精路炎症对精子密度和活率的影响

目的　了解精路炎症患者精子密度和活率的变化及其对生育影响。方法　选取慢性前列腺炎患者 5 0例 ,慢性附睾炎患者10例和正常生育者 10例 ,对其精液常规参数进行比较。结果　前列腺炎组的精子密度与正常组无显著差异 ,而精子活率显著低于正常组 (P <0 .0 5 ) ;附睾炎组精子密度和精子活率与正常组均无显著差异。结论　慢性前列腺炎患者的精子活率较正常生育者明显降低 ,而附睾炎患者无变化 ,提示慢性前列腺炎对生育可能有影响     

76例未成年患者急性附睾炎临床特点分析

目的:总结未成年患者急性附睾炎的发病特点,探讨未成年患者急性附睾炎的规范化治疗方法。方法:回顾性分析我院2008年1月~2016年6月确诊为急性附睾炎的142例患者的临床资料,根据年龄分为未成年组76例(A组,<18岁)和成年组66例(B组,≥18岁)。结果:A、B两组在发病年龄、症状持续时间、住院时间及发病部位差异有统计学意义。B组在血白细胞计数(WBC)、C反应蛋白(CRP)、脓尿发生率及尿培养的阳性率明显高于A组。A组中仅有3例出现脓尿及1例尿培养阳性。结论:未成年急性附睾炎主要以特发性附睾炎为主,对于就诊的未成年急性附睾炎常规使用抗生素治疗应慎重,但对于有脓尿无论尿培养是否阳性的患者应使用抗生素治疗。     

慢性前列腺炎在前列腺增生症发病与进展中的作用探讨

目的 探讨慢性前列腺炎在前列腺增生症发病与进展中的可能作用.方法 回顾性分析本院2011年5月至2014年12月期间因前列腺增生就诊患者356例,根据术后病理结果分为前列腺增生并慢性前列腺炎组及单纯性前列腺增生组,统计分析两组临床特征,包括:年龄(Age)、前列腺体积(PV)、PSA、IPSS评分、是否合并急性尿潴留(AUR).结果 前列腺增生并慢性前列腺炎121/356例(34.0％),发生急性尿潴留48/121例(39.7％);单纯前列腺增生235/356例(66.0％),发生尿潴留60/235例(25.5％).两组对比年龄差别无统计学意义(P＞0.05);但前列腺增生合并慢性前列腺炎组较单纯前列腺增生组PV、PSA、IPSS评分、尿潴留发生率均高,差别具有统计学意义(P＜0.05).结论 前列腺增生合并慢性前列腺炎通常具有更大的体积、更高的PSA及IPSS评分、更易发生尿潴留.因此,前列腺慢性炎症在前列腺增生的发病、进展中可能起作用.     

慢性前列腺炎的病因与临床治疗经验

慢性前列腺炎(chronic prostatitis,CP)是中青年男性常见的疾病.统计资料显示,慢性前列腺炎占泌尿科门诊8%～25%;在美国20岁以上男性慢性前列腺炎发病率为2%～16%,欧洲为14.2%.50%的男性一生中某个时刻患过慢性前列腺炎受到慢性前列腺炎影响.1995年美国国立卫生研究院(National Institutes of Health,NIH)制定了一种前列腺炎新的分类法:急性细菌性前列腺炎(Ⅰ型).     

通淋消炎颗粒治疗Ⅲ型前列腺炎的临床观察(附1 012例报告)

Ⅲ型前列腺炎即慢性前列腺炎/慢性盆底疼痛综合征(CP/CPPS),约占整个前列腺炎发病率的90%～95%[1].此类患者发病率高,好发于中青年,发病机制仍未阐明,临床治疗较为困难.中医认为其主要原因多属湿热内蕴,气滞血瘀,败精浊腐阻滞,缠绵难断,再加上肾气亏损,虚实夹杂,不易治愈.     

慢性前列腺炎/慢性骨盆疼痛综合征药物治疗进展

慢性前列腺炎(chronic prostatitis.CP)是泌尿外科门诊中最常见的一种疾病,流行病学调查显示:CP在男性人群发病率高达2.5%～16.0%,慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)是CP中最常见也是疗效最差的类型,其发病机制目前不是很清楚.治疗没有规范和标准.本文就近年来国内外有关CWCPPS药物治疗方面的新进展作一综述,并探讨目前治疗所面临的主要问题及可能原因.     

慢性前列腺炎患者前列腺液中尿酸测定及意义

目的探讨前列腺液(EPS)中尿酸(UA)水平与慢性前列腺炎(CP)的关系以及降低尿酸在前列腺炎治疗中意义。方法按国际慢性前列腺炎诊断标准确诊的126例CP患者为研究组,另将15例未患CP的正常人设为对照组,分别进行国际前列腺炎评分(CPSI-P),EPS中白细胞(WBC)和UA浓度测定,治疗4周后研究组再行CPSI-P、EPS中WBC、UA测定。结果①CP患者的EPS中UA水平与正常对照组差异有显著性意义(p0.05)。②慢性前列腺炎患者治疗前后CPSI-P,EPS中UA对比有显著性差异(p0.05),而EPS中WBC在治疗前后差异无显著性意义(p>0.05)。结论EPS中UA水平可能与CP发病有关,EPS中UA测定可能是CP诊断及其疗效监测的有用指标之一。     

慢性前列腺炎患者前列腺液IFN-γ和IL-10的表达变化及意义

目的探索前列腺局部细胞因子IFN-γ及IL-10的变化,探讨二者在慢性前列腺炎发病中的作用。方法对男科门诊的前列腺炎患者应用“两杯法”尿液细菌培养、前列腺按摩液(EPS)常规检查将52名CP患者进行分型,并行美国国立卫生院前列腺炎症状指数评分(NIH-CPSI)。应用舣抗体夹心ELISA法检测患者及16例正常对照者EPS中IFN-γ及IL-10的水平。进行差异及相关关系的统计分析。结果Ⅱ及Ⅲ_a型CP患者组EPS中IFN-γ和IL-10水平分别高于正常对照组,差别有统计学意义(组间差别P＜0．05)；Ⅲ_b型CP患者组IFN-γ和IL-10含量与正常对照组差别无明显统计学意义(组间差别P＞0．05)；CP患者EPS中IL-10水平与NIH-CPSI疼痛不适症状评分呈正相关(r=0．503,P＜0．01)。CP患者EPS中WBC计数与IL-10、IFN-γ水平和临床症状无相关性。结论IFN-γ和IL-10在Ⅱ及Ⅲ_a型CP患者EPS中水平升高,二者可能在慢性前列腺炎病程中起重要作用。     

精索封闭治疗急性附睾炎

本院男科从1994年5月至1999年8月共使用药物进行精索封闭治疗急性附睾炎38例,效果良好,现报告如下。1　临床资料11　一般资料　38例急性附睾炎病人,年龄20～86岁(平均32岁)。其中单侧35例,双侧3例。7例病人为手术后并发症(前列腺增生术后3例,精索静脉曲张术后2例,膀胱癌及鞘膜翻转术后各1例),2例为成人病毒性睾丸附睾炎,9例发病前有尿道炎症状(5例确诊为淋病)。除手术并发症7例外,3例病人有过血精,17例病人患有慢性前列腺炎。8例病人行彩色Ｂ超检查提示为附睾增大急性炎症征象,全都伴有少量鞘膜积液。病人发病前大多有饮酒、疲劳等导致抵抗…     

慢性前列腺炎常见致病因素的回顾性分析(附4062例报道)

目的探讨慢性前列腺炎(CP)可能的常见致病因素。方法回顾性分析2005年7月至2012年7月间云南省第一人民医院(昆明理工大学附属医院)泌尿外科和中山大学附属第一医院泌尿外科门诊就诊的CP患者的临床资料。患者经结合临床表现、国际前列腺炎症状评分指数表(NIH-CPSI)、前列腺液常规、尿液常规、B超等检查诊断为CP。门诊问询并记录患者可能的CP致病因素。结果共4062例经诊断为Ⅱ、Ⅲ型CP的患者纳入研究,年龄17~64岁,平均(31.56±9.06)岁,而CP患者常见的致病因素中,饮酒及食用辛辣等刺激性食物者2889例(71.12%),无规律性生活者2170例(53.42%),长期久坐者2351例(57.87%),从事易发病职业者1557例(38.33%),有不洁性交、冶游史者163例(4.01%),还有81例(1.99%)患者主诉性交后症状明显加重。此外,同时具备至少2项上述因素者2664例(65.58%)。结论目前,饮酒及食用辛辣等刺激性食物、无规律性生活、长期久坐及从事易发病职业仍是国人患CP的常见致病因素。所以对具体患者须行个体化的方案治疗。     

Acute bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: andrological implications

There is a consensus on the diagnostic management of bacterial prostatitis (acute and chronic). In chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) the diagnostic approach remains unclear, because inflammatory and noninflammatory CP/CPPS might be one entity with varying findings over time. The WHO definition of male accessory gland infection does not differentiate between prostatitis, epididymitis, and other inflammatory alterations of the urethral compartment. The definition therefore cannot be further accepted as a rational tool for the diagnosis of prostatitis and related diseases in urological andrology. Therapy in infectious prostatitis is standardised and antibiotics are the primary agents. Andrological implications are well defined, side-effects are minimal. CP/CPPS therapy has the goal to reduce pelvic pain. However, treatment regimens are not as standardised. Andrological side-effects are well defined and mainly due to the functional background of these agents.     

Detection of Chlamydia trachomatis in urethra of patients with urogenital infection

Between January, 1984 and August 1986, we examined 151 male patients with urogenital infections including 114 cases of urethritis, 18 cases of epididymitis, 19 cases of prostatitis at the outpatient clinic of the department of urology, Toho University's Ohmori Hospital. The positive rate for Chlamydia trachomatis from the urethra based on cell cultures was 29.0%, (30.5% for urethritis, 27.8% for epididymitis, and 21.1% for prostatitis). The positive rate for non-gonorrheal urethritis was 33.0% and chlamydia infections were complicated by gonorrheal urethritis in 23.3% of the cases. The mean age of the patients with positive Chlamydia trachomatis was 31.9 years. The route of infection in 77.8% of the cases was sexual intercourse the most common cause of which was infection from a prostitute in 62.1% of the cases. The latent period was in most cases from 2-3 weeks.     

Clinical study of levofloxacin (DR-3355) on uro-genital infections--with special reference to usefulness for chronic prostatitis]

The clinical usefulness of levofloxacin, an optical active isomer of ofloxacin, was investigated on uro-genital infections. Patients who were treated with the drug included 2 with complicated urinary tract infections (UTI), 29 with chronic prostatitis and 3 with chronic non-chlamydial epididymitis. Levofloxacin was given to each patient at a dose of 300 mg or 400 mg a day for 7-14 days (average 12.0 +/- 0.5 days). In 2 cases of chronic UTI, infected by P. aeruginosa in one case and P. stutzeri in another case, the isolates were eradicated, and the clinical efficacy was moderate or excellent. For evaluating the effectiveness on chronic prostatitis, the patients were divided into 2 groups; group I (G-I) was chronic bacterial (number of isolates including GNR or E. faecalis, greater than or equal to 10(4) ml) and group II (G-II) was chronic non-bacterial prostatitis (number of isolates including GPC less than or equal to 10(3)/ml). A complete bacteriological response was obtained in all 7 cases, classified in G-I, but in 20 of the 27 isolates, (74.1%) in G-II. In 3 cases of chronic non-chlamydial epididymitis, the response was moderate. In safety profile, there were slight elevations in the laboratory values of glutamic oxaloacetic transaminase (GOT), and glutamic pyruvic transaminase (GPT) in one case, and that of GOT in another case. As for side effects, a 69-year-old male complained of dizziness, and anorexia after 10 days on the drug, but recovered 2 days after discontinuance of the drug.     

Blastomycosis of the epididymis and prostate

We report a case of blastomycosis presenting as epididymitis and prostatitis. The diagnosis was suggested by pathologic findings in the prostate and epididymis and was further supported by serology. The diagnosis was confirmed by culture and special staining. Long-term cure was accomplished after a 12-month course of oral ketoconazole (400 mg/day). Therapy was monitored by culture and serology. Blastomycosis is an unusual but significant pathogen which occasionally presents with genitourinary tract involvement. Effective diagnostic and oral treatment regimens are now available but are dependent on a high degree of suspicion in cases of chronic prostatitis or epididymitis.     

Effect of cefoperazone on acute prostatitis and epididymitis

Cefoperazone (CPZ) was intravenously administered to rabbits and the concentration of CPZ in the accessory male genitals was determined. The epididymis, prostate and testicles had a high enough concentration of CPZ to kill various kinds of bacteria. Therefore, CPZ was applied to 11 clinical cases of acute epididymitis and 4 cases of acute prostatitis, but clinical effects were not so satisfactory in the cases of acute epididymitis.     

慢性前列腺炎与勃起功能障碍的相关性研究

目的研究慢性前列腺炎(chronic prostatitis,CP)患者与勃起功能障碍(erectile dysfunction,ED)之间的相关性。方法以2012年1月至2015年12月就诊于上海市第一人民医院的CP患者1232名为研究组,并以980名体检自愿者为对照组。记录两组患者的国际前列腺症状评分(International Prostate Symptom Score,IPSS)、国际勃起功能问卷(International Index of Erectile Function,IIEF-5)评分。结果所有研究组平均年龄35.5岁(20~52岁),IPSS评分为(7.9±5.2)分,轻度、中度和重度比例分别为53.0%(653/1232)、40.4%(498/1232)和6.6%(81/1232)。IIEF评分为(14.4±9.6)分,CP患者中ED总患病率占47.2%(581/1232),对照组中ED总患病率占3.3%(33/980),P0.01。轻度、中度和重度下尿路症状(lower urinary tract symptoms,LUTS)患者的ED患病率分别为42.9%(280/653)、48.0%(239/498)和76.5%(62/81)。IIEF总分与IPSS总分具有相关性(P0.05),即LUTS症状程度与ED患病程度具有相关性(P0.05)。结论 CP是ED发病的独立危险因素,并且CP患者的ED患病率和LUTS症状呈正相关。     

慢性前列腺炎对血清PSA水平的影响

目的 :研究慢性前列腺炎 (chronicprostatitis ,CP)中前列腺特异性抗原 (PSA)水平。　方法 :选择诊断为ⅢA型前列腺炎患者 4 5例 ,30例健康男性为正常对照 ,分别检测血清PSA水平 ,并进行分析。　结果 :在 4 5例ⅢA型前列腺炎患者中 ,血清PSA水平为 2 .4 1± 0 .6 4 μg/L ,而正常对照组为0 .93± 0 .5 2 μg/L ,2组PSA水平差异具有显著性(P <0 .0 5 )。其中 ,ⅢA型前列腺炎患者中血清PSA超过 4 .0 μg/L的共有 6例 (1 3.3%) ,而正常对照组中仅有 1例(3.3%)。ⅢA型前列腺炎患者中 ,随着前列腺按摩液内白细胞数增加 ,PSA水平有一定程度的增高 ,但没有显著性差异。　结论 :ⅢA型前列腺炎可以使血清PSA水平有一定程度的增高 ,在诊断过程中应予以考虑。     

Epididymitis as cause of antibody-coated bacteria in urine.

The antibody-coated bacteria (ACB) immunofluorescence test has emerged as the preferred noninvasive technique to distinguish reliably between pyelonephritis and cystitis. Investigators have recently correlated a positive test with chronic bacterial prostatitis and cystitis complicating a bladder tumor or stone. We present data that appear to prove that acute bacterial epididymitis associated with bacteriuria can also evoke a positive ACB determination.