Prostatitis, the most common urological disease in men under 50 years of age, is the most common disease in urology clinics, accounting for about 8% of urology outpatients. The population prevalence is 5 to 8.8 percent.
Chronic prostatitis, as the third prostate disease, has been neglected for a long time and is much less valued and recognized than benign prostatic hyperplasia and prostate cancer. Its impact on quality of life has been compared to that of unstable angina, myocardial infarction or active Crohn’s disease, which shows its importance. Chronic prostatitis is the last frontier area of prostate disease in the 21st century.
Classification
There are various ways to classify prostatitis syndromes, but currently most use the 1995 NIH classification, which is based on prostatic secretions (EPS), first voided urine after prostatic Massage (VB3), and/or WBC count of semen and the results of bacterial culture, prostatitis is classified into 4 types.
Type I, acute bacterial prostatitis (Acute bacterial prostatitis, ABP).
Type II, chronic bacterial prostatitis (Chronic bacterial prostatitis, CBP).
Type III, chronic non-bacterial prostatitis (inflammatory chronic pelvic pain syndrome, IIIA Chronic nonbacterial prostatitis, CNBP) and prostatodynia (non-inflammatory chronic pelvic pain syndrome IIIB Prostatodynia, PD).
Type IV, asymptomatic inflammatory prostatitis No clinical signs or symptoms, only inflammatory response of the prostate gland demonstrated on biopsy.
Etiology
1, caused by pathogenic bacteria such as Escherichia coli, Mycoplasma, Staphylococcus, Streptococcus, etc. transmitted to the prostate through blood and lymph, or by direct spread of infection from other parts of the genitourinary system to the prostate.
2, caused by incomplete treatment of acute prostatitis.
3, circumcision and prepuce increase the risk of prostatitis.
4. The sequelae of urethritis after impure sexual intercourse.
Symptoms
1, urinary irritation symptoms: painful urination, urinary urgency, frequent urination, nocturnal urination.
2, prostate drip white: the end of urination or stool force, from the urethra out of a small amount of milky white prostate fluid.
3. Pain: discomfort or pain in the perineum, perianal area, suprapubic area, lower abdomen, lumbosacral area, groin, scrotum, inner thighs and testicles, urethra.
4, sexual dysfunction and neurasthenia symptoms: sexual dysfunction, premature ejaculation, painful ejaculation, hematemesis, seminal emission and impotence, insomnia, depression.
Examination
1.rectal finger diagnosis.
2.Urinary routine.
3.Prostate fluid routine.
4.Bacterial culture of prostatic fluid, mycoplasma culture, chlamydia test.
5.Ultrasound: auxiliary examination to understand the situation of kidney ureter bladder and prostate seminal vesicle, to exclude misdiagnosis of bladder cancer and other diseases.
Diagnosis
1.History taking Pay attention to the history of urinary tract infection of the patient and his spouse, especially the history of sexually transmitted diseases.
2.Physical examination Detailed examination of external genitalia, focusing on prostate size, texture, nodules and sensitivity to pain on palpation.
3, ultrasound: transrectal prostate ultrasound is an important diagnostic method for prostate disease; urinary ultrasound can identify many urinary tract diseases.
4, laboratory tests Prostate fluid, urine after massage (VB3), semen.
5.Pathogenetic examination.
6.Pay attention to the identification to exclude diabetes and advanced bladder cancer.
Health care and treatment
1.Eat a light diet and avoid spicy food.
2.Lifestyle adjustment, ensure sufficient rest.
3.Regular semen discharge (or perform prostate massage to discharge prostate fluid).
4, hot water sitz bath (if the patient is already married), about 40 degrees is appropriate.
5, early stage antibiotic application (quinolones and macrolides, etc.).
6, the combination of Chinese and Western medicine is beneficial for this chronic disease, dialectical implementation of treatment.
Prostatitis three points of treatment, seven points of maintenance, the key is still in the patient. In fact, first of all, chronic prostatitis can cause symptoms of perineal discomfort and poor urination, resulting in adverse psychological effects on the patient thus affecting sexual function, mostly due to psychological factors, as the disease gets better sexual function will naturally recover, only a few serious cases will occur long-term sexual dysfunction, and there is no research to show that prostatitis can lead to infertility; secondly, prostatitis also belongs to The actual fact is that you can find a lot of people who have been in the business for a long time, and they’ve been in the business for a long time. The prostate gland massage, regular sex to regularly discharge semen, etc., as long as persistent, to avoid the psychology of quick success, after several months or even years of standardized treatment, most of the disease can be cured. The actual fact is that you can find a lot of people who are not able to get a good deal on this kind of things.