1. Antibacterial therapy
The discovery of pathogenic pathogens in prostate fluid culture is the basis of choosing antibacterial drugs for treatment. If patients with non-bacterial prostatitis show signs of bacterial infection, general treatment is ineffective and antibacterial drugs can be used for treatment. In the choice of antibacterial drugs, we should pay attention to the existence of prostate-blood barrier composed of lipid membrane between prostate acinus and microcirculation, which hinders the passage of water-soluble antibiotics and greatly reduces the therapeutic effect. When there are prostate stones, stones will become a refuge for bacteria.
2. Anti-inflammatory and analgesic
Non-steroidal anti-inflammatory drugs can improve symptoms. Indomethacin is generally used orally or suppository, and Chinese medicine combined with anti-inflammatory, heat-clearing, detoxification and softening drugs has also achieved certain results. Allopurinol can reduce the concentration of uric acid in the whole body and prostate fluid. Theoretically, allopurinol, as a free radical scavenger, can also remove active oxygen components, reduce inflammation and relieve pain. This is an optional adjuvant therapy.
Step 3: physical therapy
Prostate massage can empty the concentrated secretion in the prostate tube and drain the infected focus in the blocked area of gland, so for stubborn cases, you can do prostate massage every 3 ~ 7 days while using antibiotics. Using microwave, radio frequency, ultrashort wave, medium wave, hot water sitz bath and other physical factors for prostate physiotherapy is beneficial to relax prostate, posterior urethral smooth muscle and pelvic floor muscle, strengthen antibacterial effect and relieve pain symptoms.
4.m receptor antagonists
M- receptor antagonists can be used to treat the symptoms of overactive bladder in patients with prostatitis, such as urgency, frequent urination and nocturia, without urinary tract obstruction.
5. Alpha receptor antagonists
The smooth muscle tension of prostate, bladder neck and urethra increased in patients with prostate pain, bacterial or non-bacterial prostatitis. When urinating, the internal pressure of the posterior urethra rises, which makes the urine flow back into the prostate tube, which is an important cause of prostate pain, prostate stones and bacterial prostatitis. The application of α receptor antagonist can effectively improve prostate pain and micturition symptoms, which is of great significance to prevent the recurrence of infection.
6. Prostate massage and hyperthermia
Prostate massage is one of the traditional treatment methods. Studies have shown that proper prostate massage can promote the emptying of prostate tube, increase the local drug concentration, and then alleviate the clinical symptoms of chronic prostatitis. Hyperthermia mainly uses the thermal effect produced by various physical means to increase the blood circulation of prostate tissue, accelerate metabolism, benefit and eliminate tissue edema, and relieve pelvic floor muscle spasm.
7. Surgical therapy
Surgical treatment can be used for recurrent chronic bacterial prostatitis. Prostatectomy can achieve the goal of cure, but it should be used with caution. Because prostatitis usually involves the peripheral zone of glands, transurethral resection of prostate is difficult to achieve the purpose of treatment. TURP can remove the bacterial infection focus near prostate calculus and prostate catheter, which is beneficial to reduce the reinfection of peripheral lesions. Chronic bacterial prostatitis can lead to repeated urinary tract infections and infertility.