Patient's question:
What are the symptoms of chronic prostatitis?Doctor's answer:
Chronic prostatitis is more commonly non-bacterial in nature. Common causes include factors related to sexual activity such as frequent sexual intercourse, excessive inhibition of ejaculation, interrupted intercourse, or long-distance horseback riding, as well as prolonged pressure on the perineum, leading to pelvic and prostate congestion. Additionally, it can be caused by non-bacterial infections such as trichomoniasis, chlamydia, and fungal infections.Clinical manifestations include frequent urination, discomfort during urination, and dysuria. White secretions may be expelled during urination or defecation, commonly referred to as "white discharge" (hematospermia may occur if seminal vesiculitis is present). There may also be aching discomfort in the lumbosacral region, perineum, or suprapubic area, along with sexual dysfunction such as impotence, premature ejaculation, and painful ejaculation. Additionally, symptoms such as insomnia, dizziness, and fatigue may occur.
Digital rectal examination may reveal an enlarged prostate with mild tenderness. If prolonged, it may lead to scarred changes. Treatment involves avoiding irritating foods, moderating sexual activity, hot Sitz baths, physical therapy, or prostate massage to promote inflammation absorption and drainage. Medications primarily focus on anti-infective agents that can penetrate the prostate barrier, such as erythromycin, cotrimoxazole, doxycycline, and rifampicin. If the cause is non-infectious, it is also important to identify and eliminate triggers.