Specific Prostatitis

　　The specific infection routes for the onset of specific prostatitis include lymphatic infection, hematogenous infection, and direct extension, as follows:

　　1. Lymphatic Infection

      Lymphatic infection is relatively rare. Prostatitis can be caused by infections of the lower urinary tract, colon, and rectum through lymphatic channels, resulting in inflammation.

　　2. Hematogenous Infection

      Pathogenic bacteria from infection foci in other parts of the body can reach the prostate via the blood circulation, causing prostatitis. Commonly, bacteria from skin, tonsils, dental caries, respiratory tract, or intestinal infections can enter the blood and then invade the prostate.

　　3. Direct Extension

      Direct extension is a relatively common infection route. When men urinate, bacteria enter the urethra through the urethral orifice, then pass through the prostatic ducts to invade the prostate gland, causing acute or chronic prostatitis. Excessive sexual desire or over masturbation can cause repeated congestion of the prostate, leading to prostatitis. Catheterization or urethral instrument examination can introduce bacteria into the urethra, causing prostatic infection. Prostatic hyperplasia or the presence of stones can decrease the immune ability of the prostatic urethra mucosa against non-pathogenic bacteria that can coexist peacefully within the urethra, making prostatitis more likely to occur.

　　The main complications of specific prostatitis include acute urinary retention, acute seminal vesiculitis or epididymitis and vas deferens inflammation.

　　1. Acute urinary retention:Acute prostatitis causes local congestion, swelling, and urethral compression, leading to difficulty in urination or acute urinary retention.

　　2. Acute epididymitis or附睾炎and vas deferens inflammation:Acute seminal vesiculitis can easily spread to the seminal vesicle, causing acute seminal vesiculitis. At the same time, bacteria can retrograde through the lymphatic vessels into the wall and sheath of the vas deferens, causing epididymitis.

      Specific prostatitis, this kind of prostatitis is more common in clinical practice, the main symptoms are abnormal urination, pain, low sexual function, and neurotic symptoms, etc. The following aspects.

　　1. Abnormal urination:Urgency, frequency, dysuria, incomplete urination, urethral burning; white cloudy secretion drops out from the urethral orifice during defecation or at the end of urination, commonly known as 'urinary white'.

　　2. Pain:It often occurs in the lumbar sacral area, lower abdomen, perineum, pubic bone, inguinal region, testicle, spermatic cord, etc., with mild pain, mostly intermittent.

　　3. Low sexual function:Decreased libido, impotence, premature ejaculation, pain during ejaculation, etc.

　　4. Neurotic symptoms:Headache, dizziness, insomnia, frequent dreams, depression, etc.

      The prevention of specific prostatitis mainly includes the following aspects:

　　1. Drink plenty of water, do not hold urine, to keep the urinary tract unobstructed, and it is conducive to the excretion of prostatic secretions.

　　2. Pay attention to daily life and living habits, develop good living habits, prevent overfatigue, prevent colds, and carry out effective physical exercise.

　　3. Regulate sexual life, do not masturbate frequently, and pay attention to sexual hygiene to prevent excessive congestion of the prostate and the occurrence of genital organ infection.

　　Avoid smoking and drinking, and do not eat spicy and irritating foods.

　　For acute urogenital infections such as acute prostatitis, acute epididymitis, acute seminal vesiculitis, etc., active and thorough treatment should be given to prevent them from turning into chronic prostatitis.

　　For patients with chronic prostatitis who have been cured, they should take a hot water bath every night to improve blood circulation in the prostate and prevent recurrence of inflammation.

　　The imaging examination of specific prostatitis can show low echoic nodules within the prostate or uneven echo of the prostate, similar to prostate cancer, through suprapubic B-ultrasound or transrectal B-ultrasound. Other B-ultrasound findings include prostate enlargement, irregular shape but intact capsule, etc. MRI is not very helpful for diagnosis. Pay attention to the discovery of individual cases of prostate cancer concurrent with this disease. In addition, even if the diagnosis of this disease has been obtained, if suspicious evidence of prostate cancer is found during follow-up, a re-biopsy is still needed. Prostate needle biopsy is performed through the perineum using Travenol Tru-Cut biopsy needle for histological examination, or transrectal ultrasound-guided fine needle aspiration for histological examination, which can clearly diagnose the disease.

　　Patients with specific prostatitis should mainly consume light foods, pay attention to dietary regularity. Eat more foods rich in melanin, such as black beans, black rice, black sesame, walnuts, black fungus, etc. Animal meats, eggs, bone marrow, black sesame, cherries, mulberries, yam, etc., also have varying degrees of kidney-nourishing effects. Avoid cold and cool foods, as cold foods can stimulate the gastrointestinal tract. Therefore, to better recover, it is advisable to eat less or not at all. Avoid fried and spicy foods, as spicy foods such as chili, onions, raw garlic, pepper, etc., can stimulate the gastrointestinal tract.

　　Direct extension is a relatively common infection route for specific prostatitis. Specific prostatitis is generally treated with a combination of physical therapy and medication, with specific treatments including the following aspects.

　　1. Physical Therapy

      It is advisable to use hot water bath or sitting bath, and options include infrared ray irradiation, iontophoresis, ultra-short wave, CO2 laser, or electrical thermal magnetic therapy, etc. Prostate massage can help expel inflammatory secretions, performed every 5-7 days, with a course of 4-8 sessions. However, some scholars recently have proposed that regular prostate massage can promote the spread of gonococcal prostatitis, and do not advocate for its use.

　　2. Antibiotic Treatment

      The same as the treatment plan for acute gonococcal prostatitis mentioned above.

　　3. Treatment with Traditional Chinese Medicine

　　For refractory gonococcal prostatitis, there is a method of treatment in China that involves injecting through the vas deferens and urethra. This method of administering medication through trans-vesicular puncture injection and urethral perfusion allows the drug solution to diffuse along the natural ducts of the prostate, not only with a high concentration of medication but also with a wide range of diffusion, which is often effective quickly. During treatment, it is emphasized that patients should avoid staying up late, drinking alcohol, and abstain from sexual activity. The wife of the patient should also be treated to prevent re-infection.