Stevermer J J, Easley S K
Department of Family and Community Medicine at the University of Missouri-Columbia School of Medicine, 65212, USA.
Am Fam Physician. 2000 May 15;61(10):3015-22, 3025-6.
The term prostatitis is applied to a series of disorders, ranging from acute bacterial infection to chronic pain syndromes, in which the prostate gland is inflamed. Patients present with a variety of symptoms, including urinary obstruction, fever, myalgias, decreased libido or impotence, painful ejaculation and low-back and perineal pain. Physical examination often fails to clarify the cause of the pain. Cultures and microscopic examination of urine and prostatic secretions before and after prostatic massage may help differentiate prostatitis caused by infection from prostatitis with other causes. Because the rate of occult infection is high, a therapeutic trial of antibiotics is often in order even when patients do not appear to have bacterial prostatitis. If the patient responds to therapy, antibiotics are continued for at least three to four weeks, although some men require treatment for several months. A patient who does not respond might be evaluated for chronic nonbacterial prostatitis, in which nonsteroidal anti-inflammatory drugs, alpha-blocking agents, anticholinergic agents or other therapies may provide symptomatic relief.
前列腺炎这一术语适用于一系列病症，范围从急性细菌感染到慢性疼痛综合征，这些病症中前列腺会发生炎症。患者会出现多种症状，包括尿路梗阻、发热、肌痛、性欲减退或阳痿、射精疼痛以及腰背部和会阴疼痛。体格检查往往无法明确疼痛的原因。前列腺按摩前后对尿液和前列腺分泌物进行培养及显微镜检查，可能有助于区分感染性前列腺炎与其他原因引起的前列腺炎。由于隐匿性感染的发生率较高，即使患者似乎没有细菌性前列腺炎，通常也需要进行抗生素治疗试验。如果患者对治疗有反应，抗生素需持续使用至少三到四周，不过有些男性需要治疗数月。对治疗无反应的患者可能需要评估是否患有慢性非细菌性前列腺炎，对于这种情况，非甾体抗炎药、α受体阻滞剂、抗胆碱能药物或其他疗法可能会缓解症状。
