Chronic Nonbacterial prostatitis
Chronic nonbacterial prostatitis(CNBP), or chronic noninfectious prostatitis(CNIP), can be divided into the inflammatory type and noninflammatory type, which are respectively called Type ⅢA and type ⅢB.
It is generally believed that the cause of the disease is various clinical manifestations caused by tension pain of detrusor, urinary sphincter, or pelvic muscle. Some unusual pathogens (such as anaerobes, mycoplasma, chlamydia, or other protozoa, viruses, etc.) may also be the causes.
Scientists have tried to prove to be the cause of nonbacterial prostatitis, but they have not been successful. There are many conjectures that mycoplasma is related to abacterial prostatitis, but there is no sufficient evidence that there is no obvious causal relationship between mycoplasma and abacterial prostatitis.
Some researchers believe that abacterial prostatitis is an immune disease, and the diagnosis of abacterial prostatitis can only be determined after excluding another specific prostatitis.
Symptom
In addition to urinary tract infections, clinical symptoms and signs of nonbacterial prostatitis are similar to those of bacterial prostatitis. In the case of these symptoms, the patient should see a doctor in time; untimely treatment will have adverse consequences.
Urinary issues: frequent urination, urgent urination, urodynia, nocturia, incomplete bladder emptying, urinary hesitancy, white discharge after urination, etc.;
Sexual dysfunction: premature ejaculation, erectile dysfunction, premature ejaculation, weak ejaculation, low libido, impotence, spermatorrhea, etc.;
Pain: pain while urinating, testicular swelling, abdominal pain, perineum pain, foreign body in the urination, ejaculatory pain, pain in the thigh root, and other radiation areas.
Systemic symptoms: insomnia, dreaminess, hair loss, cold hands and feet, memory loss, wet scrotum, etc.
The majority of urination problems are hyperplastic patients. Pain and systemic symptoms usually occur in the middle and late stages of the disease.
Diagnosis
Detailed medical history, comprehensive physical examination (including digital rectal examination), routine urine, and prostate massage fluid examination are required. It is recommended to use NIH chronic prostatitis symptom index for symptom scoring. The two-cup method or four-cup method is recommended for the pathogen location test.
In order to make clear the diagnosis and differential diagnosis, the following examinations can be selected: semen analysis or bacterial culture, prostate-specific antigen, urine cytology, transabdominal or transrectal ultrasound (including residual urine measurement), urine flow rate, urodynamics, CT, MRI, cystoscopy, and prostate puncture biopsy.
Harm
1. Decreased sexual ability
Prostatitis can cause men's sexual activity nerve and nerve center to appear excited state often, but if going out the excited state for a long time, it is easy to cause men's sexual excitement to be inhibited, thus inducing men to appear sexual function is low.
2. Induced gynecological diseases
Due to the infection of some bacteria and induced prostatitis in men, and these bacteria can take a chance to enter into the female reproductive organs, leading to gynecological inflammation.
3. Endocrine disorders
A healthy prostate can secrete a variety of active substances, but with prostatitis, it is easy to cause secretion to be affected, resulting in male endocrine disorders, resulting in dizziness, fatigue, and other symptoms.
4. Affect normal life and work
Chronic prostatitis can lead to a variety of symptoms, such as frequent urination, urgent urination, and incomplete bladder emptying, so that patients often lose control of their emotions and are restless, thus affecting the normal life and work.
5. Infection of other adjacent organs
When prostatitis is not treated in time, it is easy to cause the spread of inflammation, thus infecting the adjacent organs and inducing the emergence of inflammation.
Treatment
1. Western medicine
1.1 drug treatment
The most commonly used drugs are antibiotics, α- receptor blockers, plant preparations, and nonsteroidal anti-inflammatory and analgesic drugs. Other drugs also have different degrees of efficacy in relieving symptoms.
Antibiotics
In the clinical practice of treating chronic nonbacterial prostatitis, the most commonly used first-line drug is antibiotics, but only about 5% of chronic prostatitis patients have a clear bacterial infection.
Inflammatory type:
Most of the treatment of inflammatory antibiotics is empirical. The theoretical basis is to speculate that some pathogens with negative conventional culture lead to the occurrence of this type of inflammation. Therefore, it is recommended to take antibiotics such as fluoroquinolone for 2-4 weeks, and then decide whether to continue antibiotic treatment according to the efficacy feedback.
It is recommended to continue to use antibiotics only when the clinical symptoms are relieved. The recommended course of treatment is 4-6 weeks.
Noninfectious type:
α - receptor blocker
Plant preparation
Nonsteroidal anti-inflammatory and analgesic drugs
M-receptor blockers
Antidepressants and anxiolytics
1.2 physical therapy
It can promote the local blood circulation of the prostate gland, effectively increase the permeability of the prostate gland bubble and gland tube of the patient, and make the inflammation subside.
At the same time, it can also destroy or prevent the α 1A receptor in the prostate tissue and bladder neck and other important parts of the patient, making the smooth muscle degeneration in the prostate matrix necrosis and rupture, and effectively reduce the pressure of the patient's posterior urethra. It can greatly reduce the urine reflux in the prostate, and then effectively reduce the symptoms of the patients.
It can relieve symptoms in a short time, but its long-term effect is not clear. It is not recommended for unmarried and unborn people. Some clinical scientists advocate periodic prostate massage, but some scholars doubt its efficacy.
Due to the complexity and diversity of etiology, the psychological pressure of patients, the treatment of chronic nonbacterial prostatitis is challenging. A large number of data studies show that traditional Chinese medicine has a significant curative effect on it, the symptoms of discomfort, dysuria and pain can be significantly improved, the quality of life can also significantly improved, and the clinical application effect is better, such as the common herbal medicine Diuretic and Anti-inflammatory Pill.
Prevention
1. Avoid frequent sexual life or abuse of aphrodisiac;
2. Avoid frequent interruption of sexual intercourse or holding back ejaculation;
3. Avoid abstinence for a long time;
4. Avoid eating spicy food, other irritating foods, drinking, or smoking.
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