Patient's question:
Detailed medical condition and consultation purpose: Diagnosis, TreatmentDuration of the current illness and persistence: June 2004, lasting about a year to the present
Current general condition: Urinary urgency, dysuria, post-micturition dribbling
Medical history: In November 2003, suddenly unable to urinate. Symptoms disappeared after taking anti-inflammatory medication. Later, there was a case of purulent discharge, but the test showed no gonococcal infection. It did not recur afterward, but only urinary fullness and yellowish-red urine appeared. After taking traditional Chinese medicine, symptoms disappeared, but post-micturition dribbling and premature ejaculation then occurred.
Previous diagnoses, treatment history, and outcomes: Urinary tract infection or prostatitis
Doctor's answer:
Hello: Based on your symptoms, it should be classified as prostatitis, and treatment should be administered accordingly.Treatment for Prostatitis:
1. General Treatment: Boost confidence, alleviate mental concerns, moderate sexual activity (but avoid forced abstinence). Avoid alcohol and irritating foods. Take warm sitz baths once a night, undergo local physiotherapy, and modify obvious lifestyle triggers, such as avoiding prolonged 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 orifice, improving glandular drainage.
5. Prostate Periurethral 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 Lipophilic alkaline drugs; ② Low binding to plasma proteins; ③ High dissociation degree.