Patient's question:
Hello, I would like to inquire about something. The other day, I had an ultrasound examination which revealed prostatitis, and I also had a routine semen analysis. The semen test showed white blood cells: 8~12 HP, liquefaction time: 50 minutes, and sperm motility: 50%. Everything else was normal. Could these two test results serve as evidence for prostatitis? Are there other possible causes for such symptoms? If it is indeed the condition mentioned above, how should it be treated? Additionally, the doctor at the hospital mentioned that the current treatment method is the fourth-generation needle injection of "Gatifloxacin," which has shown excellent results, as the medication can enter the prostate to kill harmful bacteria. Is there a scientific basis for what they said? Thank you!Doctor's answer:
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 Sitz baths once daily, 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 prostatitic secretions. Perform once weekly, and concurrently 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. Perform once weekly.
4. Urethral Dilation: For patients with urethral stenosis or obstruction, regular dilation facilitates excretion. Additionally, as the probe passes through the urethra, it can stretch the prostate orifice, promoting better glandular drainage.
5. Prostate Perineural Block: Gentamicin 80,000 units plus 1% novocaine 1–2 mL daily, for 7–10 sessions per course. Alternatively, penicillin 800,000 units, streptomycin 0.5 g, plus 1% novocaine 2–4 mL, once or twice weekly.
6. Antibacterial Drugs: General antibacterial drugs are difficult to penetrate prostate tissue, which is one reason for the clinical challenges in treatment. An ideal antibacterial drug should meet three conditions: ① Lipophilic alkaline drugs; ② Low binding to plasma proteins; ③ High dissociation degree. Currently, commonly used drugs include:
Trimethoprim-Sulfamethoxazole 1.0 g twice daily