Foot Reflexology - Prostatitis
Foot Reflexology - Prostatitis
Prostatitis is a common disease in men. It may be caused by bacterial infection or other factors, including acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis (chronic pelvic pain syndrome), etc. 35%-50% of men from adolescence to old age are affected by prostatitis. Unclean sexual life, long sitting and unhealthy eating habits, such as excessive drinking and spicy food, may all be factors that induce prostatitis.
The symptoms of the disease are diverse, ranging from acute pain, frequent urination, to sexual dysfunction and mental and psychological disorders. Acute bacterial prostatitis often manifests as frequent urination, urgency, urethral burning pain, etc., while chronic prostatitis (chronic pelvic pain syndrome) may have long-term pain and discomfort in the pelvic area, urethral discomfort during urination, sexual dysfunction, and mental and psychological problems.
Treatment methods vary depending on the type of disease. Acute bacterial prostatitis usually responds well to antibacterial drugs, and inflammation is controlled by immediate intravenous injection of broad-spectrum antibiotics. Chronic bacterial prostatitis selects appropriate antibiotics based on the results of bacterial culture and drug sensitivity tests. The treatment of chronic prostatitis includes lifestyle adjustment, drug therapy, psychotherapy, local physical therapy, etc., mainly to improve symptoms, improve quality of life and promote the recovery of related functions.
Prostatitis is a common disease. The key lies in early detection and accurate diagnosis, and then choose the most effective treatment method. At the same time, adjusting lifestyle and eating habits, as well as regular physical examinations, are also effective ways to prevent and control prostatitis.
Causes
Prostatitis is caused by pathogen infection or other reasons.
Irregular sexual life, long sitting, alcoholism, spicy food, etc. may be the triggering factors of prostatitis.
Causes
Type I: Acute bacterial prostatitis
Bacterial infection is the main pathogenic factor.
The infection route can be blood infection, and the bacteria are retained in the prostate through the blood circulation, causing acute inflammatory reaction of the prostate;
It can also be retrogradely infected through the urethra. When the urinary tract is blocked, urine retention, etc. cause urine reflux, the bacteria in the urine reflux to the prostate and cause prostatitis.
Type II: Chronic bacterial prostatitis
Pathogen infection is the main pathogenic factor, mainly retrograde urethral infection.
Type III: Chronic prostatitis/chronic pelvic pain syndrome
The cause is unknown. Most scholars believe that the main cause may be pathogen infection, inflammation, urination dysfunction, in addition, it may also be the result of the combined effects of psychological factors, immune abnormalities, etc.
Type IV: Asymptomatic prostatitis
Since it has no clinical symptoms, it is often discovered during examinations for other diseases, so there is a lack of research data on its pathogenesis. It may share some of the same causes as type III prostatitis.
Predisposing factors
-Irregular sexual life
Excessive sexual life or masturbation can cause the prostate to be in a state of repeated and continuous congestion and edema; and a long period of interruption of sexual life will cause the prostate fluid and metabolites to be discharged irregularly.
In addition, "holding back ejaculation" or interrupting sexual intercourse before reaching orgasm and ejaculation to prevent ejaculation, which can cause chronic congestion of the prostate. Excessive congestion and edema of the prostate are conducive to pathogens infecting the urethra and spreading through the urethra into the prostate.
-Unclean sexual intercourse
Pathogens cause urethritis through sexual intercourse and then infect the prostate.
-Unhealthy lifestyle
Long-term sitting and long-term riding can compress the prostate, leading to congestion and edema of the pelvic cavity and prostate, which can cause local accumulation of metabolites, obstruction of the prostate gland duct, and poor excretion of prostate fluid.
-Unhealthy eating habits
Alcoholism and eating a lot of spicy and irritating foods can cause dilation and congestion of urethral and prostate blood vessels, aggravating inflammatory reactions.
-Local coldness
It may cause blood circulation disorders and muscle spasms in the pelvic area, promoting the onset of symptoms.
Symptoms
-Acute bacterial prostatitis, often occurs suddenly, manifested as acute pain, accompanied by abnormal urination-related symptoms and fever.
-Chronic prostatitis (chronic pelvic pain syndrome), clinical manifestations are relatively numerous and complex, mostly pelvic pain, frequent urination, urinary pain, abnormal urethral secretions, sexual dysfunction, mental and psychological disorders and other symptoms.
-Type IV prostatitis (asymptomatic prostatitis) lacks obvious clinical symptoms.
Typical symptoms
-Acute bacterial prostatitis
-Systemic symptoms
-Sudden fever, chills, fatigue, weakness, anorexia, nausea, vomiting, etc.
Local symptoms
-Heavy pressure in the perineum or suprapubic area, extending to the waist, lower abdomen, back, thighs, etc., making the patient restless.
Urinary tract symptoms
-Frequent urination, urgency, urethral burning pain, urine dripping and purulent urethral secretions, bladder neck edema can cause poor urination, thinning or interruption of urine-stream, and severe urine retention.
Rectal symptoms
- Rectal distension, urgency or difficulty in defecation, white discharge from the urethra during defecation.
- Chronic bacterial prostatitis and chronic prostatitis (chronic pelvic pain syndrome)
Systemic symptoms
- Not obvious, chronic bacterial prostatitis can manifest as recurrent urinary tract infections, and fever can occur when acute prostatitis occurs.
Pelvic pain symptoms
Pain and discomfort in the pelvic area, which is widespread and unclearly located swelling and dull pain, such as the perineum, suprapubic bone, perianal area, scrotum, inner thigh root, penis and other parts.
Lower urinary tract symptoms
Frequent urination, urgency, pain, urethral discomfort or burning sensation during urination, waiting to urinate and incomplete urination, etc.
Reproductive system symptoms
Mainly manifested as decreased libido, erectile dysfunction, premature ejaculation, etc.
Nervous system symptoms
Excessive mental tension, anxiety, frequent dizziness, memory loss, suspicion, insomnia, depression, etc. Patients are also often overly sensitive to physical discomfort and pain.
Accompanying symptoms
-Acute bacterial prostatitis
If accompanied by acute cystitis, epididymitis, seminal vesiculitis and vas deferens, corresponding symptoms may occur, such as seminal vesiculitis may cause hematospermia.
-Chronic prostatitis
Often accompanied by urethral white discharge, fatigue, insomnia, dizziness, etc.
Medical treatment
When pain or discomfort occurs in the pelvic area, with or without frequent urination, urgency, pain, incomplete urination, white discharge from the urethra, and a few people may also have a sudden high fever, you should go to the hospital for treatment in time.
Diagnostic process
The doctor can make a diagnosis based on the patient's medical history, rectal examination, blood, urine, prostatic fluid examination (prostatic fluid is prohibited when fever occurs) and bacterial culture.
Departments to be treated
-Urology, andrology.
-If the neurological symptoms are severe, referral to the Department of Psychiatry and Psychology can be made.
- Related examinations
Acute bacterial prostatitis
-Rectal examination
The prostate is swollen, smooth surface, obvious tenderness, increased local temperature, etc. If an abscess is formed, a sense of fluctuation can be felt. The spread of infection can cause seminal vesiculitis, epididymitis, and bacteremia, so prostate massage or puncture is contraindicated.
- Routine blood test
It indicates leukocytosis, and blood culture is checked for bacteremia.
- Urinalysis
Common leukocytosis, urine culture often has bacterial growth.
Chronic prostatitis
-Rectal digital examination
The prostate is full, enlarged, soft, and mildly tender. In patients with a long course of disease, the prostate shrinks, hardens, is uneven, and has small nodules.
-Prostatic fluid examination
Prostatic fluid leukocytes>10/high-power field of view indicate inflammation of the prostate (possibly chronic bacterial prostatitis or type ⅢA prostatitis, i.e., inflammatory chronic pelvic pain syndrome), but bacterial culture is required for the next step of typing;
If the prostatic fluid examination is normal and there is no bacterial growth in the culture, it is called prostatitis;
The number of lecithin bodies has no clear meaning, and it is not recommended to pay attention to this indicator;
The number of leukocytes in the prostatic fluid of patients with chronic pelvic pain syndrome has nothing to do with the severity of symptoms and should not be used as an indicator to evaluate the treatment effect.
"Four cups method" segmented urine and prostatic fluid culture examination
Collect segmented urine and prostatic fluid for bacterial culture to diagnose chronic bacterial prostatitis.
Auxiliary examination
Ultrasound examination is not the basis for the diagnosis of prostatitis. Its significance is differential diagnosis to exclude other diseases. In addition, urodynamics, cystoscopy, CT, magnetic resonance imaging (MRI), etc. can all be used as differential diagnostic methods for prostatitis.
Differential diagnosis
-Acute pyelonephritis
Acute bacterial inflammation of the renal pelvis and renal parenchyma. Acute pyelonephritis is more common in women than in men; low back pain is mostly in one kidney area, and percussion pain is obvious, while acute prostatitis is more obvious in frequent urination, urgency, and pain.
-Benign prostatic hyperplasia
Generally, symptoms appear after the age of 50, with progressive dysuria as the typical manifestation, and frequent urination is the most common early symptom. Rectal examination of prostatic hyperplasia can show enlargement of both lobes of the prostate or disappearance of the middle groove, while prostatitis is fullness of the prostate and tenderness.
-Prostate cancer
Mainly occurs after the age of 50. Rectal examination shows that the surface of the gland is uneven, and hard nodules like stones can be felt. However, sometimes chronic prostatitis can also be found to have a hard texture and nodules in the prostate during rectal examination.
Prostate-specific antigen (PSA) is elevated, and B-ultrasound, magnetic resonance imaging (MRI) examinations, etc. can reveal space-occupying lesions, which can be identified by the above examinations combined with prostate biopsy.
Treatment
Acute bacterial prostatitis responds well to antibacterial drugs, and broad-spectrum antibiotics should be injected intravenously immediately to quickly control inflammation.
For chronic bacterial prostatitis, appropriate antibiotics should be selected based on the results of bacterial culture and drug sensitivity tests.
The treatment of chronic prostatitis (chronic pelvic pain syndrome) includes lifestyle adjustment, drug therapy, psychotherapy, local physical therapy, etc., mainly for the purpose of improving symptoms, improving quality of life and promoting the recovery of related functions.
-Acute treatment
Acute bacterial prostatitis should be treated with antibacterial drugs to control infection, antipyretic and analgesic treatment, and patients are encouraged to actively rest in bed and drink more water.
A few patients with urinary retention can use catheterization or suprapubic bladder puncture to drain urine.
Very few prostate abscesses are formed, which require surgical incision and drainage.
It should be noted that the acute stage must be treated thoroughly, otherwise it is easy to turn into chronic prostatitis.
-Catheterization
A method of inserting a catheter into the urethra to decompress the bladder.
Suprapubic cystostomy
Suprapubic cystostomy is suitable for patients with urinary retention who have contraindications to transurethral catheterization or who have failed intubation. Compared with transurethral catheterization, this method has a relatively low incidence of urinary tract infection and does not cause urethral stenosis. Another advantage is that the catheter can be clamped without removing the catheter to try urination, thus avoiding the need for catheterization again after urination failure.
General treatment
Quit drinking and eating spicy and irritating foods;
Avoid holding urine, sitting for long periods of time, and pay attention to bed rest;
Perform stool softening treatment;
Perform regular prostate massage (not allowed for patients with acute prostatitis);
Pay attention to keeping warm, and if necessary, perform perineal hot compresses, hot water sitz baths, physical therapy, etc. under the guidance of a doctor;
Learn more and understand the relevant knowledge of prostatitis diagnosis and treatment, and provide psychological and behavioral counseling when necessary.
-Drug treatment
According to the classification of prostatitis, the key points of drug treatment are as follows.
-Acute bacterial prostatitis (type I)
Immediately intravenously inject broad-spectrum antibiotics to quickly control inflammation. Commonly used antibiotics include broad-spectrum penicillin, third-generation cephalosporins, aminoglycosides or fluoroquinolones.
After obtaining the results of the patient's bacterial culture, choose a more targeted sensitive antibiotic for intravenous treatment.
After the fever symptoms improve, oral antibiotics can be used for treatment.
You can use drugs in combination or alternately to prevent drug resistance.
Antibiotics should be used as prescribed by the doctor, in sufficient doses and for a sufficient course of treatment, and avoid abuse.
-Chronic prostatitis
Type II: chronic bacterial prostatitis
According to the results of bacterial culture and drug sensitivity tests, choose sensitive antibiotics to control inflammation. Commonly used antibiotics include levofloxacin, azithromycin, doxycycline, etc.
Oral α-receptor blockers (such as tamsulosin hydrochloride and doxazosin) for 6 to 12 weeks to improve pain or urination symptoms. During treatment, attention should be paid to adverse reactions such as dizziness and postural hypotension caused by such drugs.
Nonsteroidal anti-inflammatory drugs (such as celecoxib) are empirical medications that help improve pain or discomfort symptoms.
Patients with symptoms of overactive bladder and no urinary tract obstruction can be treated with M receptor blockers tolterodine or solifenacin to improve urination symptoms.
Type III: Chronic prostatitis/chronic pelvic pain syndrome
Oral α-receptor blockers (such as tamsulosin hydrochloride) for 6 to 12 weeks to improve obstructive urination symptoms or pain symptoms.
Herbal medicines (such as saw palmetto fruit extract) for 6 to 12 weeks to improve pain and urination symptoms.
Patients with symptoms of overactive bladder and no urinary tract obstruction can be treated with M receptor blockers tolterodine or solifenacin to improve urination symptoms.
Neurological symptoms such as depression, anxiety, and chronic fatigue syndrome can be treated with antidepressants (such as fluoxetine, etc.) and antianxiety drugs (such as diazepam, etc.). Nonsteroidal anti-inflammatory drugs can help improve pain or discomfort.
In addition, after further classification of type III prostatitis, the treatment options are different.
Type IIIA: refers to inflammatory chronic pelvic pain syndrome, with an increase in the number of white blood cells in the microscopic examination of prostatic fluid/semen/urine after prostate massage. Fluoroquinolone and other antibacterial drugs can be taken empirically for 2 to 4 weeks, and can be continued if symptoms are relieved, with a total course of 4 to 6 weeks. If the full course of treatment still fails, antibacterial drugs should not be used for treatment unless the patient has a urinary tract infection.
Type IIIB: Antibacterial drugs are not recommended for treatment.
Type IV: Asymptomatic prostatitis
Generally, no treatment is required.
If combined with infertility or elevated serum prostate-specific antigen (PSA), the treatment method for type III prostatitis can be referred to.
- Surgical treatment
Acute bacterial prostatitis
Acute bacterial prostatitis complicated with abscess, when conservative treatment is ineffective, should be incised and drained through the rectum or urethra; if the abscess is confined to the prostate, urethroscopy can be used to perform prostate puncture and drainage, and then inject broad-spectrum antibiotics.
Incision and drainage
Transrectal prostate incision and drainage is suitable for abscesses around the posterior lobe. Incision and drainage is performed under the rectal mucosa, where the fluctuation is obvious during digital examination, and pus flows out of the anus.
The operation is simple and convenient, with little damage, thorough drainage, and no need for dressing change after surgery. However, in rare cases, if the operation is not careful, it may cause urinary fistula.
Prostate puncture and drainage
Puncture the prostate tissue through the rectum or perineum to absorb pus, which can not only extract tissue for cytological examination, but also play a role in pus drainage, and can inject local injection drugs into the prostate tissue.
-Chronic prostatitis
Chronic prostatitis itself does not require surgery. Surgical treatment is only performed when chronic prostatitis is combined with other prostate diseases and there are surgical indications, such as when combined with prostate hyperplasia.
Common surgical methods include transurethral electroresection of the prostate, etc.
Transurethral electroresection of the prostate
The purpose of the surgery is to remove the hyperplastic prostate tissue. It is suitable for patients with prostate hyperplasia who have surgical indications and has a good effect on improving the symptoms of prostate hyperplasia.
It is not recommended to use this surgery for the treatment of prostatitis alone.
Traditional Chinese Medicine Treatment
There is no evidence-based medical evidence to support the traditional Chinese medicine treatment of this disease, but some traditional Chinese medicine treatment methods or drugs can relieve symptoms. It is recommended to go to a regular medical institution and receive treatment under the guidance of a physician.
In addition to oral medications, commonly used external treatments include anal suppositories, Chinese medicine baths, Chinese medicine external applications, retention enemas, acupuncture, etc.
Other treatments
Prostate massage
It can promote prostate blood circulation, gland emptying and drainage, and increase local drug concentration. Therefore, it is recommended as an adjuvant therapy for chronic prostatitis. Combined with other treatments, it can effectively shorten the course of the disease.
For patients who cannot tolerate prostate massage, regular ejaculation can also achieve the same therapeutic effect.
Not recommended for patients with acute bacterial prostatitis.
Physical heat therapy
It mainly uses the thermal effects produced by various physical means such as microwaves, radio frequencies, and lasers to accelerate the blood circulation of prostate tissues, promote metabolism, and is beneficial to anti-inflammatory and eliminate tissue edema, relieve pelvic floor muscle spasms, etc.
It has a certain effect in relieving symptoms in the short term, but the long-term effect is unclear.
It is not recommended for unmarried and childless people.
Biofeedback and electrical stimulation therapy
Methods such as perineal muscle training and bladder function training can improve and coordinate the functional status of local muscles and organs, have a synergistic therapeutic effect on chronic prostatitis, and can significantly improve pain and discomfort symptoms and improve the quality of life.
Psychological treatment
Psychological intervention can improve patients' pain symptoms and quality of life.
It is recommended that patients with chronic prostatitis who have obvious psychological distress implement targeted psychological treatment.
Prognosis
The prognosis of different types of prostatitis varies, but most patients have a good prognosis after timely and effective treatment.
Curability
-Acute/chronic bacterial prostatitis has a good prognosis. Most patients can be cured after timely treatment. A very small number of patients with prostatic abscesses can also be cured after incision and drainage.
-Acute bacterial prostatitis can turn into chronic prostatitis if it is not treated thoroughly.
-Chronic prostatitis (chronic pelvic pain syndrome) itself can also be cured, but the symptoms of some patients can recur, which is closely related to the patient's lifestyle and work habits. Some patients themselves are depressed or anxious, and local pain is a secondary manifestation. These reasons make it difficult for some patients to "cure" their symptoms. For these patients, general treatment and psychological treatment are more important than drug treatment.
Complications
-Acute prostatitis
Acute urinary retention
The patient will suddenly experience symptoms related to bladder distension due to inability to urinate. This is because acute prostatitis causes local congestion and swelling, which can cause urination difficulties after compressing the urethra, and in severe cases can lead to acute urinary retention.
Acute seminal vesiculitis, epididymitis or vas deferens
Acute inflammation of the prostate can easily spread to the seminal vesicle, causing acute seminal vesiculitis, often with perineal pain and hematospermia. At the same time, bacteria can retrograde through the lymphatic vessels into the wall layer and outer sheath of the vas deferens, causing vas deferens or epididymitis, the latter of which is manifested by local redness, swelling and hard nodules in the epididymis, and tenderness.
Sexual dysfunction
Prostatitis congestion and edema may affect the patient's sexual function, manifested as decreased libido, erectile dysfunction, painful penile erection, sexual intercourse pain, ejaculation pain, hematospermia, etc.
-Chronic prostatitis
-Chronic seminal vesiculitis
Chronic seminal vesiculitis is the most common complication of chronic prostatitis.
Chronic inflammatory lesions caused by infection of the seminal vesicle.
The seminal vesicle is anatomically close to the prostate, vas deferens, urethra, bladder, etc. and communicates with each other, so seminal vesiculitis is often secondary to urethrogenital system infection.
The two often exist at the same time and affect each other, which can lead to sexual dysfunction.
- Erectile dysfunction
Prostatitis can affect sexual function. On the other hand, in patients with chronic prostatitis, their mental and psychological factors may affect the couple's life and cause erectile problems.
- Infertility
Inflammation of the male reproductive system, including the prostate, may lead to infertility. Patients with chronic prostatitis (chronic pelvic pain syndrome) may temporarily experience a decrease in semen quality, but there is no evidence that it will cause long-term infertility.
- Posterior urethritis
Chronic prostatitis is often accompanied by posterior urethritis. This is because the urethra passes through the prostate. When there is prostatitis, especially prostatitis caused by urinary tract infection, it will also invade the urethra in the prostate area, leading to urethritis.
- Epididymitis
Prostatitis and seminal vesiculitis exist at the same time, and the inflammation can invade the epididymis and cause chronic epididymal inflammation.
-Various types of cystitis
Inflammation of the prostate gland can spread to the bladder, leading to various types of cystitis. When prostatitis occurs, obvious urinary system irritation symptoms appear, which are mostly caused by concurrent cystitis of various types.
Daily health care
-Adhere to the treatment. Do not change the medicine or treatment method casually during the treatment, because the relief of symptoms often takes a period of time. Early treatment should be maintained for more than 2 weeks, and some infections need 8 to 12 weeks. If the medicine is changed casually, it is easy to cause bacterial imbalance or drug resistance, resulting in incomplete treatment.
-Regular sex life, can not hold back ejaculation, do not masturbate frequently, and avoid unclean sexual intercourse.
-Correctly understand prostatitis, maintain a good attitude, reduce psychological pressure, so as not to exaggerate symptoms, produce dizziness, memory loss, anxiety, suspicion, insomnia and other symptoms.
-Drink more water, urinate frequently, keep the bowel movement smooth, insist on hot water bath or hot water bag hot compress perineum.
-Avoid smoking and drinking, do not eat spicy and irritating food.
-Avoid sitting for a long time, avoid long-term cycling, insist on exercise, preferably jogging plus more lower body exercise, avoid strenuous exercise.
Acupuncture treatment
Foot reflexology
