Patient's question:
Neisseria gonococcal prostatitis current condition: dysuria, blood streaks, purulent discharge. Previous diagnosis and treatment history and effectiveness: rectal microwave, red light, urinary with antibacterial injections. First follow-up question: (2007-12-21 18:49:30) After 2 days of treatment, the effect is not significant, it can be said that there is no effect. Is it necessary to change the treatment method? Which treatment method is more effective?Doctor's answer:
Gonococcal prostatitis is related to male gonorrhea and is more common in young and middle-aged adults. It is caused by the upward infection of Neisseria gonorrhoeae from the urethra and is a complication of gonococcal urethritis. Clinically, acute gonococcal posterior urethritis almost always involves prostatitis. Most patients experience resolution of inflammation after treatment, while a small number of severe cases may develop prostatitis abscesses.1. Clinical manifestations
(1) Acute phase: Suprapubic discomfort and intermittent brief spasms. When Neisseria gonorrhoeae invades the Cowper's glands, the suprapubic pain is more pronounced, especially during urination and defecation. If it affects the bladder neck and trigone, symptoms include frequent urination, urgency, and dysuria. In severe infections, high fever, chills, difficulty urinating, and even urinary retention may occur.
(2) Chronic phase: Itching in the urethra, a burning or mild stinging sensation during urination, and a weak or intermittent urine stream. Sexual dysfunction such as erectile dysfunction and premature ejaculation may also develop.
(3) Digital rectal examination
1) Acute phase: The prostate is swollen, tender, and locally warm with a smooth surface. When an abscess forms, it may feel full or fluctuant.
2) Chronic phase: The prostate is relatively full, enlarged, soft, and less tender. In prolonged cases, the prostate may shrink, harden, become uneven, and develop small hard nodules.
2. Ancillary tests
Prostatic fluid examination: Numerous white blood cells are observed in the prostatic fluid smear, with a reduction in lecithin. Direct microscopy and culture can detect Neisseria gonorrhoeae.