Patient's question:
I got prostatitis from masturbation. I have been experiencing difficulty urinating in public places and a dribbling urine symptom for many years, so my personality is very introverted, and I almost have no friends. I'm afraid of being too embarrassed when using the restroom with boys, and I don't have any female friends either. I always feel inferior. Additionally, I have white hair, and I'm not even 24 years old yet. I went to the hospital and took medicine for several months, but not only did it not improve, but the condition worsened. Whenever I see messy advertisements everywhere, my head starts to ache. I've heard that prostatitis cannot be completely cured, and I even started myself of having AIDS. When I see advertisements for infertility, I become even more afraid.Doctor's answer:
Hello: First, I want to tell you that your psychological stress is too high, and you carry a heavy burden. Your illness is not incurable. Prostatitis, as long as you receive standard treatment, can be completely cured. Why do you always doubt? I suggest you find a job and focus your mind on work, and then seek standard treatment. Below, I will give you a detailed explanation of prostatic knowledge:The clinical features of acute prostatitis are abrupt onset, fever, urinary tract irritation symptoms, and perineal pain, all of which are related to acute congestion, swelling, and suppuration of the gland. The bacteria that cause this acute infection invade the prostate through several different routes: hematogenous infection, lymphatic infection, and direct extension. Among these, direct extension is the most common. When the bladder or posterior urethra is infected with bacteria, the pathogens can enter the prostate gland through the openings of the seminal vesicles in the prostatic urethra. If the primary bacterial infection is located in the anus, colon, or other areas, the pathogens can also invade the gland through lymphatic vessels connected to the prostate, which is lymphatic infection. If the bacterial infection is located in the mouth, pharynx, respiratory tract, or other areas, the pathogens residing in these places can enter the prostate through the bloodstream, which is hematogenous infection. All such pathogens first invade the excretory ducts of the prostate and grow and multiply there. Once conditions are favorable, they can rapidly promote significant changes, which are essentially the triggers of the disease. For an adult male, excessive alcohol consumption is a common trigger of acute prostatitis. External factors such as frequent masturbation or sexual intercourse, long-distance bicycle riding, damp and cold living conditions, catheterization, or trauma can also cause congestion, edema, exudation, and epithelial cell shedding in the excretory ducts of the prostate, creating a suitable environment for bacterial growth. If the condition is not controlled at this stage, the inflammation will continue to develop into the glandular cavity, increasing the amount of inflammatory exudate in the alveoli. If the excretory duct is further obstructed, the exudate will accumulate, forming abscesses of varying sizes, further worsening the condition.
All clinical manifestations of acute prostatitis are reflected in the word "acute." Symptoms can generally be divided into five types:
1. Systemic toxic symptoms, such as nausea, vomiting, chills, and high fever. In severe cases, persistent high fever, confusion, hypotension, and toxic shock may occur. This is mainly due to bacteria entering the bloodstream, leading to bacteremia or sepsis.
2. Local symptoms of the prostate, primarily pain, most often a sense of heaviness or discomfort in the perineum and pubic symphysis. Once an abscess forms, the pain intensifies and may radiate to the penis, testicles, thighs, and lower back.
3. Urinary discomfort symptoms, such as frequent urination, urgency, and dysuria, which appear early. Later, difficulty urinating may occur, and in severe cases, urinary retention (where urine cannot be expelled and accumulates in the bladder) may develop. Additionally, sometimes hematuria or terminal hematuria (urine with blood at the end of urination) may occur.
4. Rectal irritation symptoms, as the prostate is separated from the rectum by only a thin layer of intestinal wall. Prostate infection can directly stimulate the rectum, causing pain during defecation, a strong urge to defecate, difficulty defecating, and the leakage of purulent fluid from the urethra during defecation.
5. Sexual dysfunction, such as painful intercourse, painful erection and ejaculation, premature ejaculation, impotence, and hematospermia.
Due to different routes of infection, the clinical manifestations of acute prostatitis vary. Prostatitis caused by hematogenous infection has more severe systemic toxic symptoms but less obvious urinary irritation. Patients with direct extension from the posterior urethra or lymphatic infection primarily experience urinary discomfort and local pain, along with possible rectal irritation symptoms and sexual dysfunction. Of course, as the condition progresses, the main symptoms may change. For example, acute prostatitis caused by direct extension may easily lead to sepsis if a prostatic abscess ruptures. On the other hand, systemic toxic symptoms caused by hematogenous infection may gradually become prominent in local symptoms after effective antibiotic treatment.
For an adult male, if systemic discomfort such as chills and high fever is accompanied by local symptoms such as frequent urination, urgency, and dysuria, acute prostatitis should be considered. Of course, the final diagnosis must be made based on the doctor's examination results. Clinically, there are two simple, practical, and diagnostically valuable methods:
1. Digital rectal examination, which can detect an enlarged prostate that is usually soft, with a sense of fluctuation and significant tenderness.
2. Urine examination, under high-power microscopy, a large number of white blood cells and pus cells (usually more than 10 per field) can be observed in the urine.
The treatment of acute prostatitis is primarily anti-infection, and the chosen antibiotics should be effective in killing the pathogens. Although urine culture helps identify the pathogens and select highly sensitive antibiotics, the results take 3–5 days, which may delay the condition, making it difficult to implement universally. Fortunately, surveys have shown that about 80% of pathogens in acute prostatitis are Escherichia coli, which are generally sensitive to drugs such as gentamicin, kanamycin, and cefalexin. Therefore, these antibiotics can be used as first-line medications.
Generally, if the condition is severe, it is best to use the aforementioned antibiotics for intramuscular or intravenous injection in the first 5–7 days of treatment to allow the body to absorb the medication quickly. After a few days, if the condition improves, oral medication can be used for another 30 days of treatment.
During treatment, how can a patient cooperate? They can restly, avoid spicy and irritating foods, abstain from sexual activity, and avoid sexual stimulation and arousal. At the same time, they can often use hot water to soak or apply heat to the perineum and lower abdomen to relieve pain. It should be said that these measures are not difficult for patients to follow and can significantly enhance the effectiveness of treatment.
Most patients with acute prostatitis can be cured with the above treatment, at which point systemic symptoms disappear, local prostate swelling and pain subside, and prostate fluid tests return to normal for three consecutive months. However, a small number of patients may not recover due to delayed or inadequate treatment, leading to prolonged illness. In such cases, the long-term presence of bacteria may cause recurrent acute attacks if triggered. Multiple repeated episodes may develop into chronic prostatitis, making the condition more complex. This should be a warning and avoided at all costs.
Mainly, you need to shake off the burden in your mind, and you will be completely fine. Do you understand? If you are satisfied with my answer, please adopt it in a timely manner.