Patient's question:
Hello, doctor. I am a patient from Qingdao. I would like to ask: What are the methods of physical therapy for chronic prostatitis? Thank you!Doctor's answer:
Hello:1. General treatment: Boost confidence, eliminate psychological concerns, moderate sexual desire, but avoid forced abstinence. Avoid alcohol and stimulating foods. Take warm sitz baths once daily, local physiotherapy, and modify obvious lifestyle triggers, such as avoiding prolonged cycling.
2. Prostate massage: Regular prostate massage can promote the discharge of prostatic inflammatory secretions. Perform once weekly, 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. Perform once weekly.
4. Urethral dilation: For patients with urethral stricture or obstruction, regular dilation facilitates excretion. Additionally, when a probe passes through the urethra, it can stretch the prostate opening, promoting glandular drainage.
5. Prostatic perineural block: Gentamicin 80,000 units plus 1% novocaine 1–2 mL, once 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 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. Currently, commonly used drugs include:
Trimethoprim-sulfamethoxazole 1.0 g twice daily
Doxycycline 0.1 g twice daily