Mechanism Study Of Urethra Secretions Following Chronic Prostatitis

Background and objectives:Chronic prostatitis is the most common and confusing urological disease. Adult males are prone to have prostatitis. The incidence rate of chronic prostatitis is about 9-16%, and accounted for 25-33% of outpatient urological patients and the recurrence rate is 25% to 50%. About 50% men have had symptoms of chronic prostatitis in different times in their lives. The disease usually manifests local pain, abnormal urination, urethra secretions, sexual dysfunction, and systemic symptoms such as psychiatric symptoms and can lead to male infertility, too. Meanwhile, as one of the most common cause, the male patients under 50 years old see a doctor for it. At present, because of its complex causes, variety of symptoms, a long course of disease, and lack of diagnostic gold standard and effective treatment, whether urology doctors or patients were dissatisfied with their treatment.In recent years, great progress has been made on studies of chronic prostatitis at home and abroad. Due to the complexity of prostatitis symptom, many scholars have done deep research on their mechanism. Someone has made some progress, but can not use a single mechanism to explain the clinical phenomenon of prostatitis. Until now, scholars have various views.Urethra secretions is a common symptom of chronic prostatitis, and most scholars believe that Urethra secretions for the excessive secretion of the prostate in patients with chronic prostatitis or because of prostatic fluid discharge poor, but have not clinical investigation and animal experiments to support their view. Symptoms of some patients with chronic prostatitis improved or disappeared because of drug adherence, but symptoms of urethral secretion did not significantly improve, therefore, the urethral secretion is from the other glands? Urethral glands are in the urethral submucosa with mucus secretion high, and are secreted by the nerves or by the surrounding physical and chemical factors. The existence of a neural mechanism leading to urethral gland dysfunction caused urethral secretion? None of the existing literature related to its further reports. So far, many scholars have found that there are some neural reflexes existing among mutual viscera organs and between viscera organs and some part in the body. Stimulation on a viscera organ or some part of its body could affect another organs'related function. There are some reports of these neural reflexes related to prostatitis, too. Our preliminary study shows that a variety of perineal and pelvic organ dysfunction such as frequent urination and pain are achieved by reflex when the prostate can be stimulated by inflammation. So symptoms of urethral secretion are also due to pelvic organ reflex? The study of the subject will do research from the following three areas: 1, Whether Urethral discharge is from a prostate? 2, Can urethral gland secretion make changes by prostatitis? 3, How does the autonomic nerve receptors of urethral glands distribute? This study will concentrate on the neural mechanism of urethral secretion after chronic Prostatitis and suggest a potential neuromodulational therapy for urethral secretion of chronic Prostatitis.Methods:1, keep the urethral secretions and prostatic fluid from the patients who have urethral secretion Symptom for detecting acid phosphatase activity. Then, determine specific components of urethral secretions and prostatic fluid with t test, so as to confirm whether urethral secretion is from the prostate.2, Use healthy adult male SD rats as experimental animals, injected Freund's complete adjuvant in prostate of animal models manufacturing Prostatitis at the same time, and injected 0.9% saline in prostate of another group rats as control. Then through detecting single-cell mucus area, diameter and optical density of their urathral gland, so as to probing prostatitis on the role of urethral glands produce mucus. Do electrical stimulation to the prostatitis rats and control rats, then collect the secretion of their urethral gland. At last, determine and compare its secretion and protein concentration so as to probing prostatitis on the role of urethral glands produce mucus3, After neural antagonists completely blocking the corresponding receptor,electrical stimulusing the urethral gland, collect the secretion of urethral gland, then determine their fluid secretion and the secreted protein concentration. At the same time, respectively test their single-cell mucus area, diameter, optical density, so as to explore the neural receptors which control urethral gland secretions and their changes under noxious stimulation.Results: 1,The laboratory test result is that in the 31 surveyed cases, only one patient whose acid phosphatase activity of urethral discharge and prostatic is the same. This phenomenon shows urethral secretions are from the prostate, but this only accounts for 3.2% of the total patients investigated. The others'urethral secretions and prostatic fluid acid phosphatase activity are significantly different. 95% confidence interval of acid phosphatase activity of patients who have urethral secretions symptom and 95% confidence interval of acid phosphatase of Prostatitis is no overlap. The result confirms that the urethral secretions is not a prostate fluid overflow.2. Prostatitis rats made by Freund's complete adjuvant injected into the prostate Analog noxious stimulation. Compared with the controlled group, a single cell mucous area, diameter and optical density of urethral gland were very significant different. And do electrical stimulation on the prostatitis rats and control rats to collect the secretion of their urethral gland and determine and compare its secretion and its protein concentration. Results are significantly different. When prostate suffer the noxious stimulation, urethral glands and other organs functional change. These instructions create mechanisms and sources. Urethra secretions provide basis for animal experiments3. In prostatitis rats, nerve receptors had completely blocked by drug when given to electrical stimulation of the neurovascular bundle which after the lateral prostate. Urethral gland secretion measurement results suggest that M receptors block behind, and its secretion is significantly decreased, but the secretion mucus protein concentration increased significantly, which specific mechanisms need to be further studied. Micro-urethral gland is measured residual mucus area, diameter, and optical density and compared. The residual amount of M receptor-stimulated group is the least. The result Confirmed M receptors is urethral gland of prostatitis rat play a dominant roles. In the control rats, using the above method, experimental results confirm that M receptor is still the main nerve receptors. This experiment provides a theoretical basis for drug treatment about the symptoms of urethral secretionConclusion and Outlook:1. Urethral secretions of patients with chronic prostatitis are not primarily derived from the prostatic fluid, but are from another gland.2. Chronic prostatitis caused by increased secretion of the urethral gland is the main reason of urethral secretion3. M receptor is the major nerve receptors which dominate urethral gland secretion, and will change more efficiently because of such noxious stimulation by inflammatory. Against autonomic receptors is the alternative method for reducing urinaral secretion, and should be carried out in further clinical and basic research...