Patient's question:
Detailed medical condition and consultation purpose: Previously had chronic prostatitis, which was cured after treatment. It recurred after a year, with symptoms of painful urination and discomfort in the testicles. I want to learn more about it. After getting prostatitis, would taking Liuwei Dihuang Wan and Zhibai Dihuang Wan be helpful for me?Duration of current illness: Two months
Current general condition: Discomfort in the testicles
Medical history: Had prostatitis a year ago
Previous diagnoses, treatments, and outcomes: Prostate massage
Additional tests: None
Other: Have taken Meiling Wan
Doctor's answer:
1. General Treatment: Boost confidence, alleviate mental concerns, moderate sexual desire, but avoid forced abstinence. Avoid alcohol and stimulating foods. Take warm sitz baths once daily, undergo local therapy, and modify obvious lifestyle triggers such as avoiding prolonged cycling.2. Prostate Massage: Regular prostate massage can promote the discharge of prostatic inflammatory secretions. Perform once weekly, and concurrently conduct routine prostatic fluid tests to evaluate treatment efficacy.
3. Drug Infusion: Insert a specially designed balloon catheter through the urethra, inject sterile normal saline into the prostatic urethra, and aspirate several times to remove purulent secretions. Then, inject antibiotics. Perform once weekly.
4. Urethral Dilation: For patients with urethral stricture or obstruction, regular dilation facilitates excretion. Additionally, as the probe passes through the urethra, it can stretch the prostatic orifice, promoting glandular drainage.
5. Prostatic Perineural Block: Gentamicin 80,000 units plus 1% procaine 1–2 mL, administered once daily, with 7–10 sessions constituting one course. Alternatively, penicillin 800,000 units, streptomycin 0.5 g, plus 1% procaine 2–4 mL, administered 1–2 times weekly.
6. Antibacterial Agents: General antibacterial agents are difficult to penetrate prostate tissue, which is one of the reasons for the challenges in clinical treatment. An ideal antibacterial agent should meet three criteria: ① Lipophilic alkaline drugs; ② Low binding to plasma proteins; ③ High dissociation degree. Currently, commonly used agents include:
Trimethoprim-Sulfamethoxazole 1.0 g twice daily
Doxycycline 0.1 g twice daily