Inability to urinate and urethral pain may cause prostatitis

If a man experiences urinary incontinence and urethral pain, he should be alert to prostatitis. The incidence rate is very high among middle-aged and elderly men. This symptom is also a typical symptom of prostatitis. If not treated in time, it will cause low back pain and infertility.

1. Symptoms of prostatitis

1. Acute bacterial prostatitis: sudden onset, with chills and high fever, frequent urination, urgency, and pain during urination. Dysuria or acute urinary retention may occur. Clinically, it is often accompanied by acute cystitis, prostate swelling, tenderness, increased local temperature, smooth surface, and a feeling of fullness or fluctuation if an abscess is formed.

2. Chronic bacterial prostatitis: frequent urination, urgent urination, painful urination, urethral discomfort or burning during urination, white secretions often flow out of the urethra after urination and defecation, sometimes hematospermia, perineal pain, sexual dysfunction, mental and neurological symptoms, full, enlarged, soft prostate, mild tenderness, long-term disease, the prostate shrinks, hardens, the surface is incomplete, and there are small nodules.

3. Chronic non-bacterial prostatitis and prostatitis: The clinical manifestations are similar to those of chronic bacterial prostatitis, but there is no history of recurrent urinary tract infections. The main symptoms are urinary tract irritation and dysuria, especially the manifestations of chronic pelvic pain syndrome. Mycoplasma and chlamydia can be cultured in the prostatic fluid of some patients.

2. Common examinations for prostatitis:

1. Rectal digital examination shows that the prostate is full, enlarged, soft, and slightly tender. If the disease lasts for a long time, the prostate will become smaller, harder, uneven in texture, and have small nodules. At the same time, prostate massage is used to obtain prostate fluid and do a routine examination.

2. Prostatic fluid examination: If the number of white blood cells in the prostatic fluid exceeds 10 in the high-power field of view of the microscope and the lecithin bodies are reduced, prostatitis can be diagnosed. If bacterial culture is performed at the same time, a clear diagnosis and classification of chronic prostatitis can be made. If the bacterial culture result of the prostatitis fluid is positive, chronic bacterial prostatitis is diagnosed; otherwise, it is chronic non-bacterial prostatitis.

3. Ultrasound examination shows that the boundaries of the prostate tissue structure are unclear and disordered, which may indicate prostatitis.

4. Urodynamic examination: The main manifestations include decreased urine flow rate, incomplete relaxation of the bladder neck-urethral sphincter, and abnormally increased maximum urethral closure pressure.