Prostate shrinks and hardens

Introduction Chronic bacterial prostatitis has frequent urination, urgency, dysuria, urinary discomfort or burning when urinating. White secretions often flow from the urethra after urination and after the stool. Sometimes there may be blood, perineal pain, sexual dysfunction, and mental symptoms. The prostate is full, enlarged, soft, and tender. In the long course of the disease, the prostate shrinks, hardens, the surface is incomplete, and there is a small induration.

Cause

The pathogenic bacteria are Gram-negative aerobic bacteria such as Escherichia coli and Pseudomonas aeruginosa. Some clinicians believe that Gram-positive bacteria (such as staphylococcus, streptococcus, diphtheria-like bacteria) can also cause prostatitis, but unlike prostate infections caused by Gram-negative bacteria, caused by Gram-positive bacteria Prostate infections are rarely delayed or cause recurrent infections, except for prostatitis caused by Enterococcus. However, many authors are skeptical about Gram-positive bacteria causing chronic prostatitis. There is currently evidence that chlamydia and mycoplasma can also cause prostate infection, but it is rare.

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Laboratory examination: In the absence of secondary epididymitis or acute exacerbation of chronic infection, the blood is generally normal and white blood cells are not elevated. A large number of inflammatory cells are often found in prostate massage fluids. Many researchers and clinicians believe that more than 10 leukocytes in the high-power field of the prostatic fluid are abnormal, and more than 15 are leukocytosis. The large amount of lipid-rich macrophages in prostatic fluid is significantly associated with the presence of prostatic inflammation. When there is a secondary bladder, the middle urine can be pyuria and bacterial urine, and the pathogenic bacteria are consistent with the pathogens infected with the prostate.

When the urine itself is infected, collection of segmented urine and prostate massage fluid for bacterial culture can determine the source of the pathogen. When using this technique, doctors must carefully collect the urine from the patient and the uncontaminated specimens of prostate secretions. The above specimens were injected into the culture medium for 24 to 48 hours, and the growth of various bacteria was identified using standard microbiological examination methods. When the bladder specimen (middle urine) is grown aseptically or substantially aseptically, the colony counts of the other specimens are compared to determine the site of infection. If the urethral specimen (primary urine) colony count greatly exceeds (at least 10 times) the prostate specimen, the infection is located in the urethra, and conversely, the infection originates from the prostate.

X-ray examination: Except for various complications (such as prostatic stones, prostatic hypertrophy, urethral stricture, kidney infection, etc.), otherwise excretory urography is normal.

Device examination: cystoscopy or urethroscopic surgery may not appear abnormal, or found in the prostate segment of the urethra congestion and edema, with or without inflammatory polyps. These manifestations are not unique to chronic bacterial prostatitis and may be present in other prostatic inflammation.

Differential diagnosis

Male patients with acute or chronic symptoms of urethritis may be prompted for prostatitis. A segmented specimen of the urethra, bladder or prostate secretion is cultured or stained and smears are generally used to determine the site of inflammation and infection.

Cystitis can sometimes be confused with chronic bacterial prostatitis. It is also easy to have cystitis when the prostate is infected. The above-mentioned segmented urine specimens and prostate secretion specimens can be identified and cultured to identify the site of infection. If cystitis is complicated by bacterial prostatitis, the presence of prostate infection can be determined by repeated antibiotic treatment after repeated antibiotic treatment (using antibiotics that are difficult to diffuse in the prostate, such as furantanidine, penicillin G) to kill bacteria in the bladder.

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

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.