Prostatitis

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Prostatitis

Matthew lay on the floor withering in pain. 

“When will this nightmare end?” he asked himself.

Matthew’s wife looked on helplessly, wishing she could help in some way. As accurately as she can remember, his problem started six months ago.

Initially it was as simple as an intermittent burning sensation at the tip of the penis as he passed urine. The burning pain gradually turned into a debilitating throbbing sensation in both testicles, the perineal area and lower abdomen. It affected their sex life as well – Matthew would cringe in pain not pleasure when he ejaculated. 

They visited a doctor who ran a whole battery of tests and diagnosed him with prostatitis.

He was given antibiotics and told his symptoms would get better. It didn’t. In fact, it got worse.

Six months on and several doctors later, Matthew had given up hope. He was not the same lively person anymore. He was depressed.

Does Matthew’s issue hit close to home? If it does, you could be going down the same road Mathew has. Read on and learn more about prostatitis.


The Prostate

The prostate is a walnut-sized gland under a man’s bladder that makes fluid that protects and provides nutrients to sperm.

Prostatitis is a spectrum of disorders characterized by inflammation or infection of the prostate and the surrounding area. It can affect men of any age. During their lifetime, 25% of men will have a form of prostatitis.  


There are four types of prostatitis:

Chronic pelvic pain syndrome (CPPS)

This is the most common type of prostatitis. This condition primarily causes pelvic pain, but other symptoms such as painful urination and ejaculations, blood in semen and a heavy feeling behind one’s scrotum may also occur. Although the causes for chronic pelvic pain syndrome are not well understood, it is not caused by a bacterial infection. This type of prostatitis may persist intermittently for some time and occurs mostly in younger men. Stress, inflammation, pelvic injuries, and prior infections may be contributing factors when it comes to developing non-bacterial cases of prostatitis.


Acute bacterial prostatitis

This is a bacterial infection of the prostate. Bacteria can also spread to your prostate from your bladder, intestines, or blood stream. Symptoms can develop quickly and this condition can be very serious and may require hospitalization with intravenous antibiotic therapy. Symptoms associated with acute bacterial prostatitis include fever and pain in the thighs, lower back, and pelvic region. They may also experience a burning sensation during urination and a complete inability to urinate. This condition can be caused by a urinary infection, a biopsy, or the use of a catheter.


Chronic bacterial prostatitis

This is an infection caused by bacteria that can last for more than three months. Symptoms vary with time and common presentations include recurrent urinary tract infections, burning sensation during urination and new onset sexual dysfunction without other aetiology. Chronic bacterial prostatitis can develop from a bacterial infection when bacteria remain in the prostatic region. Men having previously suffered from a urinary infection or inflammation of the urethra are more at risk of developing this type of prostatitis.


Non-bacterial prostatitis or asymptomatic prostatitis

This type of prostatitis causes an inflammation of the prostate. Causes are unknown.


Risk factors

Prostatitis can be caused by infection with bacteria, viruses or fungi. Surgical procedures, such as a prostate biopsy or getting a catheter, can expose the prostate or urethra to infection.

Having unprotected sex also can expose the prostate to sexually transmitted infections (STIs) that can cause prostatitis. It is important to note that prostatitis itself isn’t contagious, but STIs are.


Diagnosis

In addition to your medical history and a physical rectal exam to check for abnormalities of the prostate, your healthcare provider may run these tests to get a diagnosis.

  • Urinalysis: a test from a urine sample, to check for bacteria
  • Blood tests: Blood samples check for signs of infection or other prostate problems, such as prostate cancer
  • Urodynamic tests: evaluate the function of the urinary bladder and urethra
  • Cystoscopy: a scope that is inserted into the penis under local anaesthesia; used to examine the urinary tract for narrowing, a blockage, or stones
  • Transrectal ultrasound: a device that is placed in the rectum to portray an ultrasound picture of the prostate, allowing for the assessment of the size and any abnormalities of the prostate, such as tumours
  • Semen culture: test for possible infection of the prostate

Treatment

Antibiotics

Taking antibiotics is the most commonly prescribed treatment for prostatitis. The doctor will choose the medication based on the type of bacteria that might be causing your infection.

If you have severe symptoms, intravenous (IV) antibiotics might be needed. You’ll likely need to take oral antibiotics for four to six weeks but might need longer treatment for chronic or recurring prostatitis.

Alpha blockers

These medications help relax the bladder neck and the muscle fibres where your prostate joins your   bladder. This treatment might ease symptoms, such as painful urination or ejaculation

Anti-inflammatory agents

Nonsteroidal anti-inflammatory drugs (NSAIDs) might give you pain relief.

ESWT (Electroshockwave therapy)

Electroshockwave therapy (ESWT) can sometimes be useful in controlling or treating symptoms due to CPPS or chronic prostatitis.

Neuropathic pain relief medication 

In some cases the pain/ discomfort due to prostatitis may be due to nerves, thus in such cases medications such as gabapentin may be helpful in reducing the pain/ discomfort.

Prostatitis can be very painful. It can lead to feelings of depression and hopelessness. Prostatitis can also lower your sex drive, because the pain can make it hard to enjoy sexual activity. Although it can be an unpleasant condition, there are treatments that can help with the symptoms.

Talk to a doctor and get help today.

Next read: Phimosis & Paraphimosis


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