When it's not linked to bacteria, prostate inflammation can be a mysterious and baffling complaint, frustrating patients and practitioners alike. It's up to you to work with your doctor to find a therapy--or combination of therapies--that work well for you.
The condition known as prostatitis or inflammation of the prostate--the walnut-sized gland located below your bladder--is a common medical name for several related conditions that affect one-quarter of men in some form by the time they reach the age of eighty. What these ailments have in common is pain and discomfort in the pelvic area, lower back and groin; a burning sensation while urinating; and a frequent urge to urinate.
A diagnosis of prostatitis can be difficult and you may need to see more than one doctor to get one. while this condition is not always completley curable, most prostatitis is certainly treatable. Most forms are not contagious and you can continue to have an active sex life without fear of passing the disease on to your partner. Most important, prostatitis does not mean a greater risk for developing BPH or prostate cancer. So while the ailment is not life threatening, it can certainly be uncomfortable until its symptoms are under control.
Prostatitis can usually be divided into four conditions, which are collectively known as prostatitis syndromes. Actue bacterial prostatitis represents only 5 percent of all cases and it is the easiest to threat. Symptoms come on quickly: severe pain between scrotum and anus (perineum) aggravated during a bowel movement; and painful urination with frequency, burning and sometimes blood. Acute bacterial prostatitis responds well to antibiotics and symptoms resolve almost as quickly as they arrived.
Chronic bacterial prostatitis means that after an episode of acute bacterial prostatitis, antibiotics have failed to kill all the bacteria. Treatment generally means another course of antibiotics and a fairly prolonged course of follow-up therapy. You'll need to be checked several times by your doctor to verify that the infection is finally gone.
Chronic nonbacterial prostatitis (or noninfectionus prostatitis) is the most common form and it's the most difficult to treat. Theories abound as to why this condition occurs, and none has been confirmed. Symptoms include pain in the perineum, difficult urination and a chronic pelvic discomfort. This form of prostatittis can disappear for weeks or months at a time. To treat it, doctors try a variety of therapies--antibiotics, prostate massage, dietary recommendations--but no single therapy is uniformly effective.
Prostatodynia has the same symptoms as prostatitis but without any evidence of inflammation or infection. It is also difficult to treat.
LIKELY FIRST STEPS
Seeing several doctors, about chronic prostatitis is not unusual. No one therapy, however, offers either a cure or a guarantee of long-lasting relief. Many men find that a combination of therapies is their bestbet. On the otherhand, antibiotics are extremely effective against the bacterial forms of prostatitis.
Treatment Options
MEDICATIONS
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Oral antibiotics May be prescribed for weeks.
------------------------------------------------------------------------------------------------------------------------------------------
Aspirin/NSAIDs To relieve painful symptoms.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Apply heat or cold If it feels good, keep doing it.
----------------------------------------------------------------------------------------------------------------------------------------------
Dietary changes May ease pain; drinking more water is key.
Bacterial prostatitis requires at least four weeks of antibiotic therapy, usually with a broad-spectrum antibiotic, such as amoxycillin, doxycyline, trimethoprim or norflaxacin. This is longer than the typical course for other ailments as it is difficult for bacteria-killing levels of the drug to accumualte within the prostate. Take the full course: stop too soon and often the infection will come back.
While men with nonbacterial prostatitis don't have signs of infection, some find relief with antibiotic treatment. If urinating is difficult, the medications used for benign prostate hyperplasia (BPH) may help. These include terazosin (Hytrin) and prazosin (Minipress) as well as finasteride (Proscar). When you need occasional pain relief, aspirin or other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen can be effective.
What is happening
The condition known as prostatitis or inflammation of the prostate--the walnut-sized gland located below your bladder--is a common medical name for several related conditions that affect one-quarter of men in some form by the time they reach the age of eighty. What these ailments have in common is pain and discomfort in the pelvic area, lower back and groin; a burning sensation while urinating; and a frequent urge to urinate.
A diagnosis of prostatitis can be difficult and you may need to see more than one doctor to get one. while this condition is not always completley curable, most prostatitis is certainly treatable. Most forms are not contagious and you can continue to have an active sex life without fear of passing the disease on to your partner. Most important, prostatitis does not mean a greater risk for developing BPH or prostate cancer. So while the ailment is not life threatening, it can certainly be uncomfortable until its symptoms are under control.
Prostatitis can usually be divided into four conditions, which are collectively known as prostatitis syndromes. Actue bacterial prostatitis represents only 5 percent of all cases and it is the easiest to threat. Symptoms come on quickly: severe pain between scrotum and anus (perineum) aggravated during a bowel movement; and painful urination with frequency, burning and sometimes blood. Acute bacterial prostatitis responds well to antibiotics and symptoms resolve almost as quickly as they arrived.
Chronic bacterial prostatitis means that after an episode of acute bacterial prostatitis, antibiotics have failed to kill all the bacteria. Treatment generally means another course of antibiotics and a fairly prolonged course of follow-up therapy. You'll need to be checked several times by your doctor to verify that the infection is finally gone.
Chronic nonbacterial prostatitis (or noninfectionus prostatitis) is the most common form and it's the most difficult to treat. Theories abound as to why this condition occurs, and none has been confirmed. Symptoms include pain in the perineum, difficult urination and a chronic pelvic discomfort. This form of prostatittis can disappear for weeks or months at a time. To treat it, doctors try a variety of therapies--antibiotics, prostate massage, dietary recommendations--but no single therapy is uniformly effective.
Prostatodynia has the same symptoms as prostatitis but without any evidence of inflammation or infection. It is also difficult to treat.
- Find out if bacteria is playing a role in the ailment.
- Oral antibiotics for acute and chronic bacterial cases; possibly even for chronic nonbacterial cases.
- Self-help measures for symptom relief. Keep trying until you find what works.
QUESTIONS TO ASK
- What success have you had treating prostatitis?
- If I have to use oral antibiotics for months, what can I do about their side effects?
- What do I do if the antibiotic stops working?
- Can my prostatitis be transmitted by sexual contact?
- Some researchers believe that prostatitis is an autoimmune disorder like rheumatoid arthritis, in which the immune system launches an inappropriate and excessive attack on the body and in doing so, destroys normal body tissues. The good news is that national research trials are now under way, aimed at defining the disease, finding its causes and determining effective treatments.
Treatment
Seeing several doctors, about chronic prostatitis is not unusual. No one therapy, however, offers either a cure or a guarantee of long-lasting relief. Many men find that a combination of therapies is their bestbet. On the otherhand, antibiotics are extremely effective against the bacterial forms of prostatitis.
Treatment Options
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Oral antibiotics May be prescribed for weeks.
------------------------------------------------------------------------------------------------------------------------------------------
Aspirin/NSAIDs To relieve painful symptoms.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
Apply heat or cold If it feels good, keep doing it.
----------------------------------------------------------------------------------------------------------------------------------------------
Dietary changes May ease pain; drinking more water is key.
TAKING CONTROL
- Work with a urologist. These specialsits have more experience with chronic prostatitis than most family doctors.
- Try all self-help measures. Your goal is to find symptom relief to improve your quality of life. There is no one therapy that works best for everyone. If a particular treatment fails to help your symptoms, try something else immediately.
- Ask your doctor for a prostate massage. This is an old treatment that is still used by some patients. The doctor will insert a lubricated gloved finger into your rectum and vigorously massage or rub the prostate in an attempt to empty any clogged ducts within the gland that may be contributing to your pain. Some men benefit and feel better for weeks.
Lifestyle changes
Try some different remedies until you fnd one that brings relief:
MedicationsTry some different remedies until you fnd one that brings relief:
- Take a warm bath once or twice daily to relieve the pelvic pain.
- Try cold. Sitting on an ice pack may be comforting.
- Give a 'donut' a try. This infatable device is sold at most phramacies and may help ease discomfort.
- Change your diet. Avoid alcohol, caffeine and spicy, greasy foods.
- Regular ejaculation may help, apparently by empyting the prostate of accumulated prostate fluid.
- Drink plenty of fluids. This helps to prevent constipation, increase urine flow and reduce any discomfort upon defecation.
- Consider quercetin. A study in the journal Urology reported that 82 percent of men who took the antioxidant quercetin (in onions, apples, tea, red wine and supplements) had an improvement in their chronic prostatitis; they took 500 mg twice daily for a month.
Bacterial prostatitis requires at least four weeks of antibiotic therapy, usually with a broad-spectrum antibiotic, such as amoxycillin, doxycyline, trimethoprim or norflaxacin. This is longer than the typical course for other ailments as it is difficult for bacteria-killing levels of the drug to accumualte within the prostate. Take the full course: stop too soon and often the infection will come back.
While men with nonbacterial prostatitis don't have signs of infection, some find relief with antibiotic treatment. If urinating is difficult, the medications used for benign prostate hyperplasia (BPH) may help. These include terazosin (Hytrin) and prazosin (Minipress) as well as finasteride (Proscar). When you need occasional pain relief, aspirin or other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen can be effective.
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