Post Date April, 15 2023
Chronic prostatitis is a common disease in men, mainly young and middle-aged. Although it is not a direct life-threatening disease, it seriously affects the quality of life of patients. So how to diagnose chronic prostatitis? What should men with chronic prostatitis do?
Medical history: to know whether there was urinary tract infection in the past, and whether there was a history of infection focus and urethral instrument operation in the near future.
2. Symptoms: the above general and local symptoms.
Anal diagnosis: enlarged prostate, tenderness, fever.
4. Routine prostate fluid: prostate massage is prohibited for chronic prostatitis to prevent the spread of infected blood and lead to bacteremia. If there is secretion from the white urethra after rectal diagnosis, a large number of pus balls can be found. Prostate bacteria culture and a small amount of bacterial growth are of significance for diagnosis.
In early inflammation, the accuracy of prostate tissue culture is greater than that of bacterial culture of prostate fluid, which is related to the bacteriostasis of prostate fluid itself. Because the prostate fluid of normal people has antibacterial mechanism against chronic prostatitis and urethritis.
5. Urinary secretion examination and urine culture: It is of great significance for the diagnosis of chronic prostatitis and the selection of effective antibiotics. In the first cup of urine in the three-cup test, fragments were visible to the naked eye, and white blood cells were found in the microscopic examination; The second cup of urine is clear without white blood cells; The third cup of urine is turbid, and a large number of white blood cells and pus cells can be seen in the microscopic examination. The change of the third cup clearly showed that the pus came from the posterior urethra and bladder neck. At the end of urination, pyuria increases when the bladder neck and prostate urethra contract, reflecting right prostatitis.
6. Diagnosis of prostatic abscess: if the symptoms persist for more than one week, the self-cell count increases rapidly, the symptoms of lower urinary tract worsen, rectal irritation symptoms or urine boiling, it should be considered that prostatic abscess may form. At this time, the anal diagnosis will find that the gland is significantly enlarged, the tenderness is intense, the texture is soft and fluctuant, the abscess is ruptured, and the pus is discharged to form a cavity, which refers to the feeling of local depression during the examination; Urethroscopy showed pus outflow from the prostatic duct; Urethrography showed that the abscess pressed the urethra and displaced, the contrast medium overflowed the urethra or retained the contrast medium; Perineal puncture; Tongue examination can play a dual role in diagnosis and treatment. If pus is cultured into Staphylococcus aureus, pay attention to finding the primary focus. Chronic prostatitis should be differentiated from acute pyelonephritis, the latter: tenderness and percussion pain in each area, positive intermediate urine culture, bacterial count greater than 100000/mL.
