| disease | Nonbacterial Prostatitis |
Nonbacterial prostatitis is the most common type of prostatitis syndrome, and its disease cause remains unclear. In the prostatic secretions of nonbacterial prostatitis, there are abnormal numbers of inflammatory cells, but no pathogenic bacteria can be detected through bacterial cultures or other methods. Attempts have been made to confirm certain uncommon pathogens (such as obligate anaerobes, mycoplasma, chlamydia, or other protozoa, viruses, etc.) as the disease cause of nonbacterial prostatitis, but these efforts have been unsuccessful. Many speculate that mycoplasma is related to nonbacterial prostatitis, but there is insufficient evidence from bacteriological and serological tests to establish a clear causal relationship. Some researchers believe that nonbacterial prostatitis is an immune-related disorder, and its diagnosis can only be confirmed after excluding other specific types of prostatitis.
bubble_chart Clinical Manifestations
Nonbacterial prostatitis, apart from not causing urinary tract infections, exhibits clinical symptoms and signs similar to those of bacterial prostatitis. Although a significant number of inflammatory cells are present in the prostate secretions of patients with nonbacterial prostatitis, pathogenic bacteria are not detected through segmented urine bacterial cultures or other examination methods. X-rays and endoscopic examinations provide no diagnostic assistance except for ruling out other diseases.
bubble_chart Treatment Measures
(1) Special treatment: For patients with symptoms of chronic prostatitis, if pathogenic bacteria cannot be detected bacteriologically but there are a large number of inflammatory bacteria in their prostatic secretions, a diagnosis of non-bacterial prostatitis can be made. Since it is uncertain whether mycoplasma and chlamydia are the {|###|}disease cause{|###|} of prostatitis, antibiotics targeting these pathogens can be selected for clinical trials. Minocycline 100mg, taken orally three times daily, or erythromycin 500mg, taken orally four times daily, should be tried for at least four weeks. TMP and carbenicillin are ineffective, so empirical continuous use of antibiotics is unreasonable. {|###|}antagonism{|###|}, the treatment mainly focuses on symptom control. During the acute {|###|}stage of attack{|###|}, anti-inflammatory drugs (ibuprofen, 400–600mg, taken orally three times daily) can be used.
(2) General treatment: Sitz baths with hot water often relieve symptoms. Dietary attention should be paid, and alcohol, {|###|}coffee bean{|###|}, and spicy foods should be consumed in moderation. Patients are encouraged to live as normal a life as possible (including sexual activity). Some clinicians advocate periodic prostatic {|###|}tuina{|###|} therapy, but others question its efficacy.
Nonbacterial prostatitis can cause intermittent bothersome symptoms, but so far no serious complications have been reported.
Because the cause of nonbacterial prostatitis is unknown, the disease is difficult to prevent.
It is unclear whether nonbacterial prostatitis causes other complications, but patients with recurrent symptoms often experience anxiety, depression, and other abnormal psychological reactions.
Nonbacterial prostatitis must be differentiated from other specific prostatitis, especially chronic bacterial prostatitis. Sometimes, urethritis and cystitis should also be considered in the differential diagnosis. In middle-aged and elderly male patients with irritative voiding symptoms and negative bacterial cultures, careful analysis should be performed to determine the presence of bladder tumors, especially bladder cancer. In such cases, in addition to urine cytology, cystoscopy should also be performed.
