Post Date April, 15 2023
Clinically, it is often encountered that some patients with gonococcal urethritis have symptoms that recur or persist after treatment, and have had multiple negative urine routine and urinary secretion tests in different hospitals. They have been treated with penicillin for a long time. Drug treatment such as norfloxacin is ineffective. To investigate the cause, in addition to considering the combination of infection with other pathogens (such as Chlamydia trachomatis, Mycoplasma hominis, etc.), we should be more vigilant about the possibility of concurrent gonorrheal urethritis. Because gonorrhoeal urethritis is initially an inflammatory disease of the anterior urethra, it can then spread upward to the posterior urethra, forming total urethritis. Through the prostate tubules that open in the posterior urethra, the infection reaches the prostate tissue, leading to the occurrence of prostatitis. Later, urethritis and prostatitis become the sources of infection of anterior urethritis. Such repeated circulation is an important reason for long-term treatment. If concurrent prostatitis can be detected and actively treated in a timely manner, blocking its vicious cycle, it can shorten the course of disease and achieve the goal of cure.
The clinical manifestations of gonococcal prostatitis are greatly different from the symptoms of urethritis at the initial stage of the disease. When inflammation affects the prostate, the patient urinates frequently. Urgent urination. "Symptoms such as urinalgia are often not significant, and there is generally little or no secretion from the external orifice of the urethra, but there is more perineum.". Discomfort in areas such as the scrotum, or mild urination pain. Anal pain refers to almost all prostate tenderness with varying degrees. In some cases, gonococci can be found on the smear of prostate fluid secretion. If bacterial culture of prostate fluid is conducted, the detection rate of gonococci can be improved. Therefore. "Those who suffer from gonorrheal urethritis and cannot recover should first rule out the possibility of concurrent prostatitis. Detection of prostate fluid smear and culture is essential.".
The most effective treatment for those diagnosed as gonorrheal prostatitis is drug injection into the prostate tissue. The commonly used drug is Cephalosporin 5 (0.5 g) plus hyaluronidase (1500 units), injected once a week, four times for a course of treatment. Generally, after 2 to 3 courses of treatment, the symptoms can disappear and the bacterial culture of prostate fluid turns negative. "If there are more white blood cells in the urine or urine smear, Rifampicin plus Compound Shinamine Tablets can be taken together with weekly urethral dilation and prostate massage. The treatment cycle is 1 to 3 months.". If the above treatment fails, drug injection into the prostate tissue should be performed again.
