Patient's question:
Male, 22. I have prostatitis, and also kidney deficiency premature ejaculation. I don't know what medicine to use.Duration of onset and current persistence: 3 years
Current general condition: The glans does not become erect during sex, and there is no pleasure during stimulation. Also, kidney deficiency premature ejaculation.
Medical history:
Previous diagnoses and treatment history and effectiveness: Not good, and the medication costs are too high to afford.
Additional tests:
Other:
Doctor's answer:
Hello: Based on the situation you described, what you need to do now is actively treat your 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 sitz baths once a night, undergo local physical therapy, and modify obvious lifestyle triggers, such as avoiding prolonged cycling.
2. Prostate massage: Regular prostate massage can promote the discharge of prostatitis secretions. Perform this once a week, and simultaneously conduct routine prostatic fluid tests to evaluate treatment effectiveness.
3. Drug instillation: 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. This should be done once a week.
4. Urethral dilation: For patients with urethral stenosis or obstruction, regular dilation can facilitate excretion. Additionally, when a probe passes through the urethra, it can stretch the prostate opening, promoting better glandular drainage.
5. Prostate perineural block: Inject 80,000 units of gentamicin plus 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, plus 1% novocaine (2–4 mL), administered 1–2 times 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 lipid-soluble alkaline drugs; ② low binding to plasma proteins; ③ high dissociation degree. Currently, commonly used drugs in clinical practice include: