淋菌性尿道炎后前列腺炎/慢性盆腔疼痛综合征病因的初步探讨

Pathogenesis of prostatitis/chronic pelvic pain syndrome after gonococcus urethritis

目的了解当前淋菌性尿道炎的治疗情况,以及其治疗后前列腺炎/慢性下腹部疼痛的可能病因。方法调查治疗后有慢性下腹部疼痛症状的淋菌性尿道炎患者的用药等情况,并对其尿道分泌物进行细菌培养和前列腺液常规检测及细菌培养。结果70例淋菌性尿道炎患者中,用阿齐霉素治疗21人,四环素类药物治疗13人,头孢曲松治疗12人,三代头孢菌素治疗10人,大观霉素治疗7人,喹诺酮类药治疗7人。70例患者的尿道棉拭子细菌培养显示,有细菌生长6例;前列腺液常规检测白细胞超过5个的33例,前列腺液培养有细菌生长的22例,分别为淋病奈瑟氏菌、乳酸杆菌、大肠埃希菌、金黄色葡萄球菌、表皮葡萄球菌、变形杆菌、甲型链球菌、棒状杆菌以及解脲脲原体、滴虫。结论不规范治疗可能是造成淋菌性尿道炎后前列腺炎/慢性盆腔疼痛综合征的重要因素。

Objective To understand the current situation in the treatment of gonococcal urethritis and the possible pathogenesis of prostatitis and chronic pelvic pain after the treatment. Methods The medication in 70 cases of gonococcal urethritis with symptoms after the treatment was investigated, and germiculture for urethral secretion and routine testing plus germiculture for prostate fluid were conducted. Results Among 70 cases of gonococcal urethritis, 21 were treated with azithromycin, 13 with tetracycline, 12 with ceftriaxone, 10 with third-generation cephalosporins, 7 with spectinomycin and 7 with quinolone drugs. The bacterial cultures for urethral secretion resulted in 6 cases of bacterial growth; 33 cases showed more than 5 white blood cells in the routine testing of prostate fluid; 22 cases had bacterial growth in prostatic germiculture and they were Neisseria gonorrhoeae, lactic acid bacteria, large intestinal bacillus, Staphylococcus aureus, Staphylococcus epidermidis, trichomoniasis, Proteus, alpha Streptococcus, Corynebacterium and Ureaplasma urealyticum, respectively . Conclusion Non-standard treatment of gonococcal urethritis may serve as one of the most important cause of prostatitis and chronic pelvic pain syndrome after the treatment of gonococcal urethritis.