Mechanism of Pain in Chronic Prostatitis

Date:2020-04-18 click:

Chronic prostatitis(CP) is a common disease in urology, and its treatment is challenging. Pain is the main symptom. Although the etiology of CP is different, pain is the main manifestation, and there is no difference in the nature and characteristics of pain. Some scholars think that CP may originate from a single etiology, multiple factors involved, and eventually develop into a chronic neuropathological state.
More and more scholars begin to pay attention to the research on the mechanism of CP pain. There are several theories about the mechanism of pain:
 
Spasmodic pain of pelvic floor muscles
 
In the urodynamic study of CP patients, it was found that the maximum and average flow rate decreased, the maximum urethral closure pressure increased abnormally during the rest period, the external sphincter was partially relaxed, and there were different degrees of bladder or/and urethral muscle dysfunction, which had no difference between the patients with chronic prostatitis and those with chronic prostatitis.
 
The above phenomenon shows that the pathological changes of the prostate itself are not necessarily the direct cause of pain. At the same time, some patients with CP can reduce pain symptoms by prostate or pelvic floor massage. Therefore, many scholars think that CP pain is a kind of spasmodic pain of pelvic floor muscles.
 
Some scholars also think that CP pain is a kind of spasmodic reflex pain of pelvic floor and perineum muscle caused by spinal cord reflex after prostate stimulation.
 
At the same time, the spasticity of the pelvic floor muscle group and the dysfunction of bladder neck make the pressure of prostate urethra increase during urination, the urine in urethra flows into prostate reversely, resulting in the urine reflux in the prostate, thus causing "chemical prostatitis," forming a vicious circle of pelvic floor muscle dysfunction and prostatitis, leading to intractable pain.

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