpha-adrenergic receptor antagonists, suggesting increased prostate-posterior urethral smooth muscle tone, which causes urine turbulence, urine reflux into the prostatic duct, and chemical irritation from uric acid within the urine, causing pain. Pathogens invade the prostatic ducts with the urine, leading to infection. The pathological anatomy confirms that prostatitis lesions are generally confined to the peripheral zone, where the glandular ducts are oriented perpendicular to the urinary flow or reverse to the opening in the posterior urethra, which is prone to urinary reflux; whereas the central zone and the migratory zone glandular ducts are oriented in the same direction as the urinary flow and are less prone to infection. The most recent study also found that uric acid salts of urine not only have an irritating effect on the prostate, but can also be deposited as stones, blocking the glandular ducts and becoming a place of refuge for bacteria. These findings may clarify that prostatitis syndrome is actually a common manifestation of multiple diseases and that the clinical presentation is variable and can produce a variety of complications or resolve on its own. The National Institutes of Health (NIH) has classified this group of diseases into four types. Regardless of the type of chronic prostatitis, all may present with similar clinical symptoms, collectively referred to as prostatitis syndrome, including pelvic pain, urinary disturbances, and sexual dysfunction. The pain is usually located in the suprapubic, lumbosacral and perineal areas, and the reflex pain can be manifested as pain in the urethra, spermatic cord, testicles, groin and medial femur, radiating to the abdomen like an acute abdomen, radiating along the urinary tract causing frequency, urgency, painful urination, poor urination, bifurcation of the urine line, post-urinary drip, increased nocturnal urination, and milky discharge from the urethra at the end of urination or during bowel movements. Occasionally, it can be complicated by sexual dysfunction, including loss of libido, premature ejaculation, painful ejaculation, hematemesis, weakened erection and impotence. The above symptoms can be caused by prostatitis or by other diseases of the genitourinary tract. The prostate gland may be normal, but it may be painful, full, swollen or unevenly hardened. ultrasound examination can reveal whether there are combined prostate stones and granulomas, and exclude possible prostate hyperplasia or prostate cancer. The pH of the patient’s prostate fluid is often greater than 7.8, with an increase in white blood cells and granulocytes. 10 or 15 white blood cells per high-powered field of view indicate the presence of inflammation. If you fail to press out the prostate fluid, take a urine specimen for examination after massage, if WBC ≥ 10/HP and the number of leukocytes does not increase in the regular urine specimen, it can be diagnosed as prostatitis. Fourth, the pathogen examination with prostatic fluid for standard bacteriological examination, if repeatedly cultured to the same strain, can be considered as the pathogenic bacteria.