Granulomatous prostatitis is a non-specific inflammation with multiple tissue patterns. It is related to local strong foreign body reaction. The leading factor is the obstruction of the prostate duct, and the causes include inflammation caused by a bacterial infection or tissue necrosis caused by surgical trauma.
Hyperplasia of the prostate may also cause or aggravate the obstruction of the prostate duct. The prostate induration or diffuse lump can be found through digital rectal examination, which is difficult to distinguish from prostate cancer.
The pathogenesis of granulomatous prostatitis is unknown, which is related to the strong foreign body reaction. The primary factor is obstruction of the prostate duct, which is caused by inflammation caused by a bacterial infection or tissue necrosis caused by surgical trauma.
Prostate hyperplasia may also cause or aggravate obstruction of the prostate duct. Infection and inflammation destroy ducts and glandular epithelium. Then cell debris, bacterial toxins, and prostate secretions enter the interstitial space and become foreign bodies in the matrix, triggering a granulomatous inflammatory response.
Granulomatous inflammation may be limited or involve the entire prostate. Inflammation relieves slowly and takes 2 to 3 months. Locally, it is replaced by fibrous connective tissue and the texture changes. The clinical manifestations of granulomatous prostatitis are typical. All patients have a history of recurrent lower urinary tract infections. Some patients have a history of prostatic trauma or allergic diseases.
Common clinical symptoms include chills, fever, frequent urination, urgency, pain and difficulty in urination, and even acute urinary retention. A digital rectal examination can palpate multiple or single hard nodules of the prostate.
The treatment of granulomatous prostatitis should be based on the different causes of drug selection, local physiotherapy, or surgical treatment.
1. Most cases can be observed and healed without treatment, but the disappearance of nodules takes months to years.
2. Patients with severe local and systemic infections need anti-infective treatment, usually 1-3 weeks to control symptoms.
3. Unless severe urinary tract obstruction occurs, surgery is often not required. If there is no serious lower urinary tract obstruction, it can be temporarily observed.
Oral anti-inflammatory drugs and anti-prostatic hyperplasia drugs or traditional Chinese medicine Diuretic and Anti-inflammatory Pill not only has the effects of clearing heat and detoxification, activating blood circulation and removing blood stasis, promoting diuresis and relieving stranguria but also can effectively sterilize, diminish inflammation and detumescence. If the obstruction is serious, TURP can be considered
Granulomatous prostatitis patients usually have a good prognosis, while allergic prostatitis ones may have a poor prognosis. The majority of patients relieved symptoms and disappeared sclerosis within a few months. If not, it may be related to the fibrosis of the lesion. The recurrence rate is not high. Prostate cancer occurs in some patients several years after the symptoms of the disease have been relieved, which should be paid attention to.