Treatment and prevention of prostatitis (Part 2)
**Western Medical Treatment**
**(I) Acute Prostatitis**
(1) General treatment: Rest, avoid sexual activity, avoid spicy foods, drink plenty of water, and take oral laxatives.
The medication is used to soften stools; prostate massage and urethral instrumentation are contraindicated.
(2) Antibacterial treatment: Choose broad-spectrum and highly effective antibiotics. For mild cases, oral medication is recommended; for severe cases, intramuscular or intravenous administration is recommended.
Administration. Commonly used drugs include penicillin, aminoglycosides, cephalosporins, and quinolone antibiotics. The appropriate medication should be...
High doses, sustained for a period of time, to prevent incomplete treatment from turning into chronic or recurrent episodes.
(3) Symptomatic treatment: alkalize urine, relieve spasms and pain, use estrogen to reduce prostate congestion and inhibit...
Sexual arousal, hot sitz baths, rectal diathermy, or saline retention enemas can promote the absorption of inflammation. Acute urinary tract infections...
In cases of retention, a short-term indwelling catheter can be inserted. If an abscess forms, early aspiration and injection of antibiotics can be performed.
For swelling that increases in size, drainage can be performed via digital rectal examination and massage to drain pus, urethral probe massage to drain pus, rectal incision and drainage, and episiotomy.
Treatment methods include open drainage, transurethral incision and drainage, and presacral incision and drainage.
**(II) Chronic Prostatitis**
(1) General treatment: Avoid overexertion, prevent colds, avoid prolonged cycling and sitting, and maintain a comfortable lifestyle.
Maintain regular bowel movements, drink plenty of water, and have moderate and regular sexual activity.
(2) Anti-infection: Because chronic prostatitis causes permeability obstruction in the prostate tissue, most antibiotics...
The drug cannot cross the barrier to reach an effective therapeutic concentration, resulting in a low cure rate, high relapse rate, and unsatisfactory efficacy. (Optional)
Sulfamethoxypyrimidine, sulfamethoxazole, doxycycline, erythromycin, rifampin, cephalexin, and quinolones were used.
Drugs such as doxycycline and minocycline can also be used, and antibacterial drugs can be injected into or around the prostate via iontophoresis.
Methods of radiation therapy.
(3) Symptomatic treatment: For patients with excessive prostatic fluid, female hormones, sedatives, and antispasmodics can be used.
For those with mild fibrosis, male hormones (testosterone propionate 25mg, intramuscular injection, once every 3 days) and corticosteroids can be used.
Other medications include hydrocortisone (injected around the prostate), urinary tract inhibitors, bladder inhibitors, and polyuria inhibitors.
(4) Local treatment: hot sitz bath, transdermal therapy of the rectum or perineum, physical therapy (using medium frequency, ultra-high frequency, etc.)
(Shortwave, microwave, etc.), intrarectal prostate massage, intraprostatic periprostatic block therapy, vas deferens or epididymal puncture
Injection therapy, urethral instillation therapy, rectal embolization therapy, etc.
(5) Surgical treatment: For some incurable and difficult-to-control chronic prostatitis and other conditions...
Infected prostate stones should be treated surgically, but due to tight adhesions between the surgical site and surrounding tissues, surgery...
It is quite difficult and may affect sexual function after the procedure, so it is generally not suitable for young patients.
**Traditional Chinese Medicine Treatments**
**(I) Damp-Heat Accumulation Syndrome**
[Main Symptoms] Sudden onset, distending or stabbing pain in the perineum, testicles, and lumbosacral region, which may be accompanied by urinary frequency, urgency, and dysuria.
Discomfort or burning sensation during urination, dark yellow urine, white discharge at the end of urine, occasional constipation, and even fever.
Chills, red tongue with yellow, greasy coating, and a wiry, slippery, and rapid pulse.
[Treatment] Clear heat and promote diuresis.
[Prescription] Modified Bazheng Powder (from Taiping Huimin Heji Jufang). Add raw rhubarb for those with constipation.
**(II) Qi Stagnation and Blood Stasis Syndrome**
[Main Symptoms] Primarily distending pain in the perineum, lower abdomen, or scrotum; testicular heaviness; lower back pain and weakness; hematuria or blood in the urine.
The patient has a thin, white, greasy tongue coating, a dark tongue body, and a wiry, tight pulse.
[Treatment Method] Regulate Qi and disperse blood stasis.
[Prescription] Prostatitis Decoction (Clinical Formula): Salvia miltiorrhiza, Lycopus lucidus, Prunus persica, Carthamus tinctorius, Vaccaria segetalis, Patrinia scabiosaefolia
Grass, fennel, dandelion, and wheat.
**(III) Kidney Yin Deficiency Syndrome**
[Main Symptoms] Dull, distending pain or discomfort in the perineum, lower abdomen, or scrotum; soreness and weakness in the lower back and knees; dizziness; tinnitus; loss of consciousness.
Sleep disturbances, frequent dreams, nocturnal emissions, emaciation, red tongue with white coating, and a thready, rapid pulse.
[Treatment] Nourish kidney yin.
[Prescription] Modified Zhi Bai Di Huang Tang (from *Yi Zong Jin Jian*). For premature ejaculation and seminal emission, add Rosa laevigata and Euryale ferox; for blood...
Add small thistle to the fine ones.
**(iv) Kidney Yang Deficiency Syndrome**
[Main Symptoms] Perineal and lower abdominal soreness and coldness, aversion to cold, lower back pain, fatigue, impotence, premature ejaculation, dizziness, tinnitus, tongue...
The patient is pale and plump with a thin white coating, and has a deep and thready pulse.
[Treatment] Warm and tonify kidney yang.
[Prescription] Modified Fugui Bawei Wan (from *Synopsis of Prescriptions of the Golden Chamber*): Cinnamon, stir-fried Eucommia ulmoides, Cuscuta chinensis, prepared Rehmannia glutinosa, Cornus officinalis.
Meat, prepared aconite root, tribulus terrestris, poria cocos, licorice root, alisma plantago-aquatica, and peony bark. For those with erectile dysfunction, add yangqi stone and morinda officinalis.
**VII. Prevention and Care**
(1) Prevent catching a cold from exposure to cold. Upper respiratory tract infections can cause congestion and congestion of the prostate and increased pressure in the urethra.
Symptoms such as high blood pressure and difficulty urinating worsen.
(2) It is advisable to adjust one's diet, avoid spicy and greasy foods, and refrain from excessive smoking and drinking.
(3) Pay attention to the balance between work and rest, avoid overwork, and avoid prolonged sitting, cycling, or horseback riding to prevent...
It helps prevent poor blood circulation in the perineum.
(4) Coping strategies also play an important role in the prognosis of patients with chronic prostatitis. A passive approach...
Patients who primarily adopted a coping strategy experienced significantly more severe psychosomatic symptoms than those who primarily adopted an active coping strategy, and those who primarily adopted a passive coping strategy...
Patients with this condition tend to be introverted, neurotic, and unstable in personality; unhealthy coping mechanisms are also a contributing factor.
One of the reasons for treatment failure in patients is that it can significantly affect their physical and mental health and prognosis. Chronic prostatitis
Patients with adenitis, especially those with chronic, persistent adenitis, often exhibit changes in personality traits, manifested in coping mechanisms.
Obvious abnormalities may include insomnia, forgetfulness, anxiety, depression, and even intrusive thoughts and pessimistic feelings.
Negative coping attitudes and other related anxieties sometimes even outweigh the suffering caused by the illness itself, leaving patients with four...
Seeking medical help elsewhere is one of the reasons why chronic prostatitis is difficult to treat.