Acute bacterial prostatitis

　　1. Bacterial infection by pathogens is the main pathogenic factor for bacterial prostatitis. Due to low body resistance, bacteria with strong virulence or other pathogens infect the prostate and rapidly multiply, causing the disease. It is mostly caused by hematogenous infection and retrograde infection through the urethra. The pathogens are mainly Escherichia coli, followed by Staphylococcus aureus, Klebsiella pneumoniae, Proteus, Pseudomonas, and so on, with the vast majority being single-pathogen infections.

　　2. Important triggers for the onset of prostatitis include smoking, drinking, preference for spicy foods, inappropriate sexual activity, prolonged sitting causing long-term congestion of the prostate and chronic compression of the pelvic floor muscles, catching a cold, fatigue, etc., leading to decreased body resistance or specific constitution.

　　1. Acute urinary retention:Acute prostatitis can cause local congestion, swelling, and compression of the urethra, leading to difficulty in urination or acute urinary retention. Abscesses are more common in patients aged 20-40, with symptoms such as rectal symptoms and urinary retention more common.

　　2. Acute seminal vesicle or epididymitis and vas deferens inflammation:Acute prostatitis can easily spread to the seminal vesicle, causing acute seminal vesiculitis. At the same time, bacteria can reverse through the lymphatic vessels into the wall and outer sheath of the vas deferens, leading to epididymitis, with local swelling and pain.

　　3. Acute cystitis:Symptoms such as bladder irritation, urethral leakage, difficulty in urination, lower abdominal perineal and lower lumbar pain may be present.

　　4. Enlarged testicular lymph nodes or tenderness:The prostate and testicular lymphatics have communicating branches in the pelvis. During acute prostatitis, the testicle can be involved, causing enlargement of the testicular lymph nodes with tenderness.

　　5. Sexual dysfunction:During the acute inflammatory period, the prostate may become congested, swollen, or have small abscesses, with symptoms such as seminal pain, painful erections, decreased libido, sexual pain, erectile dysfunction, and seminal blood.

　　1. Acute bacterial prostatitis has an acute onset, and can manifest as systemic symptoms such as chills, high fever, fatigue, and loss of appetite.

　　2. Accompanied by persistent and obvious lower urinary tract infection symptoms, such as frequent urination, urgency, dysuria, and burning sensation during urination, there may be difficulty in urination, urinary retention, and discomfort and distension in the posterior urethra, anus, and perineal area.

　　5. The number of white blood cells in the blood and urine increases, and the bacterial culture is positive.

　　1. The clinical characteristics of acute prostatitis are sudden onset, with symptoms such as fever, urinary tract irritation, and perineal pain, which are all related to the acute congestion, swelling, and suppuration of the gland. The bacteria causing this acute infection can invade the prostate through different ways such as hematogenous infection, lymphatic infection, and direct extension. Among them, direct extension is the most common. When there is bacterial infection in the bladder or posterior urethra, the pathogenic bacteria can enter the prostate ducts and acini through the opening of the seminal duct located in the urethra of the prostate.

　　2. If the primary bacterial infection focus is in the anus, colon, and other places, the pathogenic bacteria can also enter the gland through the lymphatic vessels connected to the prostate, which is called lymphatic infection. If the bacterial infection focus is in the oral cavity, pharynx, respiratory tract, and other places, the pathogenic bacteria寄生 in these places can enter the prostate through the blood circulation, which is called hematogenous infection. All these pathogenic bacteria first invade the prostate excretory ducts in the prostate, and reproduce here. Once the conditions are suitable, they can quickly cause obvious lesions.

　　3, Actively treat infections in various parts of the body to prevent pathogens from infecting the prostate through various ways. Pay attention to sexual intercourse under the protection of sterile condoms, clean the penis and perineum after sexual intercourse, keep it dry to help prevent infection. For those with long foreskin or phimosis, circumcision should be performed to prevent possible infection caused by pathogenic microorganisms. Maintain moderate and regular sexual life or control the frequency of masturbation to regularly release prostatic fluid, promote its continuous renewal, help relieve the feeling of fullness; avoid holding back semen without ejaculation or frequent masturbation to avoid excessive congestion of the prostate...

　　4, Do not ride a bicycle for a long time or sit for a long time without moving, avoid excessive compression of the prostate, leading to congestion. Pay attention to local warming, which helps to reduce the outlet resistance, making it easier for the already congested and swollen tissues to recover. Live a regular life, exercise appropriately, take a walk after meals to enhance the body's immunity and disease resistance. In addition, avoid overwork, prevent constipation, drink more water and urinate more, which helps the secretion of prostatic fluid and also helps prevent recurrence of infection. Do not abuse antibiotics to prevent bacteria from becoming L-type, and L-type bacteria are one of the important reasons for the difficult treatment of asymptomatic and chronic prostatitis.

　　5, Avoid unnecessary, frequent, or heavy prostate massage, avoid unnecessary catheterization to prevent damage to the prostate or infection. Widespread knowledge of prostate diseases, guide the public to protect the prostate, improve poor lifestyle, and quit bad habits. Pay attention to the prevention of patients with prostatitis after treatment, try not to use long-term empirical antibacterial drugs for prevention, and should take the above-mentioned preventive measures to alleviate the physical and psychological symptoms of patients, help prevent recurrence of infection; insist on perineal muscle exercises to relax the pelvic floor muscles, gradually increase the interval of urination, etc.

　　1, Urinalysis and urine sediment examination:Urine can be turbid, even purulent, with a large amount of flocculent and debris-like substances deposited, the initial urine and terminal urine in the three-cup test are most obvious, and a large number of white blood cells can be seen under microscopy.

　　2, Blood routine:White blood cells > 1×10^9/L, neutrophil ratio > 70%, nuclear left shift may occur, even immature cells.

　　3, Bacteriological examination:Urine smear microscopy can see bacteria, urine or blood culture can be positive.

　　Diet should be light, avoid excessive drinking and eating a lot of spicy foods.

　　Nutritional therapy:

　　1, Plantago seedling sugar water

　　100 grams of plantago seedling (fresh 400 grams), 10 grams of bamboo leaf core (fresh 30 grams), 10 grams of raw licorice, and an appropriate amount of rock sugar.

　　Preparation: First, put the plantago seedling, bamboo leaf core, and raw licorice into a pot, add some clear water, boil with medium heat, boil for about 40 minutes, then add rock sugar, boil for a while and it's ready. Drink it as tea every day.

　　2, Light heart flower bitter melon soup

　　Available light heart flower 6 bundles, fresh bitter melon 200 grams.

　　Preparation: First, clean the bitter melon, remove the core and seeds, and cut it into small segments, then decoct it with Lysimachia christinae to drink the soup.

　　3. Winter Melon, Kelp, and Coix Seed Soup

　　Use 250 grams of fresh winter melon (with peel), 50 grams of raw coix seed, and 100 grams of kelp.

　　Preparation: First, clean the winter melon and cut it into coarse pieces, clean the raw coix seed, and cut the kelp into thin slices. Put these three ingredients together into a pot, add an appropriate amount of water, and then cook into soup for consumption.

　　4. Dandelion and Lonicera japonica Porridge

　　60 grams of Dandelion, 30 grams of Lonicera japonica, 100 grams of rice, and an appropriate amount of sugar.

　　Preparation: First, put Dandelion and Lonicera japonica together into a pot, add an appropriate amount of water, and then decoct the juice. Then filter the medicine juice and add it to the rice to cook into a thin porridge. After the porridge is cooked, add an appropriate amount of sugar. Take 2 times a day.

　　5. Dioscorea opposita Porridge

　　30 grams of rhizome of Dioscorea opposita (100 grams of fresh product), 100 grams of rice.

　　Preparation: First, clean the rhizome of Dioscorea opposita, peel it, and cut it into slices (this step can be omitted if it has already been dried and sliced), then put it into a pot, boil it with medium heat for about 30-40 minutes, and then extract the juice. Add rice to the decoction of Dioscorea opposita and cook it into porridge with medium heat.

　　General treatment: Patients should rest in bed for 3-4 days, drink water appropriately, and avoid alcohol and spicy foods. Hot water sitz baths or perineal heat compresses can be used, and bowel movements should be kept smooth. Sexual activity should be avoided.

　　Symptomatic treatment: If fever occurs, antipyretic drugs such as indomethacin suppositories or aspirin should be administered.

　　Antibiotic treatment for acute prostatitis is necessary and urgent. After clinical diagnosis or blood and urine culture results are obtained, antibiotics should be applied immediately. Intravenous administration of antibiotics is recommended initially, such as broad-spectrum penicillin, third-generation cephalosporins, aminoglycosides, or fluoroquinolones, etc. After the patient's fever and other symptoms improve, oral medications (such as fluoroquinolones) are recommended, with a course of at least 4 weeks. Antibiotics should also be used for patients with mild symptoms for 2-4 weeks.

　　For those with acute bacterial prostatitis accompanied by urinary retention, suprapubic bladder puncture and stenting for urine drainage can be performed, or fine catheterization can be used, but the indwelling catheter time should not exceed 12 hours.

　　For those with prostatic abscess formation, fine needle aspiration drainage under rectal ultrasound guidance, transurethral incision of the prostatic abscess for drainage, or perineal puncture drainage can be adopted.