What Is Prostatodynia?

Prostate pain is a discomfort similar to chronic prostatitis caused by spasmodic pain in the muscles of the urethra, prostate, or muscles in the perineum and pelvis. Patients with prostate pain have abnormal urinary flow, including sluggish urinary flow and leaching. The urinary flow chart shows a tooth wave, and the urinary flow is reduced. It is characterized by a slight impaired or normal maximum urinary flow rate, and a uniform urinary flow rate. Decreased, or the uniform urine flow rate is still at the lower limit of normal, but the micturition phase is prolonged, and some patients may have obvious residual urine.

Basic Information

English name: prostatodynia
Visiting department: Urology
Multiple groups: Young men

Common causes: Infection with pathogenic microorganisms, anxiety, alcoholism; eating irritating foods such as pepper
Common symptoms: Frequent urination, urgency and nocturia, pain and discomfort, etc.

Causes of prostate pain

Prostatic hyperemia is one of the most important causes of prostate pain. Prostatitis congestion and swelling can cause compression of the urethra, compression of the bladder outlet, and stimulation of pelvic muscles; these discomforts are the same as chronic prostatitis. We call it prostate pain. Therefore, people with frequent congestion of the prostate are most likely to get prostate pain.

Biological factor

(1) It is the infection of various pathogenic microorganisms. Viruses, mycoplasma, chlamydia, bacteria, spirochaete, fungi, trichomoniasis can all cause disease. The main way is urinary tract infection. Ascending infection urine spreads retrogradely from the urethral prostate Into the prostate gland duct, causing bacterial inflammation.

(2) Biological factors also include the body's immune status. When the body's immunity is normal, even if there is a pathogen in the urethra, it will not be infected and cause disease; on the contrary, if the body's immunity is reduced, the normal presence in the urinary system Pathogenic bacteria can also cause disease.

2. Psychological factors

Due to the influence of various factors, such as anxiety, irritability, depression and other unhealthy psychological activities, these psychological activities can reduce the immune level of the human body. For example, experiments have shown that a person with long-term depression emotions has immune globulin in his blood. Levels are lower than normal people, and they are much more likely to develop colds, stomach ulcers, prostatitis, and even cancer.

3. Social factors

Mainly bad habits, or bad lifestyle. Mainly: alcoholism; eating irritating foods such as pepper; sedentary; not drinking water; long-term habitual constipation; catching cold.

Clinical manifestations of prostate pain

Prostate pain is mainly seen in young and middle-aged men. Its symptoms are also varied. Prostate pain symptoms are mainly:

Systemic symptoms

Manifestations of fatigue, weakness, anorexia, nausea, vomiting, high fever, chills, collapse, or sepsis. Systemic symptoms can mask local symptoms in the event of a sudden onset.

Local symptoms

The perineum or upper pubic area is under heavy pressure, which becomes worse during sedentary or defecation, and is released to the waist, lower abdomen, back, thighs, etc.

3. Urinary tract symptoms

Burning pain, urgency, frequent urination, urination, and purulent urethral discharge during urination. Edema of the bladder neck can cause poor urination, thin or interrupted urine flow, and urinary retention in severe cases.

4. Rectal symptoms

The rectum is full, urgency and painful defecation, and the urethra is white when the stool is flushed.

Prostate pain test

Digital rectal examination

There are no special abnormalities in the prostate.

2. Prostate fluid microscopy

For normal, cultures were negative.

3. Cystoscopy

Mild to moderate bladder neck obstruction and varying degrees of bladder trabecular formation can be seen.

4. Imaging urodynamic examination

The stiff sexual dysfunction of the bladder neck and prostate urethra, the internal sphincter, reduces the maximum urinary flow rate and the average urinary flow rate. The bladder neck and the urethra of the prostate near the external sphincter of the urethra cannot fully relax, and the maximum urethra is closed at rest. Increased pressure and electrical silence (normal relaxation) of the external urethral sphincter are typical manifestations of patients with prostate pain.

5. Urinary tract urography

Visible bladder neck obstruction or incomplete funnel shape during micturition, urethral stricture at the external sphincter.

Prostate pain diagnosis

Diagnosis can be made based on clinical manifestations. Objective inspection has the following characteristics:

1. Prostate discharge is normal;

2. Urine flow rate examination showed that the urine flow diagram was sloped and half-toothed, the average urine flow rate was significantly damaged, and the maximum urine flow rate was mostly normal;

3. Cystoscopy usually indicates moderate and mild bladder neck obstruction and various bladder trabeculae formation;

4. The course of the disease is longer, the B-ultrasound indicates obvious residual urine, but the prostate is normal.

Differential diagnosis of prostate pain

Bacterial and nonbacterial prostatitis symptoms can appear perineal pain, urinary tract secretions, urinary frequency, urgency, dysuria and other urinary tract symptoms, which are difficult to distinguish from the symptoms alone.

Bacterial prostatitis, a large number of pathogens can be found in the prostate, caused by staphylococci, a large number of staphylococci can be found; in addition, there are more white blood cells, and more than 5 white blood cells can be seen;

Nonbacterial prostatitis is actually free of bacterial infections, but a large number of white blood cells and macrophages can also be found. The pathogen can not be found, but a large number of white blood cells are present.

The current diagnosis of prostate pain is mainly an exclusive diagnosis. That is, patients with similar symptoms of prostatitis, but no inflammatory cells in prostate fluid examination, no bacterial growth in the culture of prostate fluid, and patients without urinary tract infection such as frequent urination, urgency, dysuria, can be diagnosed as prostate pain.