文档介绍：前列腺炎分类
I. Acute bacterial prostatitis
II. Chronic bacterial prostatitis
III. Chronic prostatitis/chronic pelvic pain
syndrome
A. Inflammatory
B. Noninflammatory
IV. Asymptomatic inflammatory prostatitis
acute bacterial prostatitis
Acute symptoms of a urinary tract infection, characteristically including
urinary frequency and dysuria. Some patients have
symptoms suggestive of systemic infection, such as malaise, fever,
and myalgias
chronic bacterial prostatitis
Recurrent episodes of bacterial urinary tract infection caused by the anism
lower urinary tract cultures can be used to
document an infected prostate gland
Acute and chronic bacterial prostatitis
represent the best understood, but mon, prostatitis syndromes.
CP/CPPS
1、发病率高:前列腺炎样症状(2%,%)
50%的男性有过前列腺炎
2、症状复杂:前列腺痛症状
排尿症状
性功能障碍症状(包括***
减退、勃起功能障碍和早泄)
3、处理棘手(病人不满意)
Prostatitis in chinese men,Chao-Zhao Liang,Hong-jun Li, et J Adrology 2009,153-156
CP/CPPS的诊断
1、慢性前列腺炎症状指数(chronic prostatitis symptom index,CPSI),可以用来研究前列腺炎的三个重要症状——疼痛(部位、严重性和频度)、排尿异常(排尿刺激症状和阻塞症状)和对生活质量的影响
2、总分43分,大于12分有诊断意义。
CP/CPPS临床判断
WBC不能作为依据
WBC 与症状不平行
严重程度不平行
不能作为疗效评价的依据
CPSI改善超过4分表示有效
IV型前列腺炎
无症状前列腺炎(偶然发现)
多数无须治疗
影响到生育时—需要治疗
CP/CPPS与性功能障碍(SD)
CP/CPPS患者SD发病率高
***痛为56%,
***减退为66%
勃起障碍17-48%
早泄14-50%
CP/CPPS与SD的关系
方法:用NIH-CPSI和IIEF-5评价296例CP/CPPS
结果:% ( 214) 有SD
其中ED占 % (54例) ,***%
(71例) , ED+***% ( 89例)
伴有SD者,其症状更重,生活质量更差
结论:SD可作为评价CP/CPPS的一个重要指标
Adverse Impact of Sexual Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome Shaun Wen Huey Lee, Men Long Liong, Kah Hay Yuen, Wing Seng Leong, Phaik Yeong Cheah, Nurzalina Abdul Karim Khan, and John N. Krieger UROLOGY 71: 79–84, 2008.
CP/CPPS与SD的关系
目的:评价CP/CPPS的性功能(自我评价量表)
方法:72 CP/CPPS和98例正常对照
结果:CP患者***望、性唤起和性交频度明显下降
勃起功能下降,高潮次数减少性交时生殖道疼
痛的比率显著升高
结论:疼痛、抑郁和紧张的程度增加与性活动的频度、性唤起
和勃起功能以及获得高潮的能力成反比
The association between sexual function, pain, and psychological adaptation of men diagnosed with chronic pelvic pain syndrome