acute bacterial prostatitis
Introduction
Introduction to acute bacterial prostatitis Acute bacterial prostatitis is a bacterial infection of the prostate that is often non-specific and is an acute inflammation caused by the bacteria themselves or bacterial toxins. Clinical manifestations include fever, aversion to cold, body aches, fatigue, loss of appetite and other systemic symptoms and perineal, anal pain and discomfort, frequent urination, urgency, dysuria, dysuria or hematuria, and even urinary closure. Pathogen infection is a major cause of bacterial prostatitis. Due to the low resistance of the body, bacteria or other pathogens with strong virulence are infected with the prostate and cause rapid growth and reproduction. Most of them are blood-borne infections and transurethral retrograde infections. The pathogens are mainly Escherichia coli, followed by Staphylococcus aureus, Klebsiella pneumoniae, Proteus, Pseudomonas, etc., and most of them are single pathogen infections. Mainly broad-spectrum antibiotics, symptomatic treatment and supportive care. Patients with urinary retention may be treated with thin tube catheterization or suprapubic bladder puncture to induce drainage of the urine. Patients with prostate abscess may take surgical drainage. basic knowledge The proportion of illness: 0.003% Susceptible people: male Mode of infection: non-infectious Complications: urinary retention, seminal vesiculitis, epididymitis, acute cystitis, sexual dysfunction
Cause
Cause of acute bacterial prostatitis
Pathogen infection (60%)
Pathogen infection is a major cause of bacterial prostatitis. Due to the low resistance of the body, bacteria or other pathogens with strong virulence are infected with the prostate and cause rapid growth and reproduction. Most of them are blood-borne infections and transurethral retrograde infections. The pathogens are mainly Escherichia coli, followed by Staphylococcus aureus, Klebsiella pneumoniae, Proteus, Pseudomonas, etc., and most of them are single pathogen infections.
Life factor (20%)
Inappropriate activities, sedentary cause long-term hyperemia of the prostate and long-term chronic squeezing of the pelvic floor muscles, cold, fatigue, etc., resulting in decreased body resistance or idiosyncratic.
Dietary factors (15%)
Bad lifestyle habits such as smoking, drinking, and spicy food.
Prevention
Acute bacterial prostatitis prevention
1, the clinical features of acute prostatitis is rapid onset, fever, urinary tract irritation and perineal pain, etc., these are related to acute congestion, swelling, suppuration and other lesions in the gland. The bacteria that cause this acute infection are invaded into the prostate by several different ways: blood infection, lymphatic infection and direct spread. Among them, direct spread is most common. When there is bacterial infection in the bladder or posterior urethra, the pathogen can enter the glandular duct and acinus of the prostate through the opening of the ejaculatory duct in the prostatic urethra.
2. If the original bacterial infection is in the anus, colon, etc., the pathogen can also invade the gland through the lymphatic vessels connected to the prostate. This is a lymphatic infection. If the bacterial infection is in the mouth, throat, respiratory tract, etc., the pathogens parasitic in these places can enter the prostate through the blood circulation, which is blood infection. All of these pathogens are the first to invade the prostate excretory tube in the prostate, and grow and reproduce here. Once the conditions are right, they can quickly induce the obvious lesions.
3. Actively treat infections throughout the body to prevent pathogens from infecting the prostate in a variety of ways. Pay attention to sexual intercourse under the protection of sterile condoms, clean the penis and perineum after sex, keep dry and help prevent infection. For circumcision or phimosis, circumcision should be performed to prevent infection of the prostate caused by pathogenic microorganisms. Grasp the regular sexual life or master the moderate frequency of masturbation, regularly discharge the prostatic fluid, promote its continuous renewal, help relieve the feeling of fullness; avoid repression or frequent masturbation, so as not to cause excessive hyperemia of the prostate.
4, do not ride for a long time and sit still, avoid excessive compression of the prostate, leading to congestion. Pay attention to local warmth, which will help reduce the resistance of the outlet and make the tissue that has been congested and edema easily recover. Have regular living, exercise properly, take a walk after meals to enhance the body's immunity and disease resistance. In addition, avoid overwork, prevent constipation, drink more water and urinate, help the secretion of prostate secretions, and also help prevent repeated infections. Do not abuse antibiotics to prevent bacteria from becoming L-form, which is one of the important reasons for the "aseptic" recessive infection of the prostate and the inability to cure chronic prostatitis.
5, to avoid unnecessary, excessive or excessive prostate massage, to avoid unnecessary catheterization, so as not to damage the prostate or cause infection. Greatly popularize the knowledge of prostate diseases and give the public guidance to protect the prostate, improve unhealthy lifestyles and quit bad habits. Pay attention to the prevention of post-curative prostatitis patients, try not to use long-term empirical antibiotics prevention, but should use the above-mentioned preventive measures to alleviate the physiological and psychological symptoms of patients, help prevent re-infection; adhere to the levator ani muscle Exercise to relax the pelvic floor muscles, gradually increase the interval between urination and so on.
Complication
Acute bacterial prostatitis complications Complications, urinary retention, seminal vesiculitis, epididymitis, acute cystitis, sexual dysfunction
1. Acute urinary retention : Acute prostatitis causes local congestion, swelling, compression of the urethra, resulting in difficulty in urinating or leading to acute urinary retention. Abscess is more common in patients aged 20-40 years, with rectal symptoms and urinary retention more common.
2. Acute seminal vesicle or epididymitis and vas deferens : acute prostatitis easily spread to the seminal vesicle, causing acute seminal vesiculitis. At the same time, the bacteria reversibly run through the lymphatic vessels into the wall and sheath of the vas deferens, leading to epididymitis, local swelling and pain.
3. Acute cystitis : There are symptoms of bladder irritation, urethral discharge, dysuria, lower abdomen perineum and lower back pain.
4. The spermatic lymph nodes are swollen or tender : the prostate and the spermatic lymph in the pelvis have traffic branches, and the acute inflammation of the prostate affects the spermatic cord, causing the lymph nodes of the spermatic cord to be swollen and accompanied by tenderness.
5. Sexual dysfunction : acute inflammatory phase, prostate congestion, edema or small abscess formation, may have ejaculation pain, painful erection, loss of libido, sexual pain, erectile dysfunction, blood essence.
Symptom
Acute bacterial prostatitis symptoms Common symptoms Urinary dysfunction urination pain Frequent urination with urgency and dysuria High fever chills, soreness, lack of appetite, blood, urine, anorexia, decreased prostaglandin synthesis
Clinical manifestation
1. Acute bacterial prostatitis is an acute onset, which can be manifested as systemic manifestations such as chills, high fever, fatigue, and anorexia.
2. With persistent and obvious symptoms of lower urinary tract infection, such as frequent urination, urgency, dysuria, urinary burning, dysuria, urinary retention, posterior urethra, anus, perineal area bulging discomfort.
3. The number of white blood cells in blood and urine is increased, and bacterial culture is positive.
Examine
Examination of acute bacterial prostatitis
Laboratory inspection
(1) Urine routine analysis and urine sediment examination: visible urine turbidity, even pyuria, a large number of flocs and debris-like deposits, urine three cups test initial urine and terminal urine most obvious, microscopic examination showed a large number of white blood cells.
(2) blood routine: white blood cells > 1 × 109 / L, neutrophil ratio > 70%, there may be nuclear left shift, and even naive cells.
(3) bacteriological examination: urine smear microscopic examination showed bacteria, urine or blood culture can be positive.
Diagnosis
Diagnosis and diagnosis of acute bacterial prostatitis
Diagnosis and differential diagnosis
diagnosis
The diagnosis of acute bacterial prostatitis relies mainly on medical history, physical examination, and bacterial culture results of blood and urine. A digital rectal examination of the patient is necessary, but a prostate massage is contraindicated. Mid-stage urine culture or blood culture should be performed before antibiotic treatment. After 36 hours of standard treatment, when the patient's condition has not improved, it is recommended to undergo a transrectal B-ultrasound examination to comprehensively evaluate the lower urinary tract lesions and to determine whether there is a prostate abscess.
Physical examination can be found on the suprapubic tenderness, discomfort, and those with urinary retention can reach the bladder of the suprapubic bulging. Rectal examination can reveal enlarged prostate, tenderness, elevated local temperature and irregular shape. It is contraindicated for prostate massage.
Laboratory inspection
(1) Urine routine analysis and urine sediment examination: visible urine turbidity, even pyuria, a large number of flocs and debris-like deposits, urine three cups test initial urine and terminal urine most obvious, microscopic examination showed a large number of white blood cells.
(2) blood routine: white blood cells > 1 × 109 / L, neutrophil ratio > 70%, there may be nuclear left shift, and even naive cells.
(3) bacteriological examination: urine smear microscopic examination showed bacteria, urine or blood culture can be positive.
Differential diagnosis
1, acute bacterial cystitis: generally no obvious systemic symptoms, mainly manifested as lower urinary tract irritation symptoms, that is, frequent urination, urgency, dysuria, urinary tract burning, severe cases may be accompanied by gross hematuria.
2, acute pyelonephritis: also showed severe symptoms of the province and lower urinary tract symptoms, but accompanied by low back pain, kidney pain. Imaging studies help to differentiate the diagnosis.
3, acute urinary retention: can be secondary to acute prostatitis, manifested as severe dysuria, urinary line realization, urinary insufficiency, or even unable to urinate, may be associated with abdominal pain, bulging, compression of abdominal acupressure is more obvious. Catheter or ultrasound can detect a large amount of urine in the bladder.
4, other needs to be identified include prostate hyperplasia, overactive bladder, interstitial cystitis and other identification.
