Patient's question:
Detailed medical condition and consultation purpose: Transrectal ultrasound examination revealed a 0.40.7 cm cyst in the left vas deferens, along with chronic prostatitis. Treatment for one year has shown no actual effect. What are the reasonable treatment plans?Doctor's answer:
Hello:Treatment of Chronic Prostatitis:
1. General Treatment: Boost confidence, eliminate psychological concerns, moderate sexual desire, but avoid forced abstinence. Avoid alcohol and irritating foods. Take warm sitz baths once a night, local physiotherapy, and modify obvious lifestyle triggers, such as avoiding long-distance cycling.
2. Prostate Massage: Regular prostate massage can promote the discharge of prostatitic secretions. Perform 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. Perform once a week.
4. Urethral Dilation: For patients with urethral stricture or obstruction, regular dilation facilitates excretion. Additionally, when the probe passes through the urethra, it can stretch the prostate orifice, promoting glandular drainage.
5. Prostate Periurethral Blockade: Gentamicin 80,000 units plus 1% novocaine 1–2 mL, once a day, for 7–10 sessions per course. Alternatively, penicillin 800,000 units, streptomycin 0.5 g, plus 1% novocaine 2–4 mL, once every 1–2 days.
6. Antibacterial Drugs: General antibacterial drugs are difficult to penetrate prostate tissue, which is one of the reasons 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.
The left ejaculatory duct has a 0.40.7 cm cyst.