Because many antibacterial drugs are difficult to enter the prostate through the lipid envelope of the prostate to play a therapeutic role, some doctors try to inject drugs directly into the prostate to treat prostatitis.
As early as 1938, some people began to try this method to treat prostatitis. However, due to the limited conditions at that time, there were not many antibiotics available, and the location of puncture was not very accurate, so it could not be widely used. In the past ten years, with the increase of antibiotic drugs and the progress of ultrasonic technology, some people have adopted this treatment method again and achieved certain curative effect. The specific method is as follows: the doctor generally extends the left index finger into the rectum for guidance, and the right hand uses a long needle syringe to directly penetrate the prostate through the skin of the perineum; You can also hold a needle to pierce the prostate through the mucosa of the anterior wall of the rectum. Conditional hospitals can also direct the needle through the guide to the inflammatory lesions and inject drugs under the guidance of B-ultrasound, so that the drugs can reach the predetermined position. Amikacin, gentamicin, and cephalosporin can be used as the injection solution. It may be better to select drugs according to bacterial culture and drug sensitivity test. Usually, 1-2 injections per week, 5-10 times for a course of treatment. Because this therapy is to inject drugs directly into the prostate, and the liquid medicine can directly contact with pathogenic bacteria, the curative effect is relatively positive. It is reported that the effective rate can reach about 80%.
So, how should we evaluate the advantages and disadvantages of direct intraprostate injection therapy?
The advantage of puncture direct injection method is that the drug is directly injected into the prostate and can reach effective therapeutic concentration in the prostate. The prostate puncture under the guidance of B-ultrasound can make the drugs more accurately reach the lesions to be treated. The liquid medicine injected into the prostate can also spread widely from the injection site to the surrounding tissues, which can not only kill the bacteria at the injection site, but also kill the bacteria around it, and stay in the tissues for a certain time to play an antibacterial role. Some of the absorbed blood can also synergistically eliminate the infection of urethra and other parts.
The disadvantage of direct prostate injection method is that the prostate is located in the deep part of the perineum and the lower part of the bladder. It is not easy to penetrate the injection needle into the prostate from outside. Moreover, because the prostate is located in the deep part, the puncture is also easy to cause local injury and complications such as hematuria; Secondly, it is easy to bring in bacteria through skin from outside, especially through rectal mucosa, which can cause infection around the prostate or prostate; Thirdly, both direct puncture and drug injection can cause pain and discomfort, and many patients can't bear repeated puncture. The most serious problem is that repeated and repeated direct injection of drugs will cause fibrous tissue hyperplasia and sclerosis of the prostate gland. When doctors perform digital rectal examination for such patients, they can often touch a hard prostate. As we all know, chronic prostatitis is a recurrent disease. Even if it is cured this time, it may reoccur when the human body is overworked, cold, stay up late and other resistance is low, just as children's tonsils can become inflamed - heal - relapse. In this way, once chronic prostatitis reoccurs, due to the proliferation of fibrous connective tissue and the wrapping of the focus, no matter which treatment method is used, the drug will be more difficult to enter the focus and play a role. Therefore, the author believes that the decision to adopt direct injection therapy should be cautious, unless all kinds of treatment methods including drug iontophoresis therapy are not effective, then it is appropriate to consider using this method.