Patient's question:
I got prostatitis from masturbation. I have difficulty urinating in public places and the symptom of dripping urine for many years, so my personality is very introverted, and I almost have no friends. I'm afraid of being too embarrassed when using the restroom with boys, and I have even fewer female friends. I'm always very self-conscious. Additionally, I have white hair, and I'm not even 24 years old yet. I went to the hospital and took medicine for several months, but it didn't improve; instead, my condition worsened. I get headaches just seeing all the messy advertisements. I've heard that prostatitis can't be completely cured, and I even suspect I might have AIDS. When I see advertisements for infertility, I become even more afraid.Doctor's answer:
Hello: First, I want to tell you that your psychological stress is too high, and you have a heavy burden of thoughts. Your illness is not incurable. Prostatitis, as long as you receive standardized treatment, can be completely cured. Why do you always doubt? I suggest you find a job and focus your energy on work, and then seek standardized treatment. Below, I will give you a detailed explanation of the knowledge about the prostate:The clinical features of acute prostatitis are abrupt onset, fever, urinary tract irritation symptoms, and perineal pain, all of which are related to acute congestion, swelling, and suppuration of the gland. The bacteria that cause this acute infection invade the prostate through different routes, including hematogenous infection, lymphatic infection, and direct extension. Among these, direct extension is the most common. When the bladder or posterior urethra is infected with bacteria, the pathogens can enter the prostate gland ducts and alveoli through the openings of the seminal vesicles located in the prostatic urethra. If the primary bacterial infection is in the anus, colon, or other areas, the pathogens can also invade the gland through lymphatic vessels connected to the prostate, which is lymphatic infection. If the bacterial infection is in the mouth, pharynx, respiratory tract, or other areas, the pathogens present in these places can enter the prostate through the bloodstream, which is hematogenous infection. All such pathogens first invade the prostatic excretory ducts in the prostate and multiply there. Once conditions are favorable, they can rapidly promote significant lesions. This condition is essentially the trigger for the onset of the disease. For an adult male, common triggers of acute prostatitis include excessive alcohol consumption. External factors such as frequent masturbation or sexual intercourse, long-distance bicycle riding, damp and cold living conditions, catheterization, or trauma can also cause congestion, edema, exudation, and epithelial cell shedding in the epithelial tissue of the prostatic excretory ducts, creating a suitable environment for bacterial growth. If the condition is not controlled at this stage, the inflammation will continue to develop into the glandular cavity, increasing the amount of inflammatory exudate in the alveoli. If the excretory duct is further obstructed, exudate retention can form abscesses of varying sizes, further worsening the condition.
All clinical manifestations of acute prostatitis are reflected in the word "acute." Generally, symptoms can be divided into five types:
1. Systemic toxic symptoms: Such as nausea, vomiting, chills, and high fever; in severe cases, persistent high fever, confusion, hypotension, and toxic shock may occur. This is mainly due to bacteria entering the bloodstream, leading to bacteremia or sepsis.
2. Local symptoms of the prostate: Primarily pain, most a sense of heaviness and discomfort in the perineum and pubic symphysis; once an abscess forms, the pain intensifies and can radiate to the penis, testicles, thighs, and lower back.
3. Urinary discomfort symptoms: Frequent urination, urgency, and dysuria appear early, followed by difficulty urinating. In severe cases, urinary retention (accumulation of urine in the bladder due to an obstruction) may occur. Additionally, purulent urine or terminal hematuria (blood-tinged urine at the end of urination) may sometimes be observed.
4. Rectal irritation symptoms: The prostate is separated from the rectum by only a thin layer of intestinal wall. Infection of the prostate can directly stimulate the rectum, causing pain during defecation, a strong urge to defecate, difficulty defecating, and the presence of purulent discharge from the urethra during defecation.
5. Sexual dysfunction: Such as painful intercourse, painful erection and ejaculation, premature ejaculation, impotence, and hematospermia.
Due to different routes of infection, the clinical manifestations of acute prostatitis vary. Prostatitis caused by hematogenous infection has more severe systemic toxic symptoms but less obvious urinary tract irritation. Patients with direct extension from the posterior urethra or lymphatic infection primarily experience urinary discomfort and local pain, along with possible rectal irritation symptoms and sexual dysfunction. Of course, as the condition progresses, the main symptoms may change. For example, acute prostatitis caused by direct extension may easily lead to systemic toxic symptoms such as sepsis if a prostatic abscess ruptures. On the other hand, systemic toxic symptoms caused by hematogenous infection may gradually become more prominent locally after effective antibiotic control.
For an adult male, if systemic discomfort such as chills and high fever is accompanied by local symptoms such as frequent urination, urgency, and dysuria, acute prostatitis should be considered. Of course, the final diagnosis must be made by a doctor. Clinically, two simple, practical, and diagnostically valuable methods are:
1. Digital rectal examination: Through this, an enlarged prostate can be felt, which is generally soft, may have a fluctuating sensation, and exhibits significant tenderness.
2. Urinalysis: Under high-power microscopy, a large number of white blood cells and pus cells (usually more than 10 per field) can be observed in the urine.
The treatment of acute prostatitis is primarily anti-infection, and the chosen antibiotics should be effective in killing the pathogens. Although urine culture helps identify the pathogens and select highly sensitive antibiotics, the results take 3–5 days, which can delay the condition, making it difficult to implement universally. However, studies have shown that about 80% of pathogens causing acute prostatitis are Escherichia coli, which are generally sensitive to drugs such as gentamicin, kanamycin, and cefoxitin. Therefore, these antibiotics can be used as first-line medications.
Generally, if the condition is severe, it is best to use the aforementioned antibiotics for intramuscular or intravenous injection in the first 5–7 days of treatment to allow the body to absorb the medication quickly. After several days, if the condition improves, oral medication can be used for continued treatment for about 30 days.
During treatment, how should a patient cooperate? They can rest, avoid spicy and irritating foods, abstain from sexual activity, and avoid sexual stimulation and arousal. At the same time, they can often use hot water to soak or apply heat to the perineum and lower abdomen to relieve pain. It should be said that these measures are not difficult for patients to follow, and they play a multiplier effect on the treatment outcome.
Most patients with acute prostatitis can be cured with the above treatment, at which point systemic symptoms disappear, local prostate swelling and pain subside, and prostate fluid tests return to normal for three consecutive months. However, some patients may not recover due to delayed or inadequate treatment, leading to prolonged illness. If bacteria persist for a long time, they may cause another acute episode when exposed to triggers. Multiple repeated episodes may develop into chronic prostatitis, making the condition more complex. This should be a warning and avoided at all costs.
Mainly, you need to shake off the burden of thoughts, and you will be completely fine. Do you understand? If you are satisfied with my answer, please adopt it in a timely manner.