Post Date December, 02 2023
Chronic prostatitis is a very confusing disease with a very high incidence rate (4%~25%). Nearly 50% of men will suffer from the effects of prostatitis symptoms at some time in their lives. Due to its diverse etiology, pathological changes, and clinical symptoms, click here to add pictures and descriptions, which have a certain impact on male sexual and reproductive functions, seriously affecting the quality of life of patients, causing them to suffer greatly mentally and physically.
(1) General treatment
Relieving mental unease and concerns, arranging a healthy and regular diet and life, participating in appropriate physical exercise, hot water sitz baths, and regular prostate massage have certain effects on this disease.
⑵ Antibiotic treatment
To select drugs that can enter the prostate tissue with good fat solubility, the treatment of pathogens is mainly based on bacterial culture and drug sensitivity tests to select reasonable antibiotics. "Compound sulfamethoxazole is easier to enter prostate tissue and reaches an effective antibacterial concentration. It is often used as a clinical drug of choice, two tablets per time, twice daily, and is recommended for 4 to 8 weeks to achieve the best therapeutic effect.". Other drugs with better therapeutic effects include pipemidic acid, norfloxacin, ciprofloxacin, erythromycin, and cephalosporin. These drugs have good therapeutic effects, but are prone to relapse after stopping the drug. Some people also recommend long-term or lifelong use. To prevent bacteria from becoming resistant to certain antibiotics, an antibiotic can be replaced every 10-15 days.
(3) Local treatment
① Prostate massage: The method of massage is to have the patient take a knee chest position, and the operator wear a rubber finger cover on his right index finger, coated with paraffin oil. Gently massage the circumference of the anus, then slowly extend the index finger into the rectum and indirectly touch the posterior lobe of the prostate gland through the rectal mucosa. Press the prostate from the outside up to the inside down with the end of the index finger facing the posterior lobe of the prostate, that is, press the prostate from both sides of the gland to the midline for 3-4 times, and then press the prostate fluid from the central groove up to the outside of the urethra. Generally, massage 1-2 times a week, with 4-8 times as a course of treatment. It can last for 2 to 3 courses of treatment. When massaging, the technique should be "gentle and gentle", and it is strictly prohibited to repeatedly press violently to avoid causing new damage to the prostate tissue, aggravating inflammation, and even producing toxic and side effects, which can worsen the condition. Therefore, it is often advocated to urinate immediately after massage to allow the inflammatory secretions accumulated in the posterior urethra to be discharged with urine. During the acute onset of chronic prostatitis, prostate massage is contraindicated to avoid causing inflammation to spread. Massage therapy should not be used for patients with atrophy or sclerosis of the prostate. For patients suspected of prostate tuberculosis or tumor, anterior prostate massage is also contraindicated. After general massage, the patient feels comfortable and the symptoms of urethral whitening can be alleviated or eliminated. If fever or symptoms worsen after massage, the massage should be suspended and antibiotics should be added.
② Hot water sitz bath: Soak the hips and anterior genitals in hot water as much as possible, with the water temperature controlled at 42 to 43 ℃, 1-2 times a day, for 15 to 20 minutes each time. Alternatively, you can take the third decoction of traditional Chinese medicine orally or dissolve 100g of sodium silicate in 2000ml of boiling water. When the water temperature is between 42 and 43 ℃, take a sitz bath for about 20 minutes each time. This treatment can improve local blood circulation, promote the absorption of inflammation, and have a significant effect on the improvement of local symptoms such as perineal pain.
③ Prostate hyperthermia: In recent years, a transurethral or transrectal prostate microwave or radio frequency therapy machine has been developed, which has certain therapeutic effects on chronic bacterial prostatitis. When using a prostate radiofrequency therapy instrument, insert a radiofrequency electrode into the urethra and prostate, and place the other electrode in the suprapubic region. The treatment temperature is 42~43 ℃, and the one-time time is 2 hours. After treatment, oral prostate fluid bacteria culture sensitive antibiotics. Treatment can be repeated after half a month.
(4) Symptomatic treatment: For those who have symptoms of bladder and urinary tract irritation and terminal urine dripping, flavone piperazine tablets should be given at a time of 0. 2. Three times a day; Or terazosin 2mg, once a night; Alternatively, use 15 mg of prubenosin once, three times a day. Indomethacin can be used 25mg once for pain symptoms, three times a day. For patients with neurasthenia, oryzanol can be administered 10 to 30 mg once, three times a day. Patients with impotence can receive short-term intramuscular injection of testosterone propionate, 25mg once, twice a week. Give a placebo appropriately.
(5) Complex protein zinc: In recent years, there have been reports of zinc preparations for the treatment of chronic bacterial prostatitis. Complex protein zinc is a complex of organic trace elements that is beneficial to the absorption of the body, effectively increasing blood zinc concentration, and playing a local antibacterial role. In addition, zinc is also the main component of prostate antibacterial factor (PFA), participating in the antibacterial defense mechanism of the prostate. Usage: Compound protein zinc, 1. 2g, should be taken with plain water 15 minutes before meals, three times a day, for 4 weeks.
