Patient's question:
Detailed medical condition and consultation purpose: Transrectal ultrasound examination revealed a 0.40.7 cm cyst in the left vas deferens, along with chronic prostatitis. Treatment for one year has shown no actual effect. What are the reasonable treatment plans?Doctor's answer:
Hello:Treatment of Chronic Prostatitis:
1. General Treatment: Boost confidence, eliminate psychological concerns, moderate sexual desire, but avoid forced abstinence. It is advisable to abstain from alcohol and irritating foods. Take warm water sitz baths once a night, undergo local physical therapy, and modify obvious lifestyle triggers, such as avoiding long-distance cycling.
2. Prostate Massage: Regular prostate massage can promote the discharge of prostatitic secretions. Perform this once a week, and simultaneously conduct routine prostatic fluid tests to evaluate treatment effectiveness.
3. Drug Infusion: Insert a specially designed balloon catheter through the urethra, inject sterile physiological saline into the prostatic urethra, and aspirate several times to remove purulent secretions. Then, inject antibiotics. Repeat this once a week.
4. Urethral Dilation: For patients with urethral stenosis or obstruction, regular dilation facilitates excretion. Additionally, when a probe passes through the urethra, it can stretch the prostate opening, promoting better glandular drainage.
5. Prostate Periurethral Blockade: Inject 80,000 units of gentamicin mixed with 1% novocaine (1–2 mL) once a day, with 7–10 sessions constituting one course. Alternatively, use 800,000 units of penicillin, 0.5 g of streptomycin, and 1% novocaine (2–4 mL) once or twice a week.
6. Antibacterial Drugs: General antibacterial drugs are difficult to penetrate prostate tissue, which is one of the reasons for the challenges in clinical treatment. An ideal antibacterial drug should meet three conditions: ① Lipophilic alkaline drugs; ② Low binding to plasma proteins; ③ High dissociation degree.
The left seminal duct has a 0.40.7 cm cyst.