Stewart C
Spectrum Emergency Care, Colorado Springs.
Emerg Med Clin North Am. 1988 Aug;6(3):391-402.
Prostatitis is a poorly defined group of syndromes with multiple causes, some of which are not yet determined. Although treatment of acute prostatitis is well defined and almost uniformly successful, chronic prostatitis, either of bacterial or undetermined etiology, remains a perplexing problem in both diagnosis and treatment. Identification of the etiologic agent of chronic "nonbacterial" prostatitis, if one exists, has not yet been accomplished. Undoubtedly, more than one organism may be responsible for these cases. Treatment is ineffective for a high percentage of patients with chronic prostatitis, both from proven bacterial and nonbacterial causes. Few drugs penetrate the prostatic tissues well, and few of those that do have an appropriate antimicrobial spectrum. An excellent, or even adequate, antibiotic for chronic prostatic infections has yet to be developed. Prostatodynia remains as a "wastebasket" syndrome of miscellaneous pains, aches, and pelvic discomforts. With this collection of symptoms, no easy approach to diagnosis or treatment is possible. Only when more detailed diagnosis has been developed can one hope for better therapy of this condition.
前列腺炎是一组定义不明确的综合征，病因多样，其中一些尚未确定。虽然急性前列腺炎的治疗方法明确且几乎总能成功，但无论是细菌性还是病因不明的慢性前列腺炎，在诊断和治疗方面仍然是一个棘手的问题。慢性“非细菌性”前列腺炎（如果存在病因的话）的病原体尚未确定。毫无疑问，这些病例可能由不止一种病原体引起。对于很大一部分慢性前列腺炎患者，无论病因是已证实的细菌性还是非细菌性，治疗都无效。很少有药物能很好地穿透前列腺组织，而且即便能穿透的药物中，具备合适抗菌谱的也很少。治疗慢性前列腺感染的理想抗生素，甚至是足够有效的抗生素，尚未研发出来。前列腺痛仍然是一种包含各种疼痛、酸痛和盆腔不适的“垃圾桶”综合征。有了这一系列症状，就不可能有简单的诊断或治疗方法。只有当更详细的诊断方法得以发展，才有望对这种疾病进行更好的治疗。
