Dr. Zhao Shanchao, Chief Physician, Department of Urology, Nanfang Hospital, Southern Medical University
A short time ago, a man came to the clinic, perineum, repeated testicular and lumbosacral pain, and sexual dysfunction, no fever shiver, urinary tract irritation and dysuria and other symptoms. After diagnosis, it is to make us these urinary Surgeon feels tricky - chronic pelvic pain syndrome.
According to research conducted by the National Institutes of Health, Chronic Pelvic Pain Syndrome is type III chronic prostatitis. In China, the prevalence of adult males is approximately 8% to 9%, with a prevalence of less than 50 years of age. The symptoms are more than 3 Months, persistent or recurrent pelvic pain, often accompanied by negative emotions, sexual behavior and affect, and lower urinary tract disease, sexual dysfunction, bowel dysfunction, etc. Simply put, it is not specific to a certain disease, It is a group of diseases characterized by pain or discomfort in the pelvis area and abnormal urination. Its etiology, development, and outcome are still unclear.
At present, it is widely believed that chronic pelvic pain syndrome is mainly related to the following factors: 1. Infection of pathogens. 2. Urination dysfunction: Urine reflux, not only brings pathogens into the prostate, but also directly stimulates the prostate and induces inflammation. 3 Mental and psychological factors: The patient will further aggravate the condition due to anxiety, depression, hypochondria and other negative emotions. 4. Neuroendocrine factors. 5. Immune response abnormalities. 6. Pelvic-related diseases: Symptoms of some patients or pelvic venous congestion, blood Hysteresis related.
Chronic Pelvic Pain Syndrome must be treated with a multi-pronged approach. The disease can be further subdivided into type IIIA with inflammation and type IIIB without inflammation. The former can be administered orally with quinolones, tetracyclines or macrolides. Antibiotics such as class; the latter is not recommended.
For patients with lower urinary tract symptoms and pain, tamsulosin, doxazosin, terazosin, celecoxib, etc. can effectively relieve symptoms; tolterodine and other help to treat urinary tract obstruction Nocturia, urinary urgency, frequent urination; In addition, newly developed botanical preparations, such as Putaishu, Sabah brown and its extracts, etc., also contribute to the relief of pain. These botanical preparations have a wide range of effects, have small side effects, and promote bladder force. Urinary muscle contraction and relaxation of urethral smooth muscle, etc. At the same time as the above treatment, the patient should maintain a pleasant and optimistic mood, if necessary, health education, psychological and behavioral counseling, and psychological intervention; if there is psychological disorder such as depression, anxiety, etc. Antidepressant and anti-anxiety drugs. The above specific medications need to be used under the guidance of specialists.
In addition to medication, according to the situation may choose Chinese medicine, massage, biofeedback treatment, hyperthermia and other methods, if necessary, injection therapy, but careful surgery.
Adult males, especially those under the age of 50, should pay attention to the following points: 1. Stop smoking and abstain from alcohol, do not eat spicy foods for a long period of time, pay attention to balanced nutrition on the diet; 2. Avoid urine retention, long bicycle rides, sedentary etc. In order to avoid prolonged congestion of the prostate and long-term chronic compression of pelvic floor muscles; 3. Carry out proper physical exercise for about 30 minutes a day. Exercise mainly with jogging and lower extremities to avoid strenuous exercise; 4. Keep warm and regular sex; 5 Keep your mood happy.
