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 duration: 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
Auxiliary tests:
Other:
Doctor's answer:
Hello: Based on the situation you described, what you need to do now is to 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 stimulating foods. Take warm sitz baths once a night, undergo local physiotherapy, and modify obvious lifestyle triggers, such as avoiding long-distance 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 and 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, and 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 why clinical treatment is challenging. 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: