Many men are confused about having chronic prostatitis, not knowing how it is caused and whether it can be cured after treatment. Experts from Shanghai Apollo Hospital indicate that although chronic prostatitis is a kind of inflammation, bacterial infection is not the only cause but just an external secondary factor. There are also some intrinsic important pathogenic factors in the prostate itself, which are caused by functional and organic changes in the gland. The main manifestations are as follows:
(1) Endocrine dysfunction. The prostate is the largest accessory gland in males, and it can only function normally under the regulation and control of the higher central nervous system to maintain the normal tissue structure of the gland. Experts at Apollo Hospital say that with age, the control ability of the nervous center gradually weakens, the level of male hormones decreases, leading to endocrine imbalance. At this time, the gland may undergo degenerative changes, i.e., the secretion function of the gland decreases, and fibrosis hyperplasia occurs, thereby providing favorable conditions for bacterial infection.
(2) Circulation disorders in the gland. The blood supply to the prostate is very rich, coming from three arteries: upper, middle, and lower prostate arteries. However, the veins that return blood are fewer, needing to pass through many small vessels before gradually converging into large veins, increasing blood flow resistance in the prostate. Experts at Apollo Hospital point out that if there are factors causing long-term repeated congestion of the gland, it may aggravate venous return obstacles. Over time, the gland will also experience delayed changes. Fibrous tissue replaces glandular cells, leading to gland hardening, further worsening blood circulation disorders within the gland, causing blood stasis and increasing the chance of bacterial retention. Various reasons causing congestion in the prostate, especially passive congestion, are important pathogenic factors. Non-infectious, non-microbial long-term congestion can form non-specific inflammatory reactions. The main causes inducing prostate congestion include: ① Abnormal sexual behavior, such as excessive sexual life, interrupted intercourse, and excessive masturbation. ② Passive congestion of the gland, such as prolonged cycling or long-term contact with wet ground. ③ Excessive drinking and eating of stimulating foods. ④ Excessive force or frequency in prostate massage. ⑤ Catching a cold: The prostate has abundant α-adrenergic receptors, and after catching a cold, it can trigger sympathetic nerve activity, leading to increased pressure in the urethra, obstructing excretion, and due to contraction of the prostate ducts, obstructing excretion, resulting in congestive congestion.
(3) Some patients develop it from acute prostatitis, but most patients have not gone through an acute infection stage. Experts at Apollo Hospital say that the bacterial infection pathway is the same as in acute prostatitis, mainly from infected areas in other parts of the body spreading through the bloodstream, direct extension of urinary tract infections, and lymphatic infections. Prostate stones often accompany chronic inflammatory responses, but micro-stones are not easily detected during X-ray examinations, possibly being an important source of infection. The main pathogenic bacteria are E. coli, accounting for 80% of chronic bacterial prostatitis cases, others include Klebsiella, Proteus, and Pseudomonas. Gram-positive bacteria mainly consist of Enterococcus, while the role of other Gram-positive bacteria in the etiology of chronic bacterial prostatitis remains controversial.
(4) Autoimmune factors. Chronic prostatitis has a certain relationship with autoimmune factors, as anti-prostate antibodies have been found in arthritis patients, and at least one positive antigen-antibody system has been discovered in serum tests.
(5) Allergic reactions to certain viruses can also lead to inflammation. Experts at Apollo Hospital indicate that chronic prostatitis has a certain relationship with autoimmune factors, as anti-prostate antibodies have been found in arthritis patients, and at least one positive antigen-antibody system has been discovered in serum tests.
(6) Psychological and medical factors, with some reports suggesting this factor accounts for up to 50%.
Experts at Shanghai Apollo Hospital state that precisely because of the existence of these internal factors, bacteria as external factors can play a pathogenic role. These bacteria are actually mostly already present in other parts of the body. In summary, regardless of where all these bacteria come from and how they reach the prostate, certain internal factors must be present to induce chronic prostatitis. Experts remind that the causes of prostate diseases are complex and varied. If patients feel discomfort, they should seek medical attention at a regular urology hospital as soon as possible, identify the cause, treat according to symptoms, and follow professional physician guidance for treatment to avoid recurrence and delay in treatment. Meanwhile, maintaining good living habits and an optimistic attitude can help achieve early recovery.
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