Prostate problems are partly physical and partly psychological.

Chapter Four

Prostate gland not being large, but inflammation, hyperplasia, and cancerous changes – prostate diseases

A prostate crisis is three parts physical illness and seven parts mental illness.

Li Shangyin was one of the most outstanding poets of the late Tang Dynasty, skilled in poetry writing, and authored the "Collected Poems of Li Yishan." Among his many poems and essays is a satirical poem about the historical fact that Emperor Gao Wei of the Northern Qi Dynasty indulged in debauchery and led to the downfall of his country, using the past to reflect on the present:

"A smile can topple a nation, why bother with thorns to cause harm?"

"Little Lian's jade-like body lay prone in the night; news had already arrived that the Zhou army had entered Jinyang."

The last two lines of the poem set aside commentary and present a vivid image. The third line depicts the night Consort Feng (whose name is "Xiao Lian") entered the emperor's court, "offering her beautiful face and lying prone like a jade body," a lewd and explicit erotic scene; the fourth line describes the fall of the Northern Qi dynasty. In 577 AD, Emperor Wu of Northern Zhou captured Jinyang (present-day Taiyuan, Shanxi) and marched towards the Qi capital, Ye. Gao Wei fled but was captured, and the Northern Qi dynasty was destroyed. This line also echoes the "thorns and brambles." These two lines actually vividly recreate the content of the first two lines. There was still some time between Consort Feng's entry into the emperor's court and the Zhou army's capture of Jinyang. The phrase "already reported" connects the two events to the present moment, allowing the reader to understand that even when the front lines were in dire straits and Jinyang had fallen, the emperor was still entangled with Consort Feng, emphasizing the inevitable connection between debauchery, misrule, and the fall of the country. The use of "exaggerated" rhetoric makes it even more thought-provoking.

A critical situation at the front lines often indicates a losing battle, as described in the poem, suggesting the danger of national subjugation, which should be taken very seriously by the ruler. But what if it's a man's prostate gland in crisis?

Prostatitis should also be taken seriously by men, and timely diagnosis and treatment are essential.

Prostatitis is a very common disease in men, often recurring, and is most common in adults. Based on the course of the disease, it can be divided into acute prostatitis and chronic prostatitis. Based on the cause, it can be divided into bacterial prostatitis and nonbacterial prostatitis. The newer classification method divides this disease into four categories: acute bacterial prostatitis, chronic bacterial prostatitis, chronic nonbacterial prostatitis, and asymptomatic chronic prostatitis.

In fact, for many patients, the fear of prostatitis is 30% physiological and 70% psychological. They exaggerate the severity of their condition, worry excessively, and carry a heavy psychological burden, which affects the effectiveness of treatment. Like a cold, prostatitis is prone to recurrence, but the symptoms are generally mild and not life-threatening. Both conditions can be controlled with treatment, and mild cases often resolve spontaneously.

What are the clinical manifestations of acute prostatitis?

Systemic symptoms: chills, high fever, general malaise, fatigue, muscle aches, etc.

Local symptoms include frequent urination, urgency, painful urination, difficulty urinating, incomplete urination, and in severe cases, urinary retention, perineal pain radiating to the lower back, thighs, and lower limbs.

There are many types of treatment methods:

General treatment: Bed rest for 3-4 days is recommended, with adequate hydration. Avoid alcohol and spicy foods. Warm sitz baths or perineal hot compresses can be used, and maintaining regular bowel movements is important. Sexual activity is prohibited.

Antibiotic treatment: When the patient has significant systemic symptoms, high body temperature, and a significantly elevated white blood cell count, intravenous administration should be used; when the patient's systemic symptoms are mild, and body temperature and blood counts are normal, oral administration can be used. The general course of treatment is one month. Anti-infective drugs that can diffuse into the prostate and are fast-acting should be selected to quickly control symptoms and prevent progression to chronic prostatitis.

Symptomatic treatment: If high fever occurs, antipyretics should be administered. If bladder irritation symptoms are significant, appropriate medications can be selected. If difficulty urinating or urinary retention occurs, a temporary suprapubic cystostomy should be performed to drain urine, or a thin, soft silicone catheter should be placed for indwelling catheterization.

Surgical treatment: If acute prostatitis has led to a prostatic abscess, incision and drainage should be performed transrectally or perineally. If the abscess is confined within the prostate, prostatic puncture and drainage can be performed using urethroscopy, followed by injection of broad-spectrum antibiotics.

Chronic prostatitis is a common condition and a concern for many men.

1. Will chronic prostatitis affect fertility?

Clinically, many patients equate prostatitis with male infertility. Is this really the case? In fact, patients don't need to worry excessively or carry a heavy psychological burden. Whether fertility can be objectively evaluated requires a comprehensive assessment based on andrological examination and semen analysis. When the prostate is inflamed, even if it's non-bacterial, it can cause local glandular congestion and edema, poor blood circulation, and accumulation of metabolic products, affecting the quality and composition of the prostate and thus the quality of ejaculated semen. However, these factors are not absolute. Clinically, many patients with recurrent prostatitis for many years have still been able to father children.

II. Can chronic prostatitis lead to erectile dysfunction?

This is one of the most concerning issues for patients in clinical practice. It can be stated that prostatitis itself does not cause erectile dysfunction; the two are not directly related. This is because chronic prostatitis is mostly non-bacterial and generally does not cause changes in anatomy, nerves, blood flow, or hormones, thus not leading to erectile dysfunction. Furthermore, the pathological manifestations of prostatitis mainly involve tissue congestion, edema, and impaired glandular secretion, without affecting the penile cavernous tissue, blood vessels, or nerves, and therefore do not cause organic erectile dysfunction. However, we do see many patients developing secondary erectile dysfunction in clinical practice. Why is this? Through our investigation, we have noticed that anxiety and panic are the main reasons. Therefore, patients with prostatitis should maintain an optimistic attitude, actively cooperate with their doctor's treatment, and strengthen emotional communication with their partners. Generally, erectile dysfunction will not occur, and even if it does, it usually resolves quickly.