With the onset of the cold winter months, more and more patients with prostatitis are coming to my clinic for treatment. They have a variety of symptoms and complaints, including frequent urination, incomplete urination, itching in the urethra, back pain, scrotal dampness, soreness and pain in the perineum, groin or scrotum, and testicles, and these symptoms worsen after sex, especially when the back pain, soreness and pain in the groin or testicles are more pronounced.
Although they have a variety of symptoms, more than 90% of patients have a commonality that they know a lot about prostatitis; they have been seen in many hospitals, holding thick checklists in their hands, spending a lot of money on treatment, but without good results; they are worried and worried about a lot of things, including whether prostatitis will affect their sex life, whether it will affect their fertility, whether it will turn into prostate cancer, etc. .
A. Reasons for misconceptions about prostatitis and suggestions
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The actual fact is that many of the clinical symptoms of prostatitis are not specific, which means that many other organ diseases may have similar symptoms. In the highly developed Internet now, when men, especially young men, have some symptoms of the genitourinary system, they will go online to find “information”. The actual fact is that there are a lot of articles about prostatitis in the media, especially on the internet, and there is no shortage of excessive advertising, and a lot of websites will pop up during the browsing process to give so-called “guidance”.
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. This is a very easy mistake for people who don’t have the medical knowledge, including medical students. 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. The actual fact is that there is a big gap between the knowledge in the books and the actual situation, and then they realize that they don’t have a “disease” at all.
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Since this type of patients have formed a wrong perception, even if they go to a regular hospital, it is difficult to listen to the correct explanation and treatment suggestions of the doctor, and they keep tangling with the doctor with wrong perception.
Advice to this group of people: It is impossible for the general population without sufficient medical knowledge to “learn everything” through a few articles on the Internet, and this group of patients is advised to stay away from the Internet and seek help from professional doctors in regular hospitals. These “knowledge” on the Internet can do you no good.
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In recent years, a large number of male specialty hospitals were established, many of which are excellent regular hospitals, but there is also no shortage of hospitals that have completely abandoned the medical purpose of “treating the sick and saving people” and gone commercial. The actual “patient” walks into these hospitals, regardless of whether there is a disease, will certainly be diagnosed as “chronic prostatitis”. The “multi-functional treatment system”, such as intracavitary ablation, multidimensional ultrasound, radio frequency, ion introduction, gene targeting introduction, local injection, enema, etc.
After the “baptism” of these dazzling so-called international advanced treatment programs, it is really difficult for patients not to spend more than 1000-2000 yuan per day. The actual fact is that you will find a lot of people who have spent several hundred thousand or even a hundred and twenty thousand dollars for the treatment of the so-called “prostatitis” in these irregular hospitals. Unfortunately, many of these patients have no financial ability to receive the regular treatment that costs very little, and some of them do not know that they have been cheated, but instead go to the regular hospital and say “XXX hospital doctor said they have what what disease” and ask for many kinds of tests and treatments. The actual fact is that these patients may initially suffer from a disease that can be cured with regular treatment for a period of time, but many of them end up suffering from prostate disease, and the clinical symptoms will be more and more serious, especially the mental problems.
This phenomenon is not only seen in prostatitis, but some patients visit the doctor because of circumcision, resulting in the diagnosis of “prostatitis”, “epididymitis”, “premature ejaculation”, and “spermatorrhea”. The actual fact is that you can find a number of diseases such as “varicocele” and so on.
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3, no basis for the abuse of drugs, including the abuse of antibiotics and androgens.
The actual antibiotic abuse is a serious mistake made in the treatment of prostatitis in China. Even in regular hospitals, many doctors do not understand enough about prostatitis, or use long-term, continuous, large amounts of antibiotics, which can easily cause dysbiosis or drug resistance.
The indications for the use of antibiotics are acute prostatitis, bacterial chronic prostatitis, while in clinical practice it is more common to see chronic non-bacterial prostatitis, this part of the patient does not need and should avoid the use of antibiotics.
The actual fact is that you will need to do a culture of the prostate fluid to determine whether it is bacterial or non-bacterial, but many doctors do not do this because of the trouble of taking the prostate fluid to do pathogenic bacteria culture, relying only on the increase in white blood cells in the prostate fluid as a reason to use antibiotics. The actual fact is that you will not need to get a shot or an infusion even if you are diagnosed with bacterial prostatitis. 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.
There is also a situation that deserves special mention that some prostatitis patients have changed their personalities and appear to lack a “manly image”. For this group of patients, some doctors prescribe testosterone preparations (androgens) to try to improve the patient’s “effeminate” personality without any evidence of testing. This is an absolutely wrong treatment. Androgen supplementation should be done under close observation after strict indications and after excluding contraindications to androgen supplementation.
Advice to patients: If after the consultation the doctor prescribes antibiotics without the examination of pathogenic bacteria such as bacteria and mycoplasma, especially when prescribing injections and infusions, please decisively ask the doctor to do pathogenic bacteria culture. If the doctor prescribes testosterone preparation at will, please decisively change to another professional doctor for consultation.
Second, inadequate or wrong understanding of some symptoms and answers
1, frequent urination, increased nocturia: under normal circumstances, a day’s urine volume is kept at about 1500ml is a more ideal urine volume, according to the urine volume of about 300ml each time, 5-6 times a day the number of urination is normal, so the number of urination times a day is greater than 8 times before it is considered frequent. It is normal to increase the number of urination if you drink too much water every day or in a short period of time, drink alcohol, or are stimulated by cold, and drinking more water or alcohol at night before sleeping will definitely increase nighttime urination.
Therefore, if the number of urination is significantly increased in many days, it is recommended to record the urination diary (that is, record the number of urination per day and the total volume of urination for a day, the total volume of urination for a day is the sum of the volume of urination discharged each time, which requires a dosage cup to record the volume of urination discharged each time), and when the volume of urination for a day is significantly increased, first reduce the amount of water drunk and keep the volume of urination in the normal range (about 1500ml) and then observe the number of urination.
2, the sense of incomplete urination: it is recommended to go to the hospital to do bladder residual urine examination, if the residual urine is less than 50ml, do not need to care too much.
3.After urinating there are still a few drops of urine dripping into the underwear: Before considering this as an abnormal state, observe whether there are still a few drops of water dripping down after tightening the faucet, which is the water dripping down from the water pipe at the far end of the faucet switch after tightening the faucet. For the same reason, the male urethra is relatively long, close to 500px, after urinating there will be some urine residue in the urethra, when the residual urine in the urethra has not been completely drained in the case of wearing pants, there will certainly be urine dripping into the underwear.
4, recently always sleep badly, sweat a lot, easily fatigue, back pain, more serious after sex: poor sleep, sweat a lot, easily fatigue, back pain, etc. In addition to the disease there are usually poor rest, mental tension, sub-health conditions, etc. can have these symptoms, not prostatitis specific symptoms. The actual fact is that you can find a lot of people who are not able to get a good deal on this.
The actual fact is that you will be able to get a lot of people to do the job. Therefore, if you have scrotal dampness, you can try changing your lifestyle habits first.
6, penis erection or sexual life when the urethra mouth has sticky secretions: penis erection or sexual excitement when the urethra mouth will secrete some clear liquid, this is a normal phenomenon, no need to worry.
7, recently ejaculated too quickly, erection hardness and duration is not enough, no erection in the morning: Occasionally or after a long separation couples meet ejaculation too quickly, erection hardness and duration is not enough, etc. can be a normal phenomenon, when often or always these symptoms need to seek professional medical help. In addition, nocturnal or morning erections are closely related to the usual health condition, good or bad rest, etc. It is not necessary to have a good nocturnal or morning erection every day and there is no need to worry too much. The actual fact is that you will be able to get a lot more than just a couple of hours to get a lot more than just a couple of hours.
8. Will chronic prostatitis affect sexual function?
The relationship between chronic prostatitis and sexual function is not very certain, because many patients who have suffered from chronic prostatitis for many years have normal sexual function and are not affected in any way. Penile erection is dependent on normal penile anatomy, nerve reflexes, increased perfusion of the arteries and decreased venous return. The chronic prostatitis does not cause the physiological structures necessary for penile erection, so it does not directly affect sexual function, but because of the long-term discomfort symptoms can affect the patient’s sexual excitement, prostate congestion may cause local pain, especially orgasm that occurs more often at the same time or after ejaculation.
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9. Will chronic prostatitis affect fertility?
The relationship between chronic prostatitis and fertility is not very certain, because many patients who have suffered from chronic prostatitis for many years have not had their fertility affected. Theoretically, however, the prostate is an accessory gland closely related to fertility, and its secretion of prostatic fluid is part of the semen. Inflammatory lesions of the prostate affect the composition of semen to varying degrees, interfering with the activity of sperm, thus affecting male fertility.
The reasons for this are mainly the following.
(1) When the prostate gland is inflamed, the amount of prostatic fluid secretion decreases, resulting in a decrease in the amount of semen, which is not conducive to the activity of sperm.
(2) When prostatitis, bacteria, bacterial toxins and inflammatory secretions consume the nutrients and oxygen of semen, interfere with the activity of some enzymes, increase the viscosity of semen and make semen jelly after discharge, delaying the liquefaction of semen and preventing the normal activity of sperm.
(3) When prostatitis is present, the pH of semen is often reduced and semen is acidic. When the pH of semen drops to the minimum requirement of 6 for sperm survival, sperm die easily.
(4) In the case of prostatitis, the body is stimulated to produce anti-sperm antibodies, which cause sperm coagulation and affect sperm activity and fertilization ability.
Therefore, patients with abnormal sperm parameters are best treated for prostatitis first, even if there are no symptoms of prostatitis patients, when the sperm parameters are abnormal need to be checked for prostatitis.
10. Do I need to abstain from sex if I have prostatitis?
This is the first time I’ve ever seen a woman with a prostate, and I’ve never seen a woman with a prostate.
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11, go to the hospital to do ultrasound, said prostatitis and prostate enlargement, is not the need for surgery?
The prostate gland in the country has a transverse diameter of about 100px (2.99-132.5px), a vertical diameter of about 75px (1.48-114.5px), an anterior and posterior diameter of about 50px (1.46-98.5px), and a weight of 9.21-31.8g. This shows that the size of the prostate varies from person to person and varies considerably, so it may be normal for young people to have a slightly larger prostate and there is no need to The actual fact is that some people who have not had a baby and have severe symptoms of chronic prostatitis often look for a doctor to cut off the prostate gland is not advisable.
12, take the results of the routine prostate fluid examination and ask: Is my prostatitis heavy? The actual fact is that you can find a lot of people who are not able to get a good deal on this.
The most important thing to look for in a routine prostate fluid examination is lecithin, white blood cells and red blood cells. The normal value of lecithin is usually almost covering the field of view, often marked as ++++ – ++++; less than 10 pack cells; and no or very few red blood cells, if any, less than 10. Therefore, prostate fluid is considered abnormal when the lecithin is less than ++; the inclusion cells are marked as + (each + sign represents 10 white blood cells) or more. However, routine prostate fluid examination alone cannot determine whether the condition is serious or not. Some patients have normal routine prostate fluid examination but have obvious symptoms (this is type IIIB prostatitis, see below); some patients have a full field of white blood cells in routine prostate fluid examination and may not have symptoms.
Therefore, the treatment of prostatitis needs to be based on the severity of the patient’s symptoms and the results of the prostate fluid examination to determine if treatment is needed. The actual fact is that you will need to have a good deal more than just a few of the most popular and most popular products.
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1. What is prostatitis?
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2. How is prostatitis classified? What tests should be done? How is it diagnosed?
The concept and classification of prostatitis is an inseparable unity. According to the presence or absence of pathogenic bacteria, the length of the disease, and the characteristics of the symptoms, it is classified as
Type I: acute bacterial prostatitis.
Type II: chronic bacterial prostatitis.
Type III: chronic prostatitis/chronic pelvic pain syndrome.
Type IV: asymptomatic prostatitis.
The chronic prostatitis/chronic pelvic pain syndrome is the most common type, accounting for about 90 percent of prostatitis. Because of the different typing and treatment, it is important to do typing of prostatitis.
The most common type of prostatitis is a chronic pelvic pain syndrome, which accounts for 90% of all cases. The type IIIA and type IIIB, type IIIA have elevated white blood cell counts in prostate fluid or semen and type IIIB have white blood cell counts in the normal range in prostate fluid or semen. type IV prostatitis has no subjective symptoms and only evidence of inflammation is found during examinations related to the prostate, such as prostate fluid, semen, prostate tissue biopsy, etc. The patient will not take the initiative to see a doctor because type IV prostatitis patients are asymptomatic, but prostatitis has a definite impact on male fertility, and even if there are no symptoms when suffering from male infertility or abnormal sperm parameters, common tests of prostate fluid or semen and bacterial culture are required.
Currently, the diagnosis of prostatitis is based on medical history, physical examination (including rectal examination), routine urine and prostate massage and bacterial culture, application of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) to evaluate pain and urinary symptoms and impact on quality of life, and the “two-cup method”. The company’s main goal is to provide the best possible service to its customers.
The actual fact is that you can find a lot of people who are not able to get a good deal on this.
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4, what are the causes of chronic prostatitis?
(1) Chronic prostatitis is produced by pathogens such as bacteria, chlamydia, mycoplasma and other infections on the one hand.
(2) On the other hand, neuroendocrine abnormalities, anatomical abnormalities of the bladder neck, prostate, urethra, local pathological stimulation of the prostate and urethra lead to abnormal activity of the perineum and pelvic floor muscles, and persistent pain and involvement pain in the corresponding areas other than the prostate; it also causes excessive contraction of the urethral sphincter, leading to bladder outlet obstruction and residual urine formation, causing urine to flow back into the prostate, bringing pathogens into the prostate (3) In addition, prostatitis can cause abnormal urination and pain in the pelvic region.
(3) In addition, the triggering factors of prostatitis include smoking, drinking, spicy and stimulating food intake, inappropriate sexual activity, sedentary, long-term urination, etc., causing long-term congestion of the prostate and chronic extrusion of the pelvic floor muscles; irregular life, fatigue, cold, etc., leading to a decrease in body resistance can cause chronic prostatitis.
The actual fact is that you can find a lot of people who are not able to get a good deal on this. What do you need to pay attention to in your daily life?
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（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. But a short period of sitting will not have a great impact on health, if you keep sitting for a long time, can make the perineum, pelvic organs overly congested, so that these parts of the accumulation of metabolites, leading to prostatitis and other “sedentary disease” occurrence.
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（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 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 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 actual fact is that you will need to be absolutely abstaining from alcohol when you have prostatitis, and if you encounter a party that you can’t resist, it is advisable to drink a small amount of yellow wine or wine and avoid white wine and beer. The actual fact is that you should avoid binge drinking and alcohol abuse if you don’t have prostatitis, and drink a small amount of alcohol.
(3) Caffeine, spicy and other irritating foods: Caffeine, spicy and other foods have an irritating effect on the prostate and urethra, mainly because they cause vasodilation, congestion or edema of the prostate, so avoid eating too much.
(4) Cold stimulation, overexertion: the prostate, bladder neck, posterior urethra and other parts of the a-adrenergic receptor content is high, these receptors are controlled by sympathetic nerves. 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 actual fact is that you can find a lot of people who are not able to get a good deal on this.
（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.
(2) Since chronic prostatitis is not enough to threaten the lives and vital organ functions of patients, not all patients need treatment. Only when.
① when the symptoms of prostatitis affect usual life and work and quality of life is affected.
② when there are no obvious symptoms or mild symptoms but the semen parameters are abnormal or fertility is affected.
③ Regardless of the presence or absence of symptoms and whether fertility is affected, treatment is only needed when it has been clearly identified as bacterial prostatitis.
The goal of treatment for chronic prostatitis with severe symptoms is to relieve pain, improve urinary symptoms and improve quality of life, and the evaluation of efficacy is based on symptom improvement; if fertility and semen parameters do not improve significantly after treatment of prostatitis, the causes of fertility and semen parameters should be further investigated.
(3) The current treatment methods supported by evidence-based medicine mainly include taking a-blockers, botanical preparations, anti-inflammatory and analgesic drugs, antidepressants and anti-anxiety drugs, M-blockers, Chinese herbal medicine and two or several other drug treatments, together with psychological and behavioral counseling, life and diet changes, prostate massage, prostate physiotherapy and other comprehensive treatments, and if it is clear that prostatitis is caused by pathogenic bacteria, at the same time
It is worth mentioning that the society now exaggerates the propaganda on the treatment of prostatitis and some diseases that are not prostatitis are attributed to prostatitis and take excessive treatment.