Chronic Prostatitis

　　Prostatitis is a disease caused by various complex causes and triggers, involving inflammation, immunity, and neuroendocrine participation in complex pathological changes, leading to diseases mainly manifested by urinary tract irritation symptoms and chronic pelvic pain. Generally, it is caused by the following reasons:

　　1. Chronic Bacterial Prostatitis

　　The main pathogenic factors are pathogen infection, but with strong body resistance or weak virulence of pathogens, retrograde infection is predominant. The pathogens are mainly Staphylococcus spp., followed by Escherichia coli, Corynebacterium spp., and Enterococcus spp. Prostatic calculi and urine reflux may be important reasons for the persistence of pathogens and recurrence of infection.

　　2. Chronic Non-bacterial Prostatitis

　　The etiology is very complex, and the main causes may be the combined effects of pathogen infection, inflammation, abnormal pelvic floor neuromuscular activity, and immune abnormalities.

　　(1) Pathogen infection

　　Although routine bacterial tests have not isolated pathogens in patients with this type, it may still be related to certain special pathogens such as anaerobic bacteria, L-form bacteria, nanobacteria, or chlamydia trachomatis, mycoplasma, and others. Studies have shown that the detection rate of local prokaryotic DNA in patients with this type can reach up to 77%. Some clinical chronic inflammatory prostatitis, mainly with recurrent or exacerbation, may be related to these pathogens. Other pathogens such as parasites, fungi, viruses, trichomonads, and Mycobacterium tuberculosis may also be important pathogenic factors for this type, but there is a lack of reliable evidence, and there is no unified opinion to date.

　　(2) Urinary dysfunction

　　Certain factors cause overcontraction of the urethral sphincter, leading to bladder outlet obstruction and the formation of residual urine, causing urine reflux into the prostate. This not only brings pathogens into the prostate but also directly stimulates the prostate,诱发sterile“chemical prostatitis”, causing urinary abnormalities and pelvic area pain.

　　Many patients with prostatitis have various urodynamic changes, such as reduced urine flow rate, functional urinary tract obstruction, and detrusor-urethral sphincter coordination disorders. These functional abnormalities may be only a clinical phenomenon, and their essence may be related to potential pathogenic factors.

　　(3) Mental and psychological factors

　　Studies have shown that more than half of patients with long-standing prostatitis have significant changes in mental and psychological factors and personality traits. These include anxiety, depression, hypochondria, hysteria, and even suicidal tendencies. These changes in mental and psychological factors can cause dysfunction of the autonomic nervous system, lead to functional disorders of the lower urinary tract, cause pelvic area pain and urinary dysfunction, or cause changes in the hypothalamus-pituitary-gonadal axis function, affecting sexual function and further aggravating symptoms. However, it is not yet clear whether the changes in mental and psychological factors are the direct cause or a secondary manifestation. Currently, it is still unclear whether the changes in mental and psychological factors are the direct cause or a secondary manifestation.

　　(4) Neuroendocrine factors

　　Patients with prostatitis pain often experience fluctuations in heart rate and blood pressure, indicating that it may be related to autonomic nerve reactions. Their pain has the characteristics of visceral organ pain. Local pathological stimulation of the prostate and urethra triggers spinal cord reflexes through the sensory nerves of the prostate, activating the astrocytes of the lumbar and sacral cord. Nerve impulses are transmitted out through the genital obturator and ilioinguinal nerves, causing sympathetic nerve endings to release norepinephrine, prostaglandins, calcitonin gene-related peptide, P substance, and other substances, leading to functional disorders of the bladder and urethra, and abnormal activity of perineal and pelvic floor muscles. Persistent pain and referred pain appear in the corresponding areas outside the prostate.

　　(5) Abnormal immune response

　　Recent studies have shown that immune factors play a very important role in the occurrence, development, and course of III-type prostatitis. Changes in the levels of certain cytokines such as IL-2, IL-6, IL-8, IL-10, TNF-α, and MCP-1 may occur in the seminal fluid, seminal plasma, tissue, or blood of patients. Moreover, the level of IL-10 is positively correlated with the pain symptoms of patients with III-type prostatitis, and immunosuppressive therapy has a certain effect.

　　(6) Oxidative stress theory

　　Under normal circumstances, the production, utilization, and clearance of oxygen free radicals in the body are in a state of dynamic balance. In patients with prostatitis, the production of oxygen free radicals is excessive or the clearance system is relatively reduced, leading to a decrease in the body's response ability to antioxidant stress and an increase in the products or/and by-products of oxidative stress, which may also be one of the pathogenic mechanisms.

　　(7) Factors related to pelvic diseases

　　Some patients with prostatitis often have complications such as expansion of the peripheral venous plexus of the prostate, hemorrhoids, varicocele of the spermatic cord, etc., suggesting that the symptoms of some patients with chronic prostatitis may be related to pelvic venous congestion and blood stasis, which may also be one of the reasons for the long-term treatment failure.

　　Chronic prostatitis has become one of the threats to men's health today, and the following are several common complications:

　　1, Infertility

　　Chronic prostatitis is an important cause of infertility, due to the fact that seminal fluid is an important component of semen. Once the prostate becomes inflamed, the increase in inflammatory exudates and the decrease in zinc elements in the glandular secretion fluid can affect the quality of semen, leading to male infertility.

　　2, Seminal vesiculitis

　　This is the most common complication of chronic prostatitis. The seminal vesicle, located on the sides of the prostate, is connected by ducts, so during the chronic course, inflammation spreads along the ducts, and both often coexist and influence each other.

　　3, Epididymitis

　　Chronic prostatitis often coexists with epididymitis, and inflammation can invade the epididymis, causing chronic epididymitis. There may be swelling, pain, and discomfort in the epididymis, with a sense of坠胀, especially after sexual intercourse.

　　4, Mental abnormalities

　　Patients with chronic prostatitis may experience insomnia and dreams, discomfort in many parts of the body, lumbago, weak legs, fatigue, dizziness, decreased memory, lack of concentration, fatigue, seminal emission, and other abnormal mental symptoms.

　　Chronic prostatitis is a common urogenital disease, mainly including chronic bacterial prostatitis and non-bacterial prostatitis. Chronic prostatitis is a highly prevalent and perplexing disease, with nearly 50% of men experiencing prostatitis symptoms at some point in their lives. Due to its complex etiology, pathological changes, and clinical manifestations, and its certain impact on male sexual and reproductive function, it seriously affects the quality of life of patients, causing them great physical and mental suffering.

　　The symptoms of chronic prostatitis are complex and diverse, sometimes easily confused with simple neurasthenia, and the treatment is not very satisfactory, and the treatment criteria are not unified. The clinical manifestations of patients may include urethral irritation signs, frequent urination, urgency, urethral burning pain, sticky or stringy or purulent secretions at the urethral orifice in the morning, turbid urine or white fluid flowing from the urethral orifice after defecation, discomfort in the posterior urethra, perineum, and anus, and sometimes pain in the penis, testicles, and inguinal region. Accompanied by symptoms of seminal pain, blood seminal fluid, premature ejaculation, impotence, and general symptoms such as fatigue, dizziness, insomnia, and depression due to autonomic nervous system dysfunction, the following will specifically introduce the common symptoms of this disease.

　　1. Urinary discomfort

　　Urethral irritation symptoms may occur, such as frequent urination, burning and pain during urination, and radiation to the head of the penis. In the morning, there may be mucus and other secretions at the urethral orifice, and a feeling of difficulty in urination may also occur.

　　2. Local symptoms

　　A feeling of坠胀不适 in the posterior urethra, perineum, and anus, which can be exacerbated by squatting, defecation, or sitting for a long time on chairs and stools.

　　3. Radiating pain

　　The pain of chronic prostatitis is not limited to the urethra and perineum, but also radiates to the nearby areas, with low back pain being the most common. In addition, the penis, testicular scrotum, lower abdomen, inguinal area (the root of the thigh), thigh, rectum, and other areas can also be affected.

　　4. Sexual dysfunction

　　Chronic prostatitis can cause decreased libido, seminal pain, premature ejaculation, and can also affect the quality of semen. Urethral discharge can occur after urination or defecation, and hematospermia may occur when combined with seminal vesiculitis.

　　5. Lumbar pain

　　The lumbar pain caused by chronic prostatitis can be easily confused with lumbar pain caused by orthopedic reasons, such as myofascialitis and lumbar muscle strain. However, the latter is usually located near the belt buckle and is higher than the lumbar pain caused by prostatitis.

　　6. Other symptoms

　　Chronic prostatitis can be accompanied by neurasthenia, showing symptoms such as fatigue, dizziness, and insomnia. Long-term and persistent prostatitis can even cause变态 reactions in the body, leading to conditions such as conjunctivitis and arthritis.

　　The above is an introduction to the common symptoms of chronic prostatitis. It is believed that through the above introduction, everyone has a certain understanding of this disease. However, it needs to be reminded that chronic prostatitis is a big trouble for men, with a relatively long duration and certain difficulty in treatment. Moreover, if not properly handled, it may lead to more serious consequences, and the difficulty in treatment will also increase accordingly. Therefore, patients should start from the smallest things to ensure the quick recovery of chronic prostatitis.

　　As everyone knows, chronic prostatitis is a common and frequent disease in elderly men. Its symptoms are mainly characterized by increased frequency of urination (especially at night), difficulty in urination, and thinning of urine stream. Triggers such as changes in weather, fatigue, alcohol consumption, sexual activity, or infection can cause frequent urination, urgency, dysuria, nocturia, difficulty in urination, thin urine stream, urine splitting, and white discharge from the urethral orifice, causing great pain to patients. So, how to prevent chronic prostatitis? The following measures are introduced:

　　1. Drink more water

　　It is recommended to drink 2 to 2.5 liters of water daily, which will increase urination, and concentrated urine can stimulate the prostate, causing harm to it in the long run. Drinking more water can not only dilute the blood but also effectively dilute the concentration of urine.

　　2. Do not hold urine

　　Once the bladder is full and there is an urgent need to urinate, you should urinate. Holding urine is harmful to the bladder and prostate. Before taking a long-distance bus, you should empty your bladder first and then take the bus. If you feel an urgent need to urinate during the journey, you should greet the driver and get off the bus to urinate. Never hold urine.

　　3. Control sexual life

　　To prevent benign prostatic hyperplasia, it is necessary to pay attention from young adulthood. The key is to have moderate sexual life, neither overindulgence nor abstinence. Frequent sexual life can keep the prostate in a state of congestion for a long time, leading to enlargement of the prostate. Therefore, it is especially important to control sexual life during the period of vigorous sexual desire in young people, to avoid repeated congestion of the prostate, and to give the prostate sufficient time for recovery and repair. Of course, excessive abstinence can cause a feeling of fullness and discomfort, which is also harmful to the prostate.

　　4. Relax more

　　Life stress may increase the chance of prostate enlargement. Clinical studies have shown that when life stress is relieved, the symptoms of the prostate will be alleviated, so it is advisable to keep a relaxed state in daily life.

　　5. Take a warm bath

　　Taking a warm bath can relieve the tension of muscles and the prostate, alleviate discomfort symptoms, and taking a warm bath regularly is undoubtedly very beneficial to patients with prostatitis. If you take a warm bath for the perineum 1-2 times a day, you can also achieve a good effect.

　　6. Keep clean

　　The scrotum of males has a large degree of elasticity and secretes a lot of sweat. In addition, due to poor ventilation in the perineum, long foreskin, phimosis, etc., it is easy to hide dirt and bacteria. Local bacteria often enter through the weakness, and if not paid attention to in time, it may cause serious infection, leading to prostatitis, decreased sexual function, and in severe cases, it may affect the quality of semen, leading to male infertility. Therefore, it is an important link to prevent prostatitis by persistently cleaning the perineum. In addition, it is very necessary to rinse the external genitalia before each sexual intercourse, and if there is a long foreskin or phimosis, early surgical treatment should be performed.

　　7. Prevent cold

　　Do not sit for a long time on a cold chair, because coldness can enhance the excitation of the sympathetic nervous system, causing urinary retention, leading to increased intravesical pressure and causing reflux.

　　8. Avoid friction

　　Friction in the perineum can exacerbate the symptoms of the prostate, causing obvious discomfort to the patient. To prevent harmful friction locally, it is advisable to ride a bicycle less often, and absolutely not to ride a bicycle or motorcycle for a long time or long distance.

　　9. Overcome bad habits

　　It is recommended to quit smoking as much as possible and not to drink alcohol (if there is a necessity to drink, it is better to have a little beer, but it is impossible to drink strong Baijiu), and to eat less spicy and刺激性 strong food such as chili and ginger, as well as greasy food, to avoid repeated congestion of the prostate and bladder neck, which can exacerbate the local sensation of swelling and pain. Since constipation may worsen the symptoms of prostate prolapse, it is advisable to eat more vegetables and fruits, eat some coarse grain food, keep the bowels smooth, reduce the occurrence of constipation, and use laxatives to help defecate. Eat more foods that are good for the prostate, such as black fungus, mushrooms, pork, beef, crucian carp, grass carp, beans, and grains, etc.

　　10. Enhance immunity

　　Regular physical exercise can enhance the body's resistance to diseases. Especially for those who have been sitting for a long time (such as drivers, those who sit in front of computers for a long time, etc.), it is more important to pay attention.

　　Chronic prostatitis includes chronic bacterial prostatitis and non-bacterial prostatitis. The examination items for chronic prostatitis generally include the following two:

　　1. Prostatic fluid examination

　　It can be found that there are 10 or fewer white blood cells per high-power field, or less than 10 but with clumps of pus balls accompanied by a decrease in lecithin bodies. Sometimes, a large number of white blood cells and macrophages can be seen under the microscope.

　　2. Bacterial examination

　　Prostatic fluid bacterial culture is positive, it is generally possible to collect segmented urine and prostatic fluid culture with counting.

　　What should chronic prostatitis patients eat? This is a question that many patients are currently concerned about. Many friends are very curious about what to eat to control the progression of prostatitis. Because this disease is difficult to cure and prone to recurrence, it makes patients extremely unhappy. Below, experts will introduce dietary suggestions for chronic prostatitis.

　　Firstly, what food is good for prostatitis

　　Vegetables and fruits: watermelons, muskmelons, grapes, kiwis, sugarcane, water chestnuts, winter melons, cucumbers, etc. Most of these foods are sweet and cool in nature, have the effect of diuresis and淋通, can clear heat and detoxify, transform dampness and promote diuresis, and play a role in inhibiting inflammation.

　　Dried fruits and杂粮: red beans, mung beans, pumpkin seeds, sunflower seeds, Job's tears, walnuts, sesame seeds, etc., these foods are rich in trace elements and a large amount of B vitamins, have good nutritional effects, and have the functions of clearing heat, reducing fire, killing insects, and softening the bowels. They can kill bacteria, relieve constipation, and make the prostatic ducts unobstructed, eliminating inflammation.

　　Health drinks and herbs: such as pollen, green tea, honey, as well as fresh reed roots, fresh mugwort roots, fresh bamboo leaves, and other fresh reed roots in herbs, decocted into a decoction for the treatment of prostatitis has a good effect. In honey, the honey from the Sophora japonica flower is better.

　　Secondly, dietary taboos for prostatitis

　　1. Patients with prostatitis should not smoke or drink alcohol. Patients may know that smoking can lead to impotence, but they may not realize that smoking can also increase prostatic congestion, thereby exacerbating the symptoms of acute and chronic prostatitis. Drinking can dilate organ vessels and increase blood perfusion, so it can also worsen the congestion of the prostate, leading to the recurrence of cured prostatitis.

　　2. People with prostatitis should not eat spicy foods: scallions, raw garlic, chili, pepper, and other刺激性 foods. Although these foods can enhance the taste of dishes, they can also cause vasodilation and organ congestion. For patients with prostatitis, these foods should not be consumed, otherwise, it may lead to prostatitis that is difficult to heal.

　　3. Some meats should not be eaten by people with prostatitis: dog, beef, mutton, seafood, etc. These meat products are often considered to be tonics for strengthening Yang and vitality. However, traditional Chinese medicine believes that prostatitis is caused by dampness, so using tonics that benefit dampness may not be as satisfactory. Moreover, clinical observations over many years have shown that eating the aforementioned meats often leads to a worsening of the condition.

　　4. For benign prostatic hyperplasia, indulgent and spicy foods often lead to endogenous damp-heat and impede the circulation of Qi and blood. Therefore, the elderly with benign prostatic hyperplasia should pay attention to a light diet.

　　Third, dietary choices

　　1, Loach Fish Stewed Tofu

　　500 grams of live loach fish, 250 grams of fresh tofu, salt, ginger, and monosodium glutamate as needed. When making, first cut the loach fish, remove the gills and internal organs, wash and put it in a炖盅, add an appropriate amount of salt, ginger, and clear water. First boil it with high heat, then simmer it with low heat until it is five-fifths done. Then, add tofu pieces to the炖盅, and continue to simmer with low heat until the loach fish meat is tender, and add seasonings for eating.

　　2, Magnolia Lean Pork Soup

　　Fresh Magnolia (also known as White Magnolia) 30 grams (dried 10 grams), fresh lean pork 150 grams. When making, first wash and cut the lean pork, and put it in a pot with Magnolia, add some clear water, and cook with medium heat to make soup. After the soup is done, add a little salt to taste.

　　3, Qi Mao Drink

　　Raw Astragalus 30 grams, White茅Root 30 grams (fresh 60 grams), Cistanche deserticola 20 grams, Watermelon Skin 60 grams (fresh 200 grams), sugar to taste. When making, first cut the Astragalus and White茅Root, and put them in a pot with Cistanche deserticola and Watermelon Skin, cook with medium heat to make soup for drinking, 2-3 times a day.

　　Traditional Chinese medicine has a significant advantage in the treatment of asymptomatic prostatitis. The use of traditional Chinese medicine decoctions needs to be formulated individually for different patients, which is relatively complex, but the clinical efficacy is more significant than that of Chinese patent medicines. The use of Chinese patent medicines can be different at different stages of chronic prostatitis:

　　For patients in the early stage of chronic prostatitis, the clinical manifestations are yellow, short, and hot urine, and there is some discomfort in the urethra during or after urination. Dragon Liver and Gallbladder Decoction, San Miao Wan, Ji Gu Cao Wan, Ning Mi Tai Capsule, and other Chinese patent medicines can be selected.

　　For those with chronic prostatitis accompanied by epididymal lesions and manifested as lower abdominal distension and pain, capsules such as Jin Li You Capsule, Ju He Wan, Xuan Hu Zhi Tong Pian, and Ze Gui Long Shuang Capsule can be taken; for those with high psychological stress and insomnia with dreams, the Chinese patent medicine such as Xiao Yao Wan, Qi Ye Shen An Pian, and Bai Cao An Shen Pian can be taken at the same time.

　　For those with long-standing lesions, feeling tired and weak, anal prolapse, sacral pain, and decreased sexual function, the Chinese patent medicine such as Bu Zhong Yi Qi Wan, Huan Shao Dan Capsule, and Zhuang Yang Fu Chun Ling Capsule can be selected according to different conditions.