Gonorrhea complicated with seminal vesicitis

　　Acute gonococci enter the urethra through the urethral orifice, invade the mucosal epithelial cells of the anterior urethra, and reproduce within the cells, causing acute inflammation. A large number of white blood cells aggregate at the site of inflammation, the bacteria are engulfed by white blood cells, the bacteria die and release endotoxins, leading to necrosis of the mucosal layer of the urethra and the production of a large amount of purulent secretion, which is discharged from the urethral orifice. In the later stage, the lesion spreads to the posterior urethra, causing urethral bulbitis and prostatitis, and can also occur in seminal vesiculitis by retrograde through the seminal duct.

　　The main complications of seminal vesiculitis include the following:
　　1. Blood in semen:The appearance of semen is pink, dark red, or coffee-colored, which can last for several years, usually without pain during ejaculation. It is more common in young males, and blood in the semen is the initial symptom in most cases. In patients with cysts and seminal vesicle calculi, small stones may be discharged when blood-stained seminal fluid is expelled.
　　2. Hematuria:It can be gross hematuria, initial or terminal hematuria, especially the initial hematuria after ejaculation.
　　3. Male infertility:In addition to congenital seminal vesicle developmental abnormalities, there are also seminal duct stenosis or obstruction leading to oligospermia and asthenospermia. Long-term chronic seminal vesiculitis leads to atrophy of the seminal vesicle and severe reduction in function, which also reduces fertility.
　　4. Sexual dysfunction:Chronic seminal vesiculitis often occurs concurrently with chronic prostatitis. Due to reasons such as fear and tension, symptoms such as decreased libido and sexual dysfunction may occur.
　　5. Difficulty in urination:It is caused by the compression of the bladder neck and the posterior urethra by the cyst, and the degree of difficulty in urination is related to the size and position of the cyst. Some patients have symptoms of bladder irritation such as frequent urination and urgency.

　　The clinical manifestations of patients with complications are divided into two aspects:
　　1. Manifestations of gonorrhea
　　The main manifestation is acute urethritis, and patients usually develop symptoms 3 to 5 days after infection, with the longest reaching 10 days, depending on their physical condition, such as widespread use of antibiotics, weakened immunity due to physical weakness, excessive sexual activity, etc. The initial symptoms are redness and itching of the urethral opening, thin or purulent discharge, and after 24 hours, the symptoms worsen, with pain and burning sensation during urination, and the discharge of thick, deep yellow pus. When the symptoms at night are prominent, patients may experience painful erections. There may also be frequent urination and urgency. Some patients may also experience systemic symptoms, such as fever (around 38℃), general fatigue and weakness, discomfort, loss of appetite, and even nausea and vomiting.
　　2. Symptoms of seminal vesiculitis
　　Some patients may have no other symptoms except for blood in the semen, and sometimes they may show symptoms such as pain during ejaculation, reduced semen volume, and symptoms of chronic prostatitis.

　　The key to preventing gonorrhea complicated with seminal vesiculitis is to prevent the primary disease. The following points are helpful for preventing sexually transmitted diseases.

　　1. Publicize knowledge of sexually transmitted diseases, advocate noble moral sentiments, and strictly prohibit prostitution and pimping.

　　2. Using a condom can reduce the incidence of gonorrhea infection.

　　3. Preventive use of antibiotics can reduce the risk of infection. Fluorophenac or amoxicillin can be taken before and after sexual intercourse to effectively prevent the infection of sexually transmitted diseases.

　　4. Treat sexual partners at the same time.

　　5. Patients should pay attention to personal hygiene and isolation, do not sleep or bathe with family members, especially girls.

　　6. Implement the system of instilling silver nitrate solution or other antibiotic solution into the eyes of newborns to prevent the occurrence of gonococcal ophthalmia.

　　The clinical examination of gonorrhea complicated with seminal vesiculitis mainly relies on the patient's medical history, clinical symptoms, signs, detection of pathogenic bacteria, and results of urological examination for diagnosis.

　　1. Gonorrhea examination
　　Direct smear examination: Take the pus that exudes from the urethral orifice or squeeze the pus from the urethra, gently wipe it with a cotton swab, and then spread it on a slide for microscopic examination. Gram-negative gonococci can be seen in and around white blood cells, arranged in pairs and light red.
　　2. Seminal vesiculitis examination
　　Ultrasound examination or seminal vesicle造影 can be performed.

　　The diet principle for patients with gonorrhea complicated with seminal vesiculitis should be light, and avoid eating spicy and irritating foods. The following are two suitable food therapy recipes.

　　1. Pork bladder Job's tears porridge

　　Pork bladder (bladder) 2, Job's tears 100 grams. Rinse the pork bladder with warm water, cut it into strips, add a little oil to the pot and stir-fry it slightly, then add Job's tears rice, an appropriate amount of scallion, ginger, and sugar, and cook into porridge with water. The above is the amount for one day, and take 1 to 2 times on an empty stomach. A course of 15 days. Clear heat and promote diuresis. It is suitable for blood in the urine caused by damp heat retention.

　　2. Pork kidney stewed black beans

　　Pork kidney 1 pair, black beans 500 grams. Remove the adrenal glands from the pork kidney, wash it clean, and boil it with black beans and water. Do not add too much water, and boil until the black beans are cooked but not overdone. Remove the black beans and dry them in a strong fire and then fry. Eat the pork kidney and chew the black beans. Take 30 to 60 grams daily, with a course of 15 days. Nourish the kidneys and benefit the essence. It is suitable for blood in the urine caused by kidney deficiency and instability.

　　Patients with gonorrhea complicated with seminal vesiculitis generally have severe conditions and should increase the dosage of drug treatment and extend the treatment time. The following methods can be adopted:
　　1. Ceftriaxone or spectinomycin
　　Intramuscular injection of ceftriaxone or spectinomycin.
　　2. Ciprofloxacin
　　Oral ciprofloxacin treatment is prohibited for patients with liver and kidney dysfunction and teenagers under 18 years old.