Misunderstanding of chronic prostatitis

One morning, I went to work early and saw a young man waiting outside the consulting room from a distance, his expression very worried. Upon enquiry, I learned that the young man had been married for more than three years. Due to his separation from the two places, his younger age, and strong sexual desire, he developed a dull pain in the lower abdomen last year. During urination, he had a burning sensation in the urethra, sometimes with burning pain. After urinating, he had white mucus dripping out of the urethra. Upon examination at the hospital, he was found to have two "+" cells in the anterior glandular fluid, which was diagnosed as chronic aseptic prostatitis. The doctor told him to pay attention to life conditioning and resume normal sexual life, but how can a husband and wife live separately and resume regular sexual life? The doctor also taught him the method of ejaculation and prescribed some medication for him. After the treatment of the doctor, although the condition has improved somewhat, the sensory and sexual functions have significantly decreased. Especially after the wife returned to the city three months ago, she often felt powerless and sometimes suffered from impotence, while the wife's sexual desire seems to be particularly strong. Regarding this, the wife has a strong opinion and suspects that he has an affair, causing the couple to often quarrel, and the relationship between the two people almost collapsed. I immediately asked him how he felt about sex. He told me that he was afraid that chronic prostatitis would infect his wife, and that sometimes when ejaculating, the urethra really hurts. "The original sticking point is here. I immediately enlightened him that chronic prostatitis itself generally does not affect sexual function. It is likely that his situation is due to a heavy ideological burden, and told him that as long as he puts down the ideological burden, he will definitely be fine.". He just happily left the consulting room.

Doctor's comments: In clinical practice, we often see many patients with chronic prostatitis. When they seek medical advice, most of them will tell their doctors that their sexual desire has decreased significantly since they got the disease, and some also have varying degrees of sexual dysfunction, such as impotence and premature ejaculation. Can chronic prostatitis lead to sexual dysfunction?

Theoretically, the erection of the penis is mainly related to neurovascular factors. Chronic prostatitis itself does not directly damage the nerves and blood vessels of the penis and does not cause impotence, which is certain. But what we should see is:

(1) Patients with chronic prostatitis often experience psychological stress due to long-term discomfort in the lower abdomen, perineum, or lumbosacral region, resulting in depression and worry. Especially those with a limited understanding of the disease often worry about problems with their sexual function. Over time, mental factors can lead to a decrease in the patient's libido, which can lead to functional sexual dysfunction.

(2) There is no denying that chronic prostatitis itself, due to the presence of inflammation in the prostate, can lead to increased symptoms of prostate congestion during sexual excitement, which may lead to premature ejaculation and ejaculation pain, thereby causing patients to have a sense of fear of sexual life.

(3) Some patients are afraid to inject inflamed semen into the woman's vagina through sexual activity, causing her to become infected. They try to control their libido and reduce the frequency of sexual activity. This can also lead to decreased libido in the long run. In fact, chronic prostatitis, especially chronic aseptic prostatitis, has no possibility of infection, and can be assured. Sometimes there is ejaculation pain, which can be resolved with some medicine.

From a clinical perspective, due to the anatomical and physiological specificity of the prostate itself, chronic prostatitis can have a certain impact on sexual function. However, the vast majority of patients can lead a normal sexual life. Some patients with chronic prostatitis have severe inflammation, but their sexual function is very normal. Therefore, the treatment of chronic prostatitis is not only a matter of drug treatment, but also psychological treatment. It is important to keep patients happy, relieve unnecessary concerns, teach them medical knowledge about the disease, and ask a psychologist to cooperate if necessary. It is important to tell patients to establish a moderate and regular sexual life, which not only does not aggravate the condition of chronic prostatitis, but also is an active treatment method for chronic prostatitis.

Of course, if you are suffering from sexually transmitted diseases, especially chronic prostatitis patients who have detected the pathogenic bacteria, strict measures should be taken to prevent their spouses from being infected.

Chronic prostatitis and infertility

Xiao Wang is a lively and dynamic young man full of youthful vitality. After a lapse of thought, he suffered from gonorrheal urethritis. After becoming ill, I dared not go to a regular hospital for medical treatment, preferring to go to a roadside clinic. After treatment, the symptoms of urethritis quickly disappeared, but later there were secretions dripping from the urethra and there was a spicy pain when urinating. At this point, he no longer ignored his face and went straight to the municipal hospital for treatment. After examining the prostate fluid, he found gonococcal positive, 2 "+" white blood cells, and 1 "+" pus ball. The doctor told him that it was chronic gonococcal prostatitis. After several months of regular treatment, his condition quickly came under control, and most of his discomfort disappeared. "But he was still depressed, so he approached me and after a detailed inquiry into his condition, he was examined. The prostate fluid had basically returned to normal, with only a few white blood cells.". I told him these problems were not serious. "But he hesitated and asked me, will this disease affect fertility?"? "Because he has looked up many books and said that chronic prostatitis can affect fertility, he still dare not fall in love.".

Doctor's comments: Whether chronic prostatitis has an impact on fertility cannot be generalized. In theory, first of all, the prostate gland is the accessory gonad of the human body, and the prostate fluid it secretes is an important component of semen. Inflammatory lesions inevitably affect the composition of semen and interfere with sperm activity and function, thereby affecting male fertility. Secondly, due to the influence of bacteria and bacterial toxins, it can consume the nutritional components of semen, change the pH value of semen, interfere with the activity of some enzymes, increase the viscosity of semen, affect sperm movement, stimulate the production of antisperm antibodies in the body, and may affect male fertility. In clinical practice, we have seen that infertility in some patients is indeed related to chronic prostatitis. But at the same time, we often see that many patients with chronic prostatitis for many years have no impact on their fertility.

Due to the intractable nature of chronic prostatitis, as well as many inappropriate publicity about the disease and excessive introductions by individual doctors, the impact of the disease on fertility has been exaggerated, placing a heavy ideological burden on many young patients, leading to the recognition that chronic prostatitis can lead to infertility and increasing the difficulty of treatment. There are many reasons for infertility, and we should look for the reasons in various ways. At the same time, we should know that chronic prostatitis can be completely eradicated.

Chronic prostatitis and prostatic hyperplasia

On a drizzly morning, a patient over 30 years old came to the sexual psychological consultation room and reported that he had suffered from chronic prostatitis for many years. After treatment, his condition has greatly improved. However, due to his frequent business trips, it is difficult to maintain normal medication and life conditioning. Moreover, these symptoms are not enough to affect daily life, so he has not paid more attention to it. Recently, I saw Lao Zhao from the same unit who was hospitalized for prostate hyperplasia. I was really horrified to see his painful appearance. He suddenly thought of whether his chronic prostatitis was related to prostate hyperplasia? "I have had chronic prostatitis for many years. Every time I go to see a doctor, the doctor writes on the medical record that the prostate is slightly larger and has a hard texture. Is it hyperplasia?"? The more he thought, the more afraid he became, so he immediately came to consult. To be cautious, I gave him a careful examination and found that the prostate was indeed larger than normal and had a fairly normal texture. "I immediately told him that prostate hyperplasia and prostatitis are two different types of diseases, with different etiology and pathogenesis, and there is no necessary connection.".

Doctor's comments: Whether chronic prostatitis can cause prostate hyperplasia is a question that patients often ask doctors in clinical practice. According to modern research, chronic prostatitis and prostatic hyperplasia are two different diseases with different etiology and pathology, and there is no necessary connection between the two. The enlargement of the prostate in chronic prostatitis is caused by the infiltration of inflammatory cells into the gland or fibrosis of the gland tissue. The enlargement of the prostate in benign prostatic hyperplasia is caused by hyperplasia of glandular cells and smooth muscles. Prostatic hyperplasia is common in elderly men over the age of 50. Its etiology and pathogenesis have not yet been fully understood. However, BPH must meet two conditions, namely, the presence of testicles and the growth of age. The presence of testicles indicates the normal secretion of male hormones. Studies have shown that the synergistic effect of androgens and estrogen plays an important role in the process of prostate hyperplasia. Chronic prostatitis has no significant impact on the secretion function of the testis and the metabolic process of hormones. So far, no research data has shown that patients with chronic prostatitis are more likely to develop prostate hyperplasia than normal people. In clinical practice, although some elderly men are also seen suffering from prostate hyperplasia and chronic prostatitis, there is no necessary connection between them, and they should be treated and treated separately.

Chronic prostatitis and prostate cancer

On a quiet night, I was working at night shift when an old classmate, Lao Zhou, who had not seen me for many years, called me and said that he had been suffering from chronic prostatitis for many years, during which he also received intermittent treatment, but he often repeated it. In recent years, I also checked some books and learned that one of the causes of cancer is the stimulation of chronic inflammation, such as gastric ulcers that can turn into stomach cancer if they persist for a long time. So he wondered whether this chronic prostatitis, which had not healed for many years, would turn into prostate cancer? So he asked me for advice by phone. This is a rather thorny issue. "I know Lao Zhou is a bit clever, and I have to reason with him. Otherwise, he won't be convinced.". "I told him that the problem was relatively complex, and I'll call him back when I get home.".

Doctor's comments: The etiology of prostate cancer is not very clear at present. According to a large number of observations, it has been shown that prostate atrophy in humans and animals after castration does not occur, that is, prostate cancer. The experimental results also show that androgens can accelerate the growth of the prostate in animals, while the growth of prostate cancer is slow after estrogen administration or testicular resection. Therefore, it can be considered that androgens play an important role in the occurrence and development of prostate cancer. Epidemiological studies also believe that men, age increase, and androgen stimulation are the three essential factors in the occurrence of prostate cancer, and have proposed the view that prostate cancer is related to viral and chronic infections. This seems to have established some links between chronic prostatitis and prostate cancer. However, these studies are difficult to prove the necessary link between chronic prostatitis and prostate cancer. Therefore, according to the characteristics of chronic prostatitis, which has a high incidence of young adults and does not affect the function of testosterone secretion and hormone metabolism, we can think that chronic prostatitis will not directly lead to prostate cancer in the short term. As for the statement that he suffered from chronic prostatitis when he was young and that the incidence rate of prostate cancer in old age is higher than that in normal people, there is no conclusive evidence at present, which needs further research.