How Does Chronic Prostatitis Cause Urinary Issues?

Date:2020-04-21 click:0
The mechanism of urinary issues caused by chronic prostatitis is complex and unclear, and a single mechanism can not explain all kinds of manifestations satisfactorily.

1. Functional posterior urethral obstruction
It is the most commonly used mechanism. Other scholars also think that the autonomic contraction of the external sphincter of the urethra is the cause of this kind of obstruction. This autonomic contraction is due to the dysfunction of the sympathetic nerve in the pelvic cavity, which can lead to the spasm of the external sphincter and the stricture of the urethra.
Obstruction can increase the internal bladder pressure and smooth muscle hypertrophy, and eventually lead to the decrease of the density of nerves related to the smooth muscle innervating the bladder and urethra, so as to be in a state of denervation, which can induce the detrusor to contract without inhibition and form an unstable bladder and lead to urinary issues.
2. Local stimulation factors of prostate
The local prostate is stimulated by various inflammatory or noninflammatory factors, resulting in cell and interstitial edema, narrowing of the prostate urethra, increasing of pressure, resulting in urine flowing back into the prostatic duct and peritubular tissue, resulting in "chemical prostatitis," forming continuous stimulation, and recurrent dysuria.
Clemens and others think that local stimulation of the prostate may cause habitual contraction and spasm of pelvic floor muscles, which may lead to tension myalgia of the posterior pelvic floor through some mechanism, and thus lead to urinary issues.
3. Mental and psychological factors
Psychological factors are one of the important causes of CP dysuria, especially mental depression, which leads to the aggravation of urinary symptoms score and the significant decline of quality of life; psychological investigation shows that patients have emotional disorders, different degrees of social psychological or sexual psychological abnormalities, and even suicidal tendencies.

The local inflammatory reaction and mental disorder of the prostate can increase the excitability of local α one adrenergic receptors and aggravate the symptoms of neuromuscular dysfunction of the posterior urethra. They interact with each other to form a cascade reaction.
Abnormal urination is easy to recur, which in turn aggravates the mental and psychological disorders of the patients, and can even manifest as the mental frequency of urination.
4. Possible neural reflex between prostate and bladder
Some CP patients have urinary issues, but there is no obvious cause for it. Many scholars have found that there is a neural reflex between the internal organs and internal organs, between the internal organs and some parts of the body, which can affect the corresponding function of another organ through the stimulation of one organ or one part of the body.
It has been found that the injury afferent pathways of the two internal organs, prostate, and bladder, have the same or similar control areas in the spinal cord center, and the painful inflammatory stimulation of prostate may activate the pain afferent nerves of the bladder at the same time.

It is reasonable to think that there should also be nerve reflexes between prostate and bladder. When the current row gland is stimulated by various kinds of injurious factors, it can cause the change of bladder function through this nerve reflex mechanism, and then urinary problems will appear. This may be a new mechanism, which needs further study.
5. Other factors
Some scholars think that pelvic venous diseases can induce CP and cause dysuria; in addition, structural and functional abnormalities of adjacent organs of the prostate can also affect the occurrence and development of prostatitis and urinary issues.

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