Prostatitis disease is divided into multiple types, and chronic prostatitis is divided into chronic bacterial prostatitis and chronic non-bacterial prostatitis. Due to different causes and manifestations, it is a complex syndrome. To sum up, the clinical manifestations mainly include the following aspects:
① In terms of urination, there are frequent urination, urgent urination, painful urination, burning urethra, incomplete urination, sometimes difficult urination, nocturnal urination, etc.
② Whitening of the urethra: white secretion drips out of the urethra at the end of urination or during defecation.
③ Pain: due to continuous chronic inflammatory stimulation, the perineum, anus, scrotum and other parts have severe tenderness and swelling, and often radiate to the pubic, lumbosacral, bilateral groins, perineum, and cause lower limb pain. The symptoms are usually more obvious in the morning.
④ Sexual function changes: premature ejaculation, ejaculation, decreased libido or impotence, and some patients have ejaculation pain and blood sperm. Chronic prostatitis is an important cause of some infertility.
⑤ Neurasthenia: insomnia, dreaminess, fatigue, dizziness, lack of self-confidence, depression, memory loss.
Four pathological changes of acute prostatitis
(1) Catarrhal prostatitis: the infection spreads from the excretory duct of the prostate to the gland cavity, and the congestion, edema and exudation increase. The glandular epithelium in the lumen is accompanied by mild inflammatory cell infiltration, and the glandular epithelium is hyperplasia and desquamation.
(2) Follicular prostatitis: epithelial exfoliation and purulent cell infiltration are found in the ducts of each acinar gland. Hyperemia and edema are aggravated due to the development of inflammation, and the lumen is narrow and occluded, which can form pseudoabscess or small abscess. The whole gland becomes soft, swollen and elastic.
(3) Substantial prostatitis: the disease develops again, eosinophils infiltrate into the stroma, expand to the parenchyma, and form a small abscess. Epithelial necrosis and exfoliation make it difficult to distinguish the glandular cavity. Interstitial inflammation spreads to one leaf or the whole gland.
(4) Prostate abscess: the development of parenchyma into localized abscess, or inflammation in other parts of the body, caused by hematogenous infection and lymphatic infection. In about 1/2 cases, the abscess continued to increase and finally penetrated the urethra, perineum or rectum.
Common sense of diagnosis of prostatitis
Our common inspection methods are as follows:
1. Digital rectal examination
The prostate is plump, enlarged, soft and slightly tender. If the disease lasts for a long time, the prostate will become small, hard, uneven in texture and have small induration. At the same time, the method of prostate massage is used to obtain prostate fluid for a routine examination.
2. Prostate fluid examination
There are more than 10 white blood cells in the prostatic fluid in the high power field of the microscope, and the lecithin body is reduced, which can be diagnosed as prostatitis. If bacterial culture is carried out at the same time, a clear diagnosis and classification of chronic prostatitis can be made. If the bacterial culture result of prostatitis fluid is positive, chronic bacterial prostatitis will be diagnosed; On the contrary, it is chronic non-bacterial prostatitis.
3. B-ultrasound examination shows that the boundary of prostate tissue structure is unclear and disordered, which can indicate prostatitis.
Through the above tests, we can make diagnosis, differentiation and classification of prostatitis. We suggest that patients with symptoms of prostatitis should not blindly make their own diagnosis, but should go to the hospital for corresponding examination and diagnosis to guide treatment and medication and reduce unnecessary waste.