2020年10月29日星期四

hemorrhoids in toddlers,Prostatitis 6

    1. How to distinguish chronic prostatitis from non-gonococcal urethritis?

    Nongonococcal urethritis is a sexually transmitted disease, that is to say, it is a sexually transmitted disease. It refers to urethritis transmitted through sexual contact caused by pathogens other than Neisseria gonorrhoeae. The most common pathogen is Chlamydia. Nongonococcal urethritis and chronic prostatitis can be causal to each other. The pathogen of non-gonococcal urethritis can spread directly from the urethra to the prostate, and can also flow back into the prostate duct and tissues with urine, causing bacterial prostatitis. Bacteria in the prostate tissue of patients with chronic bacterial prostatitis can also be discharged into the urethra with the prostatic fluid, causing non-gonococcal urethritis. But in general, urethritis caused by chronic prostatitis is non-specific urethritis, not non-gonococcal urethritis. The so-called non-specific urethritis in medicine is a type of urethritis relative to specific urethritis. The so-called specific urethritis refers to urethritis caused by gonococcus, chlamydia, tuberculosis and other special bacteria. It is named because of its special clinical manifestations. Non-specific urethritis is caused by common bacteria. Nongonococcal urethritis is a kind of specific urethritis, which is a kind of venereal disease. The pathogenic bacteria of chronic prostatitis are mostly common bacteria, such as E. coli. Therefore, non-gonococcal urethritis is generally not caused.

    Both chronic prostatitis and non-gonococcal urethritis can cause lower urinary tract infection syndrome.

    Such as frequent urination, urgency, painful urination, inexhaustible urination, urethral discomfort or burning during urination. Can also have morning urethral secretions. However, non-gonococcal urethritis is a venereal disease, and generally has a history of unclean sexual intercourse before the onset. The symptoms of non-gonococcal urethritis are mainly painful urination and urethral secretions, while chronic prostatitis is mainly pelvic pain, such as penis, scrotum, testicles, groin, perineum, pubis, lower back pain or discomfort. Ejaculation pain, etc., dysuria is relatively rare and mild. Nongonococcal urethritis has a rapid onset and persistent symptoms, while chronic prostatitis has a long course, with recurrent symptoms, sometimes severe and sometimes mild, and sometimes it can slow down by itself. If the judgment is difficult, you can go to the hospital for further examination, such as urethral secretions, bacterial culture, bacterial culture of lower urinary tract, etc., so that the doctor can make a diagnosis for you.

    But it must not be considered that the detection of chlamydia and mycoplasma is a non-gonococcal urethritis. Most non-gonococcal urethritis is sensitive to minocycline, doxycycline, azithromycin, etc. The treatment course of minocycline and doxycycline is 1 to 2 weeks, and azithromycin can be effective with only a single dose. Antibiotic treatment is ineffective, and the diagnosis of nongonococcal urethritis is suspicious.

    2. Is prostatitis a venereal disease? Is it contagious?

    Prostatitis is not a venereal disease. Type I and type II prostatitis, namely bacterial prostatitis, are only a few, accounting for 5% to 10% of prostatitis. Most of the pathogenic bacteria of bacterial prostatitis are non-specific bacteria, the so-called ordinary bacteria. Although the bacteria can be brought into the woman's body through sexual intercourse, it will generally not cause female infection, because the female vagina has a strong resistance to external The ability of bacteria. Therefore, for the vast majority of patients, it is not necessary to consider the infectious problem of chronic prostatitis. For this reason, it is not necessary to restrain or refuse sex. Over time, it may also affect the emotional communication between the couple, the normal life of the couple, and their own diseases. Rehabilitation has a certain adverse effect. But in a few cases, prostatitis can be caused by Neisseria gonorrhoeae, Chlamydia, Treponema pallidum, and Trichomonas. It is a venereal disease and is contagious.

    3. Will prostatitis cause prostate hyperplasia or prostate cancer?

    There is currently no definite evidence that prostatitis can cause prostate hyperplasia and prostate cancer. Recent studies have found that prostatitis may increase the risk of prostate cancer. However, current medical research pays more attention to prostate hyperplasia and prostate cancer, and less research on prostatitis. Whether prostatitis can cause prostate hyperplasia or prostate cancer remains to be further studied.

    Prostatic hyperplasia is often accompanied by prostatitis. The risk of prostatitis in patients with benign prostatic hyperplasia will increase by 7.7 times. 12%~57% of patients with prostatic hyperplasia have prostatic fluid leukocytosis. Some people even found that 98% of surgically removed prostate specimens have inflammation. This is because the obstruction of the lower urinary tract caused by prostatic hyperplasia is prone to secondary urinary tract infection. This is the same as the water will smell when the waterway is blocked. After the obstruction, the resistance of the urethra increases and the urine easily flows back into the prostate duct. In addition, the prostate hyperplasia The posterior prostate duct is squeezed, narrowed, twisted, and elongated, and the discharge of prostate fluid is blocked, which easily causes prostatitis. Similarly, prostate cancer is also prone to prostatitis. 50% of prostate cancer biopsy specimens have prostatitis, and the possible mechanism is similar to that of prostate hyperplasia.

    4. What is the relationship between prostatitis and varicose veins and hemorrhoids?

    Patients with chronic prostatitis are more likely to have varicose veins and hemorrhoids than normal people. Is there any internal connection between them? Medical workers are very interested in this. Some experts have conducted a pathological anatomy study on chronic prostatitis and found that 89.9% of patients with chronic prostatitis have enlarged prostate venous plexus, prostatic venous plexus, spermatic vein, subrectal submucosal and subcutaneous venous plexus (with hemorrhoids) Formation related) are all pelvic veins, and the three are anatomically related. Therefore, it is guessed that the occurrence of some prostatitis is related to pelvic venous disease, and varicose veins and hemorrhoids belong to pelvic venous disease and influence each other. Another study found that between the hemorrhoidal venous plexus in the lower rectum and the genitourinary venous plexus, there are 2-6 small hemorrhoidal and reproductive veins communicating. These communicating branches transport the venous blood from the rectum to the urogenital veins around the prostate in one direction. In other words, the venous plexus of the prostate is connected to the rectal vein, and pathogens around the rectum and anus can infect the prostate through the venous system, which provides a basis for this conjecture.

    However, the relationship between prostatitis and varicose veins and hemorrhoids cannot be concluded, and some direct and clear evidence is needed to confirm it.

    5. What is going on with prostate stones?

    True prostate stones (true prostate stones) refer to stones that occur in the acinar or glandular ducts of the prostate. They are stones that originate in the prostate tissue. Generally speaking, prostate stones refer to true prostate stones. The number of stones in the prostate is large, often reaching hundreds. There are reports of as many as 1247 in one case. The stones are of different sizes, but the diameter is mostly 1 to 4 mm, and they are brownish-gray. Generally, prostate stones cannot be discharged by themselves.

    The cause of the formation of prostate stones is still unclear, and may be related to the following factors:

    ①Urine reflux Although prostate stones occur in the prostate acini, studies have found that most stones contain urine components instead of prostate fluid, suggesting that their occurrence may be related to urine reflux. Urine reflux urinary salt deposits to form stones.

    ②Amyloid Amyloid is a small oval corpuscle that exists in the prostate acinar, composed of protein and a small amount of fat. It is rarely seen in children, but gradually increases with age. In some cases, amyloid may cause inflammation in the prostate acinar, causing calcium-containing substances to deposit on its surface and form stones.

    ③Prostatitis Bacteria, necrotic tissue or exfoliated epithelial cells in the prostate acinar can be used as the core of stone formation; pus and debris that cannot be fully drained can be calcified to form stones.

    ④ Obstruction. Prostatic hyperplasia can also increase the pressure in the ducts, expand the ducts, and accumulate secretions in the glands, condensate and form round protein bodies, and then calcify to form stones. After the cortex or outer membrane around the prostate is compressed, the components of the stones can also be deposited to form stones due to poor drainage. In prostatitis, the prostate tissue is hyperemia, edema, and scar formation, and the stenosis of the gland can lead to obstruction. After the obstruction, the stone components are easy to deposit and form stones.

    The age of onset of prostate stones is mostly over 40 years old, with the most being between 50 and 65 years old. But the exact incidence is unknown, because many cases are found in routine X-ray or B-ultrasound examinations. Prostate calculus itself is asymptomatic, and the symptoms are mostly due to accompanying prostatitis, prostate abscess, prostatic hyperplasia, and urethral stricture.

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