Symptoms of chronic prostatitis and its impact on sexual function and fertility

[Chronic prostatitis] The symptoms of chronic prostatitis are diverse and vary greatly in severity. Some patients may be asymptomatic, while others may experience general malaise.

The common symptoms can be summarized as follows.

(1) Bladder and urethral irritation symptoms: frequent urination, urgency, painful urination, urethral burning, dribbling urination, and sometimes difficulty urinating.

A feeling of heaviness and discomfort in the posterior urethra, perineum, and anus, which worsens when squatting, defecating, or sitting on a chair for a long time.

(2) White discharge from the urethra: This is often seen at the end of urination or during defecation, when white secretions drip from the urethral opening.

(3) Radiating pain: The pain of chronic prostatitis is not limited to the urethra and perineum, but also radiates to nearby areas, with lower back pain being the most common.

In addition, the penis, spermatic cord, testicles, scrotum, lower abdomen, groin, thighs, rectum, and other areas can be affected.

It should be noted that the lower back pain caused by chronic prostatitis is located in the lower back. Although it can be easily confused with lower back pain caused by orthopedic reasons such as myofascitis and lumbar muscle strain, the latter is mostly located near the belt line, which is higher than the lower back pain caused by prostatitis, so they can be distinguished.

(4) Sexual dysfunction: Chronic prostatitis can cause decreased libido, premature ejaculation, erectile dysfunction, nocturnal emission, painful ejaculation, etc.

(5) Other: Chronic prostatitis can be complicated by neurasthenia, which manifests as dizziness, weakness, dreaminess, insomnia, fatigue and weakness.

Long-term, persistent prostatitis can even cause allergic reactions in the body, leading to conditions such as conjunctivitis and arthritis.

It should be noted that while the above list contains many symptoms, not every patient will present with all of them. Generally, one symptom is predominant, with one or two other symptoms present. Furthermore, the severity of symptoms is often related to the patient's psychological factors. For example, depression, fear, and heavy mental burden can all worsen symptoms, affect the treatment effect, and lead to prolonged illness.

[Chronic prostatitis affects sexual function] Patients with chronic prostatitis often experience symptoms such as urinary urgency, urinary frequency, urethral burning pain, testicular and scrotal pain, and discomfort in the lower abdomen and perineum, which can affect their sexual interest.

During sexual arousal, prostate congestion can cause local pain. The most severe pain often occurs simultaneously with orgasm or immediately after ejaculation. Spasmodic and painful contractions of the prostate can lead to pain in the rectum, testicles, and glans penis, and can also easily trigger premature ejaculation.

Patients with chronic prostatitis generally do not experience erectile dysfunction.

Because chronic prostatitis does not cause lesions in the anatomical structure, nerves, blood vessels, or endocrine system of the reproductive organs, it does not lead to erectile dysfunction.

However, due to the prolonged nature of chronic prostatitis, a lack of knowledge about sexual medicine, and self-doubt about their masculine image, patients are prone to worry and anxiety.

Some people are afraid of the pain of ejaculation, fearing it will harm their partner, or they accept the wrong advice that they must abstain from sex, which reduces the frequency of sexual activity and decreases libido.

Over time, this may lead to secondary erectile dysfunction.

Patients with chronic prostatitis should take a proactive approach to treatment. Although there is no specific cure for the disease, most can be relieved or cured by taking comprehensive measures and persevering.

As for concerns about infecting the woman, this can be resolved by using condoms.

The idea that patients with prostatitis should abstain from sex is incorrect, because long-term congestion in the prostate is not conducive to the resolution of inflammation. Instead, ejaculation should occur once a week to achieve the goal of "running water does not stagnate," which is also beneficial for relieving sexual tension and reducing prostate congestion.

In short, people with chronic prostatitis should relieve themselves of unnecessary worries, learn about relevant sexual medicine, and receive psychological treatment when necessary, which is very beneficial and sometimes even decisive.

[Chronic prostatitis affects fertility] When suffering from chronic prostatitis, there are abnormalities in the secretion of the prostate and problems with the quality of prostatic fluid.

Let's look at it from the following aspects:

(1) Quality of prostatic fluid: When there is prostatitis, the amount of prostatic fluid secreted decreases, which in turn reduces the amount of semen, which is not conducive to the survival and motility of sperm.

The quality of prostatic fluid produced under inflammatory conditions also changes, often containing a large number of bacteria, bacterial toxins, and inflammatory secretions. These harmful substances reduce the amount of nutrients or substances that sperm need or that help sperm motility, especially the amount of trace element zinc. Zinc is essential for sperm survival; without it, sperm cannot function properly.

(2) When suffering from prostatitis, the pH of semen often decreases, making the semen more acidic.

When the pH of semen drops to the minimum required level for sperm (pH 6-6.5), the sperm will become inactive, which is detrimental to the normal reproductive process and thus affects fertility.

(3) Semen viscosity: When suffering from chronic prostatitis, the production of liquefaction factors in prostatic fluid will decrease because bacterial toxins or excessive congestion of the prostate can destroy liquefaction factors and increase coagulation factors, causing semen to become gelatinous after being discharged from the body, thus delaying the liquefaction time of semen.

This results in high semen viscosity and poor sperm motility.

All of the above factors can affect male fertility.

Chronic prostatitis is a significant cause of infertility in some cases.

While it cannot be said that chronic prostatitis will always lead to infertility, patients with unexplained infertility should undergo some examinations to determine if they have chronic prostatitis.

The relationship between chronic prostatitis and fertility is not yet fully understood.

Many men with chronic prostatitis have good fertility and normal sexual function. Therefore, chronic prostatitis is curable, so there is no need to worry too much.

[Home Prostate Massage] Prostate massage is one of the methods for treating chronic prostatitis, especially important for patients with nonbacterial prostatitis who do not ejaculate regularly.

However, due to various reasons of the patients themselves or the hospitals, very few patients are actually able to receive regular and consistent massage therapy.

In fact, prostate massage is not mysterious. The method is simple and easy to master. Family and friends can help with the treatment, or you can treat yourself.

Here is a simple introduction to prostate massage methods, using the example of family members assisting.

First, you should buy some rubber or latex finger cots or gloves, or you can use condoms instead; then prepare some soapy water or edible vegetable oil, or petroleum jelly or glycerin for rubbing your hands.

Before the procedure, the patient empties their bladder and bowels, then kneels on the bed in a chest-knee position, with both elbows and knees on the bed, head down, and buttocks raised.

The practitioner stands to the left of the patient, with a cot on the right index finger and a small amount of soapy water or grease lubricant applied.

During the procedure, gently massage the anus a few times with the pad of your index finger to reduce patient discomfort. Then, slowly insert your index finger into the rectum. About 4 centimeters below, you can feel the prostate, which is about the size of a chestnut. It is quite different from the smooth intestinal wall around it. There is a shallow groove in the middle called the central groove of the prostate, which is easy to identify.

During the massage, use your fingertips to gently rub but firmly press from both sides of the prostate towards the central sulcus, pressing each side from top to bottom about 3 times. Then, squeeze the prostatic urethra at the central sulcus of the prostate from the inside out. At this time, the patient will feel the urge to urinate, and milky white prostatic fluid can be seen dripping from the urethral opening.

For individuals who do not experience fluid leakage, urination immediately after the massage, and the discharge of cloudy urine, is also effective.

Precautions: ① If there is significant tenderness in the prostate, it indicates acute inflammation, and massage is not recommended.

② Avoid using your fingertips during massage to prevent injury.

③ Beginners often use too light a touch; they should apply more pressure, using the force needed to push an open drawer back into the table with their index finger.

However, violence should be avoided.