Ludwig M, Weidner W
Urologische Klinik, Justus-Liebig-Universität Giessen.
Ther Umsch. 1995 Jun;52(6):367-73.
During the last years, diagnosis and therapy of prostatitis have advanced rapidly. A detailed standardized diagnostic procedure is mandatory to delimit inflammatory from noninflammatory variations of the prostatitis syndrome. Whereas Gram-negative pathogens are agreed to be etiologically responsible, the relevance of chlamydia and mycoplasma is still under debate. Further diagnostic work-up should comprise ejaculate analysis, screening of the bladder voiding and transrectal prostatic sonography. The therapy of the inflammatory prostatitis is aimed to the demonstration of relevant pathogens, antibiotic treatment must be suited to expected sensitivity of the pathogen. Surgical procedures may be discussed when antibiotic treatment has failed. If it is not possible to identify relevant pathogens, the therapy remains of experimental character. Prostatodynia as noninflammatory disease often requires psychodynamic exploration.
在过去几年中，前列腺炎的诊断和治疗进展迅速。必须有详细的标准化诊断程序来区分前列腺炎综合征的炎症性与非炎症性变体。虽然革兰氏阴性病原体被认为是病因，但衣原体和支原体的相关性仍在争论中。进一步的诊断检查应包括精液分析、膀胱排尿筛查和经直肠前列腺超声检查。炎症性前列腺炎的治疗旨在确定相关病原体，抗生素治疗必须适合病原体的预期敏感性。当抗生素治疗失败时，可以讨论手术程序。如果无法识别相关病原体，治疗仍具有实验性质。前列腺痛作为非炎症性疾病通常需要进行心理动力学探究。
