Overview
The etiology of chronic prostatitis is complex, and although there is a considerable degree of understanding of its numerous pathogenesis, none of it has been groundbreaking. It is now believed that chronic prostatitis may be due to primary or secondary diseases of the prostate and its surrounding tissues and organs, muscles and nerves, and that even after these diseases have been cured or completely eradicated, the damage and pathological changes caused by it(them) continue to act independently, and that the etiology may center on a combination of infection, inflammation and abnormal pelvic floor neuromuscular activity.
Hazards
2, induced female gynecological disease: due to some bacterial infection and induced male prostatitis, it is easy to lead to sex, these bacteria into the female reproductive organs, so that women are infected, induced gynecological inflammation.
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Symptoms
The symptoms of chronic prostatitis are complex and varied, sometimes easily confused with simple neurasthenia, not very satisfactory in terms of therapeutic effect, the standard of treatment is not uniform. From the clinical manifestations patients can have signs of urethral irritation, frequent urination, urinary urgency, burning pain in the urethra, mucus, mucus filaments or purulent discharge from the urethra in the early morning, cloudy urine or white liquid flow from the urethra after defecation, discomfort in the posterior urethra, perineum and anus, sometimes pain in the penis, testicles and groin, accompanied by painful ejaculation, hematemesis, premature ejaculation, impotence and symptoms of vegetative nerve dysfunction such as weakness, dizziness, insomnia and melancholy.
1, urinary discomfort: bladder irritation may occur, such as frequent urination, burning and pain in the urethra during urination and radiating to the head of the penis. In the morning, there can be mucus and other secretions at the urethral opening, and there can also be a feeling of difficulty in urination.
2, local symptoms: the posterior urethra, perineum and anal swelling discomfort, squatting, defecation and sitting on a chair for a long time will feel increased swelling and pain.
The pain of chronic prostatitis is not limited to the urethra and perineum, but also radiates to its vicinity, most often to the lower back pain. In addition, the penis, spermatic cord, testicles scrotum, small abdomen, inguinal area (root of thigh), thighs, rectum and other places can be involved.
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6, chronic prostatitis caused by low back pain and orthopedic causes of low back pain, such as myofasciitis, lumbar muscle strain, etc. easily confused, but the latter is more near the belt tie, than prostatitis caused by low back pain location is high.
1, reduce sperm vitality Prostate fluid is necessary for sperm survival, because the enzymes, lecithin and trace elements contained therein can provide energy and nutrition to the sperm, and when the disease decreases the secretion of these nutrients, the sperm vitality is reduced.
2, non-ejaculation or reverse ejaculation Prostatitis may lead to non-ejaculation or reverse ejaculation, resulting in sperm not being able to enter the vagina naturally and infertility.
3, increased acidity in the patient’s body increases the acidity of the semen, making it unsuitable for sperm survival and leading to reduced sperm viability.
4, semen is not liquefied patient semen liquefaction process will be affected, so that sperm vitality is reduced, resulting in infertility.
5, the role of bacterial toxins The pathogenic microorganisms and bacterial toxins contained in the prostatic fluid of patients with prostatitis enter the semen and can directly kill sperm, causing dead sperm, deformed sperm, decreased viability, anti-sperm antibodies, and reduced sperm acrosome enzyme activity, finally leading to male infertility.
Diagnosis
1, prostate pain: these patients show persistent frequent urination, painful urination, difficulty in urination, pain and discomfort in the perineum, lower abdomen and lumbosacral area, aggravated after prolonged sitting and cycling. The rectal examination shows significant pressure pain on both sides of the anal levator muscle and normal palpation of the prostate without pressure pain. In the past, this syndrome was called pear-shaped muscle anal raphe syndrome, the prostate fluid microscopy is normal, bacterial culture without growth.
2, prostate abscess: most of the complications of acute bacterial prostatitis, mostly occurring in the 50 to 60 years of age, half of the patients have acute urinary retention, urinary frequency, difficulty urinating, rectal discomfort, urethral flow, and some are accompanied by epididymitis. The prostate gland is enlarged on the diseased side of the rectal finger, soft to touch, and has a fluctuating sensation. Occasionally, prostate abscesses can break naturally to the urethra and also to the rectum and be mistaken for perirectal abscesses.
3, prostate stones: refers to stones that occur in the prostate alveoli and within the ducts of the prostate gland. This is a good way to get the most out of your life. Inorganic salts such as calcium oxalate, calcium phosphate, magnesium phosphate, etc. are deposited on amyloid bodies, epithelial cells and inflammatory exudates in the prostate alveoli to form stones. Patients can show various symptoms of chronic prostatitis, but rectal examinations can look for stones rubbing sensation in the prostate, pelvic x-ray has a positive stone shadow on the side of the pubic symphysis area, and ultrasound examinations can show strong light bands with acoustic shadow at the prostate stone site.
4, prostate tuberculosis: symptoms are similar to chronic prostatitis, but there is often a history of urological tuberculosis or other sites of tuberculosis lesions, rectal examination of the prostate is irregularly nodular, the epididymis is enlarged and hardened, the vas deferens has beads of hard nodules, the prostate fluid tuberculosis bacillus direct smear or pcr test has tuberculosis bacteria.
5.Prostate cancer: symptoms such as frequent urination, painful urination and difficulty in urination can appear in late stage, but patients often have obvious systemic symptoms such as emaciation, weakness, anemia, loss of appetite, etc. There is a hard stone like lump in the prostate gland with uneven surface on rectal examination, and the serum prostate-specific antigen and prostatic acid phosphatase are increased.
The prostate puncture biopsy can reveal cancer cells. ultrasound examination can reveal enlarged gland with uneven border echogenicity or defect, uneven internal light spots, brighter light spots or light clusters at the site of cancer. ct examination can reveal asymmetric prostate morphology, and if the tumor infiltrates to the outer envelope, the tissue gap between the seminal vesicle and the posterior bladder wall can be seen to disappear. ct can determine the degree of infiltration of prostate cancer.
6.Pubic osteitis: clinically it often shows the symptoms of chronic prostatitis, but the anal examination and prostatic fluid examination are normal. The main features are obvious pressure pain at the pubic symphysis, pelvic x-ray showing widening of the pubic symphysis gap >10 mm, bilateral difference of >2 mm in the level of the superior pubic branch, irregularity of the pubic symphysis margin, erosion and reactive osteosclerosis.