Rehabilitation and health care of chronic prostatitis, its relationship with infertility, and the definition of benign prostatic hyperplasia (BPH).
How to recover and maintain health in patients with chronic prostatitis
Chronic prostatitis can occur secondary to acute prostatitis, cystitis, or pyelonephritis, or it can be caused by non-infectious factors such as frequent intercourse, excessive masturbation, interrupted intercourse, excessive alcohol consumption, habitual constipation, and overwork, leading to chronic congestion and edema of the prostate and resulting in chronic inflammation. Patients with chronic prostatitis should try to reduce the frequency of intercourse to allow the prostate to rest fully, reduce congestion, and promote early healing of the inflammation. Failure to practice moderation can create a vicious cycle, making prostatitis difficult to cure and worsening symptoms of sexual dysfunction. Therefore, excessive sexual desire should be corrected, interrupted intercourse or excessive masturbation should be avoided, prolonged cycling or sitting should be avoided, and adequate water intake and regular bowel movements should be maintained. Daily hot sitz baths and Kegel exercises can help with prostate activity. However, hot baths can affect sperm production, so those wishing to conceive should avoid them. Regular physical exercise to strengthen the body and prevent colds can also contribute to the recovery from chronic prostatitis.
From a physiological perspective, sitting slows blood circulation, especially in the perineum, directly leading to chronic congestion in the perineum and prostate. While short periods of sitting have no immediate impact, prolonged sitting due to work or other reasons can affect the prostate. This is because congestion in the perineum and prostate can cause the accumulation of metabolic waste products, blockage of the prostate ducts, and impaired drainage of prostatic fluid, leading to chronic prostatitis. Studies have shown that a significant proportion of chronic prostatitis patients are drivers, and that this condition is difficult to cure, illustrating this point. Therefore, drivers should be aware of this and avoid prolonged sitting during work; avoid holding urine. Taking appropriate breaks and changing positions regularly can improve local prostate congestion and reduce or prevent the occurrence of chronic prostatitis.
Can chronic prostatitis lead to infertility?
Whether chronic prostatitis affects fertility is currently unclear. Some patients with severe prostatitis can still conceive; however, theoretically, inflammation of the prostate can affect the quantity, quality, and composition of semen, potentially leading to infertility. Therefore, this issue should be viewed dialectically.
First, when the prostate gland is inflamed, the secretion of prostatic fluid decreases, thus reducing semen volume and interfering with sperm survival and motility. Simultaneously, it reduces the activity of enzymes in the prostatic fluid, increases semen viscosity, and prolongs liquefaction time. Furthermore, inflammation can lower the pH of the semen and cause the body to produce antisperm antibodies, leading to sperm death. The prostatic fluid, due to inflammation, contains a large number of bacteria and bacterial toxins, which can consume nutrients in the seminal plasma, thereby affecting sperm survival.
Therefore, it is evident that chronic prostatitis may indeed affect fertility. However, clinical cases show that most patients with chronic prostatitis have normal fertility. Although a small number of patients may also experience infertility, it should be recognized that there are many causes of infertility. Overemphasizing chronic prostatitis often leads to overlooking other causes, thus delaying the best time for treatment and potentially unnecessarily exacerbating the patient's fear of the disease.
What is benign prostatic hyperplasia (BPH)?
The prostate gland in male infants grows slowly after birth, but its growth accelerates during puberty, and its size remains relatively constant until middle age, approximately 4×3×2 cubic centimeters. After about age 50, it exhibits two trends: in some men, it tends to atrophy, with the gland gradually shrinking; in others, it tends to enlarge, with the gland gradually increasing in size. When the enlarged prostate reaches a certain size and compresses the urethra, causing a series of symptoms such as difficulty urinating, it is called benign prostatic hyperplasia (BPH).
A normal prostate in an adult male is about the size of a large chestnut, neither too soft nor too hard, and slightly elastic to the touch. Benign prostatic hyperplasia (BPH) is a different story! In BPH, the prostate enlarges, and the fibrous tissue, smooth muscle tissue, and glandular tissue within the prostate all grow and increase abnormally. If the hyperplasia is primarily of fibrous and muscle tissue, the prostate becomes very hard; if it's primarily of glandular tissue, the prostate becomes very soft. However, most prostates involve the hyperplasia of all these tissues together, so the texture becomes harder, and the prostate can grow to the size of a chicken egg, duck egg, or goose egg. Clinically, these are correspondingly termed Grade I, Grade II, and Grade III prostate hyperplasia.
Furthermore, the continuous growth of the enlarged portion of the prostate compresses the surrounding true prostate tissue, forming a so-called "outer capsule." Due to the internal prostate enlargement, this capsule is compressed outwards, causing it to thicken as well, further exacerbating the prostate enlargement. This capsule is approximately 2-5 millimeters thick, grayish-white, and very hard, with a clear boundary from the enlarged prostate tissue, making it easy to bluntly dissect during surgery. Once the enlarged portion of the prostate is removed, the symptoms of benign prostatic hyperplasia (BPH) disappear. However, some patients, such as the elderly, those with weak constitutions, severe heart disease, or high blood pressure, are not suitable for prostatectomy and should primarily receive conservative treatments such as traditional Chinese medicine based on syndrome differentiation.