How should men treat prostatitis?

The discovery of pathogenic pathogens in prostate fluid culture is the basis of choosing antibacterial drugs for treatment. If patients with non-bacterial prostatitis show signs of bacterial infection, general treatment is ineffective and antibacterial drugs can be used for treatment. In the choice of antibacterial drugs, we should pay attention to the existence of prostate-blood barrier composed of lipid membrane between prostate acinus and microcirculation, which hinders the passage of water-soluble antibiotics and greatly reduces the therapeutic effect. When there are prostate stones, stones will become a refuge for bacteria. The above factors constitute the difficulty in the treatment of chronic bacterial prostatitis, which requires a long course of treatment and is easy to recur.

At present, the use of quinolones such as ofloxacin or levofloxacin is advocated. If it is ineffective, continue to use it for 8 weeks. Recurrence and the same strain, with preventive doses to reduce acute attacks and relieve symptoms. If long-term use of antibiotics induces serious side effects, such as pseudomembranous enteritis, diarrhea and the growth of intestinal drug-resistant strains, it is necessary to change the treatment plan. Whether non-bacterial prostatitis is suitable to be treated with antibacterial drugs is still controversial in clinic. Patients with "aseptic" prostatitis can also use drugs effective for bacteria and mycoplasma, such as quinolones, SMZ-TMP or TMP alone, in combination with tetracycline and quinolones or at intervals. If the antibiotic treatment is ineffective and the patient is diagnosed as aseptic prostatitis, the antibiotic treatment will be stopped. In addition, sealing prostate urethra with double balloon catheter and injecting antibiotic solution into prostate canal from urethral cavity can also achieve the therapeutic purpose.

Type I is mainly broad-spectrum antibiotics, symptomatic treatment and supportive treatment. Oral antibiotics and sensitive drugs are recommended for type ⅱ. The course of treatment is 4-6 weeks, during which patients should be evaluated in stages. Type ⅲ can be treated with oral antibiotics for 2 ~ 4 weeks, and then the curative effect can be evaluated. At the same time, non-steroidal anti-inflammatory drugs, α receptor antagonists and M receptor antagonists can improve micturition symptoms and pain. Type IV does not require treatment.

2. Anti-inflammatory and analgesic

Non-steroidal anti-inflammatory drugs can improve symptoms. Indomethacin is generally taken orally or suppository, and Chinese medicine combined with anti-inflammatory, heat-clearing, detoxification and softening drugs has also achieved certain results. Allopurinol can reduce the concentration of uric acid in the whole body and prostate fluid, which can be used as a free radical scavenger in theory, and can also scavenge active oxygen components, diminish inflammation and relieve pain. This is an optional adjuvant therapy.

Step 3: physical therapy

Prostate massage can empty the concentrated secretion in the prostate tube and drain the infected focus in the blocked area of gland, so for stubborn cases, you can do prostate massage every 3 ~ 7 days while using antibiotics. Using microwave, radio frequency, ultrashort wave, medium wave, hot water sitz bath and other physical factors for prostate physiotherapy is beneficial to relax prostate, posterior urethral smooth muscle and pelvic floor muscle, strengthen antibacterial effect and relieve pain symptoms.

4.m receptor antagonists

M receptor antagonists can be used for patients with prostatitis who have excessive bladder activity such as urgency, frequent urination and nocturia, but have no urinary tract obstruction.

5. Alpha receptor antagonists

The smooth muscle tension of prostate, bladder neck and urethra increased in patients with prostate pain, bacterial or non-bacterial prostatitis. When urinating, the internal pressure of the posterior urethra rises, which makes the urine flow back into the prostate tube, which is an important cause of prostate pain, prostate stones and bacterial prostatitis. The application of α receptor antagonist can effectively improve prostate pain and micturition symptoms, help to prevent urine reflux in the prostate, and is of great significance to prevent the recurrence of infection. It also plays an important role in the treatment of type ⅲ prostatitis. α receptor antagonists should be used for a long time in order to have enough time to adjust the function of smooth muscle and consolidate the curative effect. Different α receptor blockers can be selected according to patients' conditions, mainly including doxazosin, naftopidil, tamsulosin and terazosin.

6. Prostate massage and hyperthermia

Prostate massage is one of the traditional treatment methods. Studies have shown that proper prostate massage can promote the emptying of prostate tube, increase the local drug concentration, and then alleviate the clinical symptoms of chronic prostatitis. Hyperthermia mainly uses the thermal effect produced by various physical means to increase the blood circulation of prostate tissue, accelerate metabolism, benefit and eliminate tissue edema, and relieve pelvic floor muscle spasm.

7. Surgical therapy

Surgical treatment can be used for recurrent chronic bacterial prostatitis. Prostatectomy can achieve the goal of cure, but it should be used with caution. Because prostatitis usually involves the peripheral zone of glands, TURP is difficult to achieve the purpose of treatment. TURP can clear the bacterial infection focus near prostate calculus and prostate catheter, which is helpful to reduce reinfection of surrounding lesions.

8. Other treatments

Including biofeedback therapy, perineal extracorporeal shock wave therapy, psychotherapy, traditional Chinese medicine treatment and so on.