Non-gonococcal prostatitis

Introduction to non-leaching prostatitis Non-gonococcal prostatitis, also known as aseptic prostatitis, its causes mainly include chlamydia, mycoplasma, viral infection, prostate congestion, urine reflux, and psychological factors, immune factors. Statistics show that chronic non-bacterial prostatitis accounts for 64% to 90% of patients with prostatic inflammation, which is a common and frequently-occurring disease in young and middle-aged men. There may be abnormal urination: urgency, frequent urination, dysuria, urinary urinary tract, urinary tract burning, white turbid secretions in the urethra at the end of the stool or at the end of urination, commonly known as urine white. Pain: often occurs in the lumbosacral region, lower abdomen, perineum, pubis, groin, testis, spermatic cord, etc., the pain is mild, mostly intermittent. Male scrotum is large and flexible, and it has more sweat secretion. In addition, the genital ventilation is poor, and it is easy to hide dirt. Local bacteria often take advantage of it. This will lead to prostatitis, enlarged prostate, and decreased sexual function. A serious infection has occurred. Therefore, pay attention to cleanliness in life. basic knowledge The proportion of illness: 0.001% Susceptible people: more common in young and middle-aged men Mode of infection: non-infectious Complications: urinary retention, seminal vesiculitis, epididymitis

Causes of non-leaching prostatitis

Non-infectious factors (30%):

(1) Repeated hyperemia of the prostate: It is believed that frequent and excessive sexual stimulation causes repeated hyperemia of the prostate is one of the causes of chronic prostatitis in young adults;

(2) Urine reflux: Because many adult males have found stones in the prostate through B-ultrasound examination, but X-ray films cannot be detected;

(3) Immune factors: Many scholars have found that IgA, IgG, and IgM in the prostatic fluid of patients with chronic prostatitis are elevated, especially IgA is elevated;

(4) Stress factors: Some studies have suggested that tension can cause non-gonococcal prostatitis, without drugs, without prostate massage, but only for the purpose of relaxation for the purpose of behavioral therapy for non-gonococcal prostatitis, and even put forward "tension of the prostate "Inflammation" to name this type of disease. But the same question is whether tension is the starting factor (cause) or the end performance (result), and there is still insufficient basis.

Life factor (30%):

(1) Atrioventricular factors: young and middle-aged men, active in thought and sexual desire. If there is excessive and frequent sexual stimulation, the penis will continue to erect, but there is no normal, complete ejaculation process.

(2) Have had non-marital sex. The sensation of gonococcal virus. Do not pay attention to health care in the later stage of treatment.

(3) Dietary factors: eating spicy spicy food, excessive drinking, etc., not only breeds damp heat, but also tends to be disordered after drinking.

(4) Living factors: driving, office, etc. can not afford to sit for a long time; or drinking less water; or urinating.

(5) Other undesirable factors: wading, rain, cold and cold.

Infectious factors (20%):

(1) Mycoplasma infection;

(2) viral infection;

(3) Chlamydia infection.

Non-leaching prostatitis prevention

1. Keep it clean. Male scrotum is large and flexible, and it has more sweat secretion. In addition, the genital ventilation is poor, and it is easy to hide dirt. Local bacteria often take advantage of it. This will lead to prostatitis, enlarged prostate, and decreased sexual function. A serious infection has occurred.

2, do not urinate. Once the bladder is filled with urine, it should be urinated, and urine is not good for the bladder and prostate. Before taking a long-distance bus, you should empty the urination and then take the bus. If you are urinating on the way, you should greet the driver and get rid of the urination. Don't be hard.

3. Moderate life. To prevent prostate hypertrophy, it is necessary to pay attention from the young and middle-aged. The key is to have a moderate sex life, and not to abstain from sex. Sexual life frequently causes the prostate to be in a state of hyperemia for a long time, causing the prostate to enlarge. Therefore, especially in the youth period when sexual desire is relatively strong, pay attention to the restraint life, avoid repeated hyperemia of the prostate, and give the prostate full recovery and dressing time. Of course, excessive abstinence can cause discomfort and discomfort, as well as the prostate.

Non-leaching prostatitis complications Complications, urinary retention, seminal vesiculitis, epididymitis

1. The complications that are easily caused by acute prostatitis are:

(1) Acute urinary retention: Acute prostatitis causes local congestion, swelling, and compression of the urethra, resulting in difficulty in urinating or causing acute urinary retention.

(2) Acute seminal vesiculitis or epididymitis and vas deferens: acute inflammation of the prostate easily spreads to the seminal vesicle, causing acute seminal vesiculitis. At the same time, the bacteria can retrograde through the lymphatic vessels into the parietal wall and sheath of the vas deferens leading to epididymitis.

(3) The lymph nodes of the spermatic cord are swollen or tender: the prostate and the spermatic cord have traffic branches in the pelvis, and the acute inflammation of the prostate affects the spermatic cord, causing the lymph nodes of the spermatic cord to be swollen and accompanied by tenderness.

(4) Sexual dysfunction: acute inflammatory phase of prostate congestion, edema or small abscess formation, may have ejaculation pain, painful erection, loss of libido, sexual intercourse pain, impotence, blood essence and so on.

(5) Others: Acute coronitis may be accompanied by renal colic.

The above symptoms are not present in all cases, and some have only fever, urinary tract burning, and are mistaken for a cold. Acute bacterial prostatitis can also be complicated by orchitis, seminal vesiculitis and vas deferens.

2. Complications of chronic prostatitis include

(1) The impact on sexual function and fertility: mainly manifested as sexual dysfunction, such as short room time or premature ejaculation, may be related to the inflammatory stimuli of the prostate. The relationship between impotence and prostatitis is not certain. Chronic prostatitis does not directly impair the neuro-vascular function of penile erection. Long-term discomfort creates pressure on the patient's mind, causing them to suppress and worry, especially for patients who do not understand the disease often think that their sexual function is problematic. Over time, it may cause mental impotence. Blood may be present when prostatitis complicated with seminal vesiculitis.

The main component of semen is prostatic fluid, and the sperm excreted from the testis and epididymis must have the ability to bind to the egg through the nutrition and transportation of seminal plasma including prostatic fluid. In patients with chronic prostatitis, the semen routine is often characterized by lower sperm motility and higher mortality. The incidence of infertility in patients with prostatitis is significantly higher than in the normal population.

(2) Effects on the whole body: In addition to the symptoms of local urinary system, chronic prostatitis can also manifest as allergic iritis, arthritis, endocarditis, myositis and the like.

Patients with chronic prostatitis often show obvious mental symptoms. Patients are emotionally stressed and stressed. In the long run, they can cause general malaise, insomnia, multiple dreams, fatigue, illness and anxiety. These patients often pay too much attention to their health. And looking for evidence in many ways to confirm that it is difficult to change their suspicion regardless of how patiently patiently interpret them. Although patients are often skeptical about the interpretation and treatment of physicians, the psychology of seeking treatment is quite urgent. The relationship between prostatitis and mental symptoms is still unclear. Why does mental stress lead to prostatitis? How does prostatitis produce neuropsychiatric symptoms? It is worthy of further study. Psychotic symptoms are directly related to the individual's personality traits, so individuals with different chronic prostatitis can show varying degrees of mental symptoms.

Non-leaching prostatitis symptoms Common symptoms Male sexual dysfunction ejaculation pain back pain with frequent urination, urine... Loss of libido, poor urination, prostaglandin synthesis, reduced urination pain

1, abnormal urination : urgency, frequent urination, dysuria, urinary dysfunction , urinary tract burning, white turbidity secretions in the urethra at the end of the stool or urinary tract, commonly known as urine white.

2, pain : often occurs in the lumbosacral region, lower abdomen, perineum, pubis, groin, testis, spermatic cord, etc., the pain is mild, mostly intermittent.

3, low sexual function : loss of libido, impotence, premature ejaculation, ejaculation pain.

4, neurasthenia symptoms : headache, dizziness, insomnia, dreams, depression and so on.

Non-leaching prostatitis

Laboratory examination

(1) routine examination of prostatic fluid: prostatic fluid lecithin small body reduction (generally <++/HP; leukocytosis (general >+/HP), or white blood cells <+/HP, but piled up; pH value can be increased ( PH>7.0).

(2) regular urine examination: no significant change.

(3) Bacterial culture of prostatic fluid: no bacterial growth.

(4) Prostatic fluid Mycoplasma, Chlamydia culture or PCR detection: positive or negative.

2. B-mode ultrasound examination : there may be no obvious changes, but also there may be unevenness of prostate spot, spot or light group, abnormal prostate capsule, hypoechoic area in glandular parenchyma, low or no echo area around gland.

3. Bacterial localization culture plus colony count (four cups of urine) .

Prostate rectal examination: The prostate can be full, asymmetrical, soft, tough, hard, nodules, tenderness, tenderness and other changes. There is tension and discharge during massage.

Other checks:

1. Prostate biopsy: prostate biopsy can be taken by perineal or urethroscopic puncture. Generally only used for differential diagnosis of prostate cancer.

2. Computerized tomography (CT) examination: CT is not sensitive in the diagnosis of chronic non-bacterial prostatitis, but when chronic non-bacterial prostatitis needs to be differentiated from benign prostatic hyperplasia, prostate cyst, prostate tuberculosis, prostate cancer, etc. This check is possible.

3. Magnetic resonance imaging (MRI) examination: MRI, like CT, is not sensitive to the diagnosis of chronic non-bacterial prostatitis, and is only used for differential diagnosis with other diseases.

4. Urodynamic examination: This test is feasible for suspected lower urinary tract obstruction.

Diagnosis and identification of non-leaching prostatitis

1. Differential diagnosis of acute bacterial prostatitis

(1) acute pyelonephritis: also manifested as acute chills, fever, frequent urination, urgency and dysuria. Usually also manifested as suffering from back pain, low back pain; not pubic, perineal pain, and no dysuria. There was no prostate tenderness in the rectal examination, and the prostate fluid was normal.

(2) pus and kidney: also manifested as acute chills, fever, frequent urination, urgency and dysuria. Also manifested as obvious ipsilateral low back pain; and no shame on the bone, perineal pain, no dysuria, rectal examination without prostate tenderness. Prostatic fluid examination is normal.

(3) prostate abscess: also manifested as acute chills, fever. With frequent urination, urgency and dysuria, is the result of the development of acute prostatitis. After rectal B-ultrasound and CT examination, there is a liquid occupying position in the prostate. Puncture and pus extraction can confirm the diagnosis.

2. Differential diagnosis of chronic bacterial prostatitis

(1) Prostate cancer: The late stage also manifests as urination discomfort, which may have frequent urination, urgency, and difficulty urinating. Rectal examination revealed that the prostate was hard and had nodules; serum PSA was significantly elevated, and there was an inhomogeneous mass in the prostate through rectal B-ultrasound. A prostate biopsy can confirm the diagnosis.

(2) Prostate tuberculosis: also manifested as frequent urination, urgency, dysuria with urethral drip, pain in the lower abdomen and perineum. There is usually a history of genitourinary tuberculosis. Rectal examination can reveal irregular nodules in the prostate, and acid-fast bacilli can be found in the prostatic fluid.

(3) Chronic aseptic prostatitis: also manifested as frequent urination with urethral drip, pain in the lower abdomen and perineum. The two were mainly identified by bacterial culture of VB1, EPS and VB3, and the bacterial cultures of VB1, EPS and VB3 of aseptic prostatitis were negative.

(4) benign prostatic hyperplasia: also manifested as frequent urination with poor urination. Occurred in older men, mainly due to poor urination, rectal examination revealed a significant increase in prostate, while prostate fluid is generally no white blood cells.

(5) seminal vesiculitis: also manifested as frequent urination, urgency, dysuria with urethral drip, abdominal pain and perineal pain. Often there is blood, and the seminal fluid can be seen in red blood cells and white blood cells.

(6) Chronic cystitis: also manifested as frequent urination, urgency, dysuria accompanied by lower abdomen and perineal pain. White blood cells were observed in both VBl and VB3, and bacterial growth was observed in the culture, but the EPS examination was normal.

3. Differential diagnosis of aseptic prostatitis

(1) Chronic bacterial prostatitis: also manifested as frequent urination, urgency, dysuria with urethral drip, pain in the lower abdomen and perineum. Both were mainly identified based on bacterial culture of VB1, EPS, and VB3. Chronic bacterial prostatitis VB1 may or may not have bacteria, EPS usually has bacterial growth, VB3 is positive for bacterial culture, and chronic nonbacterial prostatitis VB1, EPS, VB3 is negative for bacterial culture.

(2) Chronic cystitis: also manifested as frequent urination, urgency, dysuria with lower abdomen and perineal pain. However, the bacterial culture of chronic cystitis VB1, VB3 was positive, while EPS had no bacterial growth.

(3) Chronic urethritis: also manifested as frequent urination, urgency, and dysuria. The bacterial culture of VB1 was positive, while the bacterial culture of VB3 and EPS had no bacterial growth.

4. Differential diagnosis of prostate pain

Chronic bacterial prostatitis: also manifested as frequent urination, urgency, with lower abdomen and perineal pain. Both were mainly identified based on bacterial culture of VB1, EPS, and VB3. Chronic bacterial prostatitis has VB1 with or without bacteria, EPS usually has bacterial growth, VB3 is positive for bacterial culture, and VB1, EPS, and VB3 for prostate pain patients are negative.

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