Seminal vesicle shrinkage

Introduction The narrowing of the seminal vesicle is one of the clinical manifestations of prostatitis. Prostatitis refers to the systemic or local symptoms caused by acute and chronic inflammation caused by prostate specific and non-specific infection. The causes of prostatitis are diverse, and the different types of prostatitis have different causes. Infectious factors predominate in the pathogenesis of bacterial prostatitis. In the pathogenesis of non-bacterial prostate and prostate pain, the infection factor may be an induced or initial factor, and non-infectious factors may play a leading role.

Cause

(1) Causes of the disease

The causes of prostatitis are diverse, and the different types of prostatitis have different causes. Infectious factors predominate in the pathogenesis of bacterial prostatitis. In the pathogenesis of non-bacterial prostate and prostate pain, the infection factor may be an induced or initial factor, and non-infectious factors may play a leading role.

The factors that may play a role in the pathogenesis of prostatitis are as follows:

Infection factor

(1) Bacteria: Pathogenic microorganisms in bacterial prostatitis are similar to pathogenic bacteria causing genitourinary tract infections. Common pathogens are Escherichia coli (E. coli), a few are Proteus, Klebsiella, Enterococcus, etc.; Gram-positive bacteria cause less chance of infection. Absolute anaerobic bacteria rarely cause prostate infections. The role of Gram-positive bacteria in etiology is still controversial, and most researchers agree that enterococci cause chronic prostatitis. However, many Gram-positive bacteria such as Staphylococcus, Streptococcus,ococcus, and diphtheria have a pathogenic effect on prostatitis, and many scholars still have doubts. Recently, some researchers believe that Gram-positive bacteria rarely cause obvious prostatitis except for Enterococcus. In China, Staphylococcus aureus is a common bacterium in the prostatic fluid culture of patients. Whether it is different from foreign countries, it is still a contamination of urethra bacteria and needs further clarification. Most prostate infections are caused by a single consistent pathogen, but occasionally by two or more strains or types of bacteria.

Bacterial prostatitis may be caused by retrograde or reflux infection of the urine after bacterial infection. Infected urine can be invaded through the prostate duct opening to the posterior urethra. Urine influx into the prostate is more common, and certainly plays an important role in the pathogen of bacterial prostatitis. Some researchers have analyzed the crystal morphology of prostatic stones and found that many components in the stone do not appear in normal prostatic fluid but only in the urine.

Others may include the spread of bacteria in the rectum through direct or lymphatic spread and blood-borne infections.

Some researchers have found that some patients with chronic bacterial prostatitis have the same pathogens as the vaginal secretions of their female sexual partners. This suggests that bacterial prostatitis may be retrograde through the external urethra during sexual intercourse. The result of the infection. Neisseria gonorrhoeae (gonococcus) or non-gonococcal urethritis patients with Neisseria gonorrhoeae prostatitis is a sexual contact disease. Anorectal intercourse without condom protection may cause urethritis, genitourinary tract infection or epididymitis due to intestinal bacterial infection, which may also cause bacterial prostatitis.

Many bacterial prostatitis are the result of transurethral catheterization of the urinary tract and urinary tract infection.

The route of infection for non-bacterial prostatitis and bacterial prostatitis may be:

1 ascending urinary tract infection;

2 rows of infection of the posterior urethra to the prostate tube;

3 rectal bacteria directly spread or spread through the lymphatic vessels into the prostate;

4 blood-borne infections.

(2) Mycoplasma and Chlamydia: Chronic non-bacterial prostatitis is an unexplained inflammatory lesion. It has been shown that non-bacterial prostatitis is 8 times more than bacterial prostatitis. Some people think that it is decomposed into ureaplasma (ureaplasmas). Urealyticum and Chlamydia trachomatis may be the causative factors of non-bacterial prostatitis, but the evidence is still insufficient.

Many scholars believe that the decomposition of urea urinary tract may be the cause of this prostatitis, or it may be a saprophytes. Whether Chlamydia trachomatis is a causative factor of prostatitis is still controversial. 40% of men with non-gonococcal urethritis and most acute epididymitis under 35 years of age are caused by Chlamydia trachomatis infection, and about 1/3 of patients with non-bacterial prostatitis have urethritis. Therefore, it may be the cause of non-bacterial prostatitis, but many studies have proved that even if it is, it is not an important factor.

(3) Fungi and parasites: Fungal infections caused by prostate are mainly found in AIDS patients. The patient's resistance was severely damaged and fungal prostatitis occurred. The parasites that cause prostatitis mainly include Trichomonas vaginalis and Schistosomiasis.

2. Chemical factors

The causes and pathogens of non-bacterial prostatitis are still unclear. Pathogenic bacteria may be pathogenic microorganisms that cannot be determined. In recent years, clinical studies have found that chlamydia and mycoplasma may be the main pathogens of chronic prostatitis. Or it is a non-infectious disease, and some speculate that it may be a "chemical" prostatitis caused by urine flowing back into the prostate.

In recent years, studies have found that patients with chronic prostatitis have urinary reflux in the prostate, which may be important for the occurrence of various types of prostatitis. In addition, many adult males have found that there are stones in the prostate through B-ultrasound examination, but they cannot be detected on the X-ray. The analysis of the stone components was found to be a component of the urine rather than a component of the prostatic fluid. Therefore, it is speculated that the formation of prostatic stones is related to urine reflux. The stones after infection can exist in the gland for a long time, and it is not easy to eliminate as an infection. Some people have studied to inject the carbon powder solution into the bladder of the patient before prostatectomy, and then found the gland in the gland and the catheter in the excised prostate specimen; the non-bacterial prostatitis patient first injected the carbon powder solution into the bladder, and then carried out after 3 days. Prostate massage, there are many macrophages in the prostatic fluid containing carbon particles; non-bacterial prostatitis and prostate pain patients in the urinary bladder urethra angiography, found that urine reflux is very serious, prostate and ejaculation can be seen in the development. Therefore, it is believed that the chemical factors caused by urinary reflux in the prostate may be an important cause of the pathogenesis of non-bacterial prostatitis.

Studies have shown that urine reflux into the prostate is an important factor, affecting the metabolism of pyrimidine and purine, increasing the concentration of uric acid and causing prostatitis, the incidence of non-bacterial prostate and uric acid levels in prostate secretion. According to the above theory, allopurinol is used to treat non-bacterial prostatitis. However, some studies have concluded that contrary to the above results.

3. Immunity factors

Immunological studies on prostatitis can be traced back to the initial study of immunoglobulins in prostatic fluid, the discovery of antibody-coated bacteria, and the presence of anti-prostate antibodies. The recent application of animal models to successfully model prostatitis is an autoimmune response process. Encouragingly, the study found that bacterial products provide initial antigenic stimulation during the onset of prostatitis, causing a subsequent immune response.

an examination

Related inspection

Semen consistency, urine culture, bacterial culture

The symptoms are varied, the weights are very different, some are all asymptomatic, and some are discomfort. Common symptoms are roughly the following.

1, urination discomfort: bladder irritation may occur, such as frequent urination, urinary tract burning, pain and radiation to the head of the penis. In the early morning, the urethra may have secretions such as mucus, and it may also have a feeling of dysuria.

2, local symptoms: urethral, perineal and anal bulge discomfort, squat, stool and long time sitting on the chair stool increased pain.

3, radiation pain: chronic prostatitis pain is not limited to the urethra and perineum, but also to the vicinity of radiation, the following low back pain is most common. In addition, the penis, spermatic cord, testicular scrotum, lower abdomen, groin area (thigh root), thigh, rectum, etc. can be affected. It should be pointed out that the low back pain caused by chronic prostatitis is in the lower back, and it is easy to be confused with orthopedic causes of low back pain such as myofascial inflammation and lumbar muscle strain, but the latter is mostly near the belt, which is lower than the location of lupus caused by prostatitis. High, can be identified.

4, sexual dysfunction: chronic prostatitis can cause loss of libido and ejaculation pain, ejaculation premature, and affect the quality of semen, urinary tract vaginal discharge after urination or stool, combined with seminal vesiculitis can appear blood.

5, other symptoms: chronic prostatitis can be associated with neurasthenia, showing fatigue, dizziness, insomnia, etc.; long-lasting prostatic inflammation can even cause the body's allergic reaction, conjunctivitis, arthritis and other diseases.

6, rectal examination: the prostate is full, enlarged, soft texture, mild tenderness. If the disease is long, the prostate will become smaller, harder, uneven in texture and have a small induration. At the same time, the prostatic fluid is obtained by applying the prostate massage method, and a routine examination is performed.

7, prostatic fluid examination: white blood cells in the prostatic fluid in the microscope high power field of more than 10, lecithin small body reduction, can be diagnosed as prostatitis. If bacterial culture is performed at the same time, a clear diagnosis and classification of chronic prostatitis can be made. If the bacterial culture result of prostatitis is positive, then diagnose chronic prostatitis; on the contrary, it is chronic non-bacterial prostatitis.

8, B-ultrasound: shows that the boundaries of the prostate tissue structure is unclear, disorder, can prompt prostatitis.

Differential diagnosis

Increased seminal vesicles: The seminal vesicle, also known as the seminal vesicle, is the accessory gland of the male genitalia. The seminal vesicle produces mucus, which provides carriers and nutrients for sperm, which facilitates the transportation and storage of sperm. The enlargement of the seminal vesicle is generally more common in seminal vesicle. Seminal vesiculitis is a disease caused by Escherichia coli or the like causing infection in the adjacent organs such as the prostate or in any case causing the prostate and the seminal vesicle to be congested, and the bacteria invade the seminal vesicle and induce inflammation, thereby causing blood essence as the main clinical manifestation. Seminal vesiculitis is divided into two categories: non-specific and specific seminal vesiculitis. The former includes acute seminal vesiculitis and chronic seminal vesiculitis, the latter including seminal vesicle tuberculosis and gonococcal seminal vesiculitis. Among them, non-specific chronic seminal vesiculitis is the most common.

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