Chronic Bacterial Prostatitis

Chronic bacterial prostatitis is a complex pathological change of prostatic inflammation, immunity, and neuroendocrine, which is caused by a variety of complex causes and inducements, resulting in the main clinical manifestations of urinary tract irritation and chronic pelvic pain.

 

 

 

As the name implies, it is caused by a bacterial infection. Staphylococcus and Escherichia coli (also known as Escherichia coli) are the most common pathogenic bacteria. It can also be caused by bacterial infection of surrounding organs and the prostate. Its etiology is very complex, pathogens, dysuria, psycho mental factors, neuroendocrine, immune response, oxidative stress, pelvic abnormalities, urothelial dysfunction, etc., may lead to inflammation of the prostate. There is also often accompanied by a history of chronic urinary tract infection.

 

There are three ways of infection:

 

Bacterial prostatitis can be caused by a blood infection, which is secondary to skin, tonsil, teeth, intestinal tract or respiratory tract infection, and can cause prostate infection through infectious bacteremia;

 

It can be directly spread through the urethra, such as urinary tract infection, urine return to prostate, and anterior urethra infection, up to prostate;

 

It can also be caused by lymphatics, inflammation of adjacent organs such as the lower urinary tract of rectum and colon, and prostatitis by lymphatics.

 

 

 

Pain: There is a burning sensation in the urethra, formication, pain in the perineum, anus area and lower abdomen, penis, testicles, and so on.

 

Urinary issues: When inflammation involves urethra, patients may have mild frequent urination, urgent urination, painful urination, and mucus or purulent secretion that may be discharged from urethra before the first-morning urine or during bowel movements.

 

Sexual dysfunction and infertility: Patients may have decreased libido, impotence, premature ejaculation, ejaculatory pain, increased frequency of spermatorrhea, etc. It may also affect the quality of semen, cause problems such as non-liquefaction of semen, decreased sperm motility, and infertility.

 

Neurasthenia symptoms: Due to the patient's lack of correct understanding of the disease or recurrent condition, there may be depression, fatigue, insomnia, etc.

 

 

 

 

In male patients with acute or chronic urethritis, prostatitis may be indicated. The location of inflammation and infection can be generally determined by culturing or staining the segmental specimens of the urinary tract, bladder, or prostate secretion.

 

Cystitis can sometimes be confused with chronic bacterial prostatitis, and it is easy to be complicated with cystitis when the prostate is infected. The above-mentioned subsection urine specimen and prostate secretion specimen can be used for microbiological examination and culture to identify the infected site.

 

If cystitis is complicated with bacterial prostatitis, the presence of prostatic infection can be confirmed by killing the bacteria in the bladder after appropriate antibiotic treatment (antibiotics that are difficult to diffuse in the prostate, such as nitrofuran, penicillin G) and repeated bacterial culture.

 

Anal diseases (such as anal fissure, thrombotic hemorrhoids) can cause pudendal pain or even frequent urination, but physical examination should be able to distinguish them.

 

 

The recurrence of urinary tract infection is the characteristic of chronic bacterial prostatitis. Although the symptoms and signs of urinary tract infection can be eliminated rapidly after the bacteria in the urine are killed during the appropriate antibacterial treatment, the infection caused by the same bacteria is easy to reoccur after a period of time after treatment.

 

Due to the complete killing of bacteria in the urine, the pathogenic bacteria in the prostate remain unchanged because most of them are resistant to antibiotics It is difficult for biotin to penetrate into the prostatic fluid, so after the treatment, the bacteria remain in the prostate, which will eventually cause urinary tract reinfection.

 

Ascending upper urinary tract infection and bacterial epididymitis may also be complications of chronic bacterial prostatitis. It may also form infectious prostatic stones and lead to chronic infection, which is difficult to be treated by drugs. Sometimes chronic bacterial prostatitis may be complicated with urethral bladder obstruction caused by bladder neck contracture, but whether there is a causal relationship between them is unclear.

 

 

 

 

Because the predisposing factors have not been determined, it is difficult to prevent the disease. The normal prostatic fluid contains zinc, which is a powerful antibacterial factor. In the chronic bacterial prostatitis patients, the zinc content in the prostatic fluid is significantly reduced.

 

Some authors think that this antibacterial factor in the male prostatic fluid is a natural defense against the upward infection of the genitourinary system. However, oral administration of zinc to male patients can not stimulate the increase of zinc content in prostatic fluid.

 

Therefore, it is necessary to actively treat acute bacterial prostatitis and prevent the occurrence of chronic bacterial prostatitis. Strict aseptic technology should be used to prevent iatrogenic infection of presplitic gland during transurethral device examination and catheterization.

 

 

 

 

 

Pharmacokinetic studies and clinical experience have shown that only a few antibiotics can achieve an effective therapeutic concentration in prostate secretion under the condition of nonacute prostatitis. TMP can penetrate into prostatic fluid, and it has been proved that TMP can successfully cure chronic bacterial prostatitis caused by sensitive bacteria. Long-term treatment (12 weeks) is more effective than short-term treatment (2 weeks).

 

The principle of individual differences must be considered in special treatment, and the patient's tolerance to drugs must also be considered. Most of the patients with chronic bacterial prostatitis can rarely be cured by medical treatment, but as long as the appropriate oral medicine is used daily to maintain a small dose of inhibitory treatment to ensure sterility in the urine. If inhibition therapy is interrupted, urine will be reinfected, and symptoms will reappear.

 

 

Whether chronic prostatitis can be cured by medical treatment or not, surgical treatment can be carried out. Because it is difficult to cure prostatitis with calculi only by antibiotics, chronic prostatic infection and calculi are often indications for operation.

 

Unfortunately, surgical complications (sexual dysfunction and urinary incontinence) limit the choice of this procedure. If transurethral prostatectomy can completely remove the infected tissues and stones, prostatitis will be cured, but it is difficult to achieve this effect because there are a large number of infection focus around the prostate.

 

 

A warm sitz bath can relieve symptoms, anti-inflammatory drugs (indomethacin, ibuprofen), and anti bilinergic drugs (prubenoxin, etc.) can relieve the symptoms and pain of urinary irritation.

 

 

 

 

Traditional Chinese medicine(TCM) believes that chronic bacterial prostatitis is mainly due to the low immunity of the body and the excessive dampness and internal heat in the body. TCM emphasizes holistic concept and syndrome differentiation.

 

Therefore, the most important feature of TCM in treating diseases is to adjust the functions, balance and coordination of organs. The anti-inflammatory function is not enough; the key is to enhance immunity, so as to fundamentally cure chronic bacterial prostatitis and prevent a recurrence.

 

Herbal medicine Diuretic and Anti-inflammatory Pill contains more than 50 kinds of herbal ingredients such as plantain, safflower, peach kernel, Houttuynia cordata, cowherb seed, etc., which can activate blood circulation and remove blood stasis, promote vital energy and relieve pain, effectively kill all kinds of pathogenic bacteria and inflammation.

 

Besides, it can treat not only prostatitis, but also other reproductive system inflammation, such as seminal vesiculitis, cystitis, orchitis, and urethritis. It completely meets the requirements in the treatment of chronic bacterial prostatitis, as well as help patients, improve the internal environment of the urogenital system, enhance immunity, so as to achieve the effect of getting a thorough cure and preventing recurrences.