诊断

前列腺炎的诊断包括排除引起症状的其他病因,并确定您患上哪种前列腺炎。医生会询问您的病史以及症状。还会进行体格检查,可能包括直肠指检。

初次诊断检查可能包括:

  • 尿液检测。医生可能会对您的尿样进行分析,确定尿液中有无感染迹象(验尿)。医生也可能将您的尿样送往实验室,以确定是否发生感染。
  • 血液检测。医生可能会检查血样,确定是否有感染和其他前列腺问题迹象。
  • 前列腺按摩后。极少数情况下,医生可能会按摩您的前列腺并检查流出的液体。
  • 影像学检查。有些情况下,医生可能为您安排尿路和前列腺 CT 扫描,或前列腺超声检查。CT 扫描影像可获得比普通 X 线光片更详细的信息。超声波图是超声波产生的视觉影像。

根据您的症状和检查结果,医生可能会得出结论,您患有以下类型的前列腺炎:

  • 急性细菌性前列腺炎。通常由常见细菌引起,这种类型的前列腺炎一般会突然发作,引起类似流感的体征和症状,如发热、寒战、恶心和呕吐。
  • 慢性细菌性前列腺炎。当抗生素无法消除引起前列腺炎的细菌时,您可能出现复发性感染或难以治疗的感染。在两次慢性细菌性前列腺炎发作间隙,您可能没有任何症状,或者只是轻微症状。
  • 慢性前列腺炎/慢性盆腔疼痛综合征。这种类型的前列腺炎最常见,不是由细菌引起。确切原因通常无法确定。对一些男性来说,症状不会随时间变化。对另一些人来说,可能会经历加重和缓解的周期。
  • 无症状炎性前列腺炎。这种类型的前列腺炎无症状,通常只会在您做其他检查时偶然发现。不需要治疗。

Test for diagnosing bacterial infections

Diagnostic tests to assess for infection will likely include:

  • Digital rectal exam. With this procedure, your health care provider inserts a lubricated, gloved finger into your rectum to detect inflammation of the prostate.
  • Urine test. You'll need to provide a urine sample to be tested for the presence and type of bacterial infection.
  • Blood test. Blood samples may be tested for signs of infection and other prostate problems.
  • Prostatic specimen test. In some cases, a health care provider may gently massage the prostate during a rectal exam to release prostate fluid into your urethra. A urine sample after the massage expels the prostate fluid for bacterial testing.

Other tests

If initial tests show no sign of infection, you may undergo other tests, including:

  • Urodynamic tests. A variety of tests can be used to measure how well the bladder and urethra hold and release urine. These tests can help characterize problems with urinating and identify the source of problems.
  • Imaging. Imaging tests may be ordered for identifying irregularities in the prostate, abnormal growths or other problems in the pelvic region that may be contributing to pain.

治疗

如何治疗前列腺炎取决于引发此病的根本原因。治疗方案包括:

  • 抗生素。服用抗生素是治疗前列腺炎时医生最常用的方法。医生会根据可能导致感染的细菌类型为您选择相应的药物。

    如果您的症状很严重,则可能需要静脉注射(IV)抗生素。您可能需要口服抗生素 4-6 周,但治疗慢性或复发性前列腺炎可能需要更长时间。

  • α 受体阻滞剂。这些药物有助于放松膀胱颈和膀胱与前列腺连接处的肌肉纤维。这种治疗可能会减轻尿痛等症状。
  • 消炎药。非甾体消炎药(NSAID)可能会让您感觉舒适一些。

Treating infection

If you have acute or chronic bacterial prostatitis, you'll take antibiotics. Acute disease may require intravenous (IV) antibiotics in the hospital for a short period. The entire course of antibiotic treatment is usually 4 to 6 weeks — or longer in some cases. Taking all the prescribed medication is important for eliminating the infection and reducing the risk of chronic bacterial prostatitis.

Treating urinary symptoms

Medications, called alpha-blockers, help relax the bladder neck and the muscle fibers where your prostate joins your bladder. This treatment might ease urinary symptoms, such as painful or difficult urination. While this is commonly prescribed for men with chronic prostatitis/chronic pelvic pain syndrome, it may be prescribed to relieve urinary symptoms of bacterial infections.

Treating pain

Your health care provider may prescribe pain medication or recommend nonprescription drugs, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others).

Managing psychological symptoms

Your health care provider may recommend psychotherapy with a mental health care professional to help you manage stress, depression or anxiety that may be associated with chronic pain.

生活方式与家庭疗法

以下举措可减轻前列腺炎的部分症状:

  • 浸泡温水浴(坐浴)或使用加热垫。
  • 限制或避免摄入酒精、咖啡因、辛辣或酸性食物,这些食物会刺激膀胱。
  • 避免刺激前列腺的活动,如久坐或骑自行车。
  • 多喝不含咖啡因的饮料。这将增加排尿,有助于将细菌从膀胱冲走。

替代医学

有可能减轻前列腺炎症状的其他替代疗法包括:

  • 生物反馈。生物反馈专家利用监测设备发出的信号来教您控制身体的特定功能和反应,包括放松您的肌肉。
  • 针刺疗法。针刺疗法需要将非常细的针经皮以不同深度插入到您身体的特定部位。
  • 草药与补充剂。尽管许多男性服用草药,但是没有证据表明草药和补充剂能改善前列腺炎。一些治疗前列腺炎的草药包括黑麦草(舍尼通)、在绿茶、洋葱和其他植物中可获取的一种化学物质(槲皮素),以及锯棕榈提取物。

与医生讨论使用替代疗法和补充剂。

准备您的预约

您可能会先去看初级保健医生。或者您也可能立刻被转诊至尿路和性障碍专科医生(泌尿科医生)。

以下信息可以帮助您做好就诊准备。

June 23, 2022
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