Chronic Prostatitis - An Infectious Disease?

Date:2020-04-21 click:0
Chronic prostatitis refers to the chronic inflammation of prostate tissue caused by various causes, which is the most common disease in urology. It includes chronic bacterial prostatitis and chronic nonbacterial prostatitis.

Causes
 
Among them, chronic bacterial prostatitis is generally caused by pathogen infection, retrograde infection is more common, and Staphylococcus is the main pathogen. There is often a history of recurrent urinary tract infection or persistent pathogens in the prostatic massage fluid.
 
Non-bacterial prostatitis is a complex pathological change of inflammation, immunity, and neuroendocrine, which is caused by many complicated causes and inducements. It leads to the main clinical manifestations of urinary tract irritation and chronic pelvic pain and often combined with mental and psychological symptoms. The course of the disease is long, and the condition is recurrent.
 
Symptoms
 
1. Pain
 
The pain symptoms are mainly manifested in the pain of the prostate as the center and radiating the surrounding tissues, which are common in the scrotum, testicles, abdomen, perineum, lumbosacral, medial thigh and other parts.
 
2. Urination problems
 
It is manifested as frequent and urgent urination, painful urination, burning of the urethra, residual urine, or white secretion overflowing from the urethra in the morning, at the end of urination or defecation.
 
3. Psychoneurosis
 
Patients often have dizziness, tinnitus, insomnia, anxiety and depression, or even impotence, premature ejaculation, spermatorrhea and so on.
 
Diagnosis
 
Detailed medical history, comprehensive physical examination (including digital rectal examination), routine urine and prostate massage fluid examination are generally required. It is recommended to use NIH chronic prostatitis symptom index for symptom scoring. Two cup method or four-cup method is recommended for the pathogen location test.
 
In order to make the diagnosis clear and differential diagnosis, the following examinations can be selected: 
 
1. semen analysis or bacterial culture
2. prostate-specific antigen
3. urine cytology
4. transabdominal or transrectal ultrasound (including residual urine measurement)
5. urine flow rate
6. Urodynamics
7. CT
8. MRI
9. Cystoscopy and prostate puncture biopsy
 
Treatment
 
Chronic bacterial prostatitis
 
Treatment is mainly based on oral antibiotics, and sensitive drugs are selected. The course of treatment is 4-6 weeks, during which the patients should be evaluated in stages. If the efficacy is not satisfactory, other sensitive antibiotics can be used. α - blocker can be used to improve the symptoms and pain of micturition. Plant preparations, NSAIDs and M-receptor blockers can also improve the symptoms.
 
Chronic nonbacterial prostatitis
 
Take antibiotics orally for 2-4 weeks, and then decide whether to continue the antibiotic treatment according to its curative effect feedback. It is recommended to use α - receptor blocker to improve micturition symptoms and pain, as well as plant preparations, non-steroidal anti-inflammatory, and analgesic drugs and M-receptor blockers to improve micturition symptoms and pain.
 
The main therapeutic objectives of chronic prostatitis are to relieve pain, improve micturition symptoms, and improve quality of life.
 
It is also recommended to treat prostatitis with traditional Chinese herbal medicine Diuretic and Anti-inflammatory Pill for treatment. It is made up of more than 50 varities of natural herbs with functions of clearing heat and detoxification, promoting blood circulation and removing blood stasis through reasonable compatibility, therefore, it will not produce any side effects or adverse reactions on patients. Besides, it can also enhance human's resistance to prevent recurrence.
 
Prevention
 
1. Avoid alcohol, spicy and greasy food.
 
2. Develop good and regular living habits, strengthen exercise, combine work with rest, and avoid holding urine, sitting, or cycling for a long time.
 
3. Keep sex regular
 
4. Keep the prostate area warm.
 
5. Adjust emotion, keep in an optimistic mood, and massage prostate moderately.

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