What is Prostatitis?
Prostatitis is any inflammation of the prostate gland. Prostatitis generally takes two forms: bacterial and nonbacterial. It is found in men of any age, with a typical peak onset in the early 30s.
In 5% of the cases, a bacterial infection is responsible for the symptoms, while in an overwhelming majority of 95% of the cases, no bacterial infection is present.
This is a poorly-understood disorder, and the term ‘prostatitis’ is often used incorrectly. If bacteria are not causing the symptoms, the correct diagnosis is actually non-bacterial prostatitis or chronic pelvic pain syndrome (CPPS), which is the case for most men.
HOW IT STARTS
Prostatitis Symptoms
The symptoms of bacterial and nonbacterial prostatitis (CPPS) are quite similar. Even if some symptoms vary, men often experience pain in and around the penis, testicles, perineum, anus, lower abdomen, or lower back. This pain is often accompanied by urinary frequency, burning or painful urination, and/or pain after ejaculation. Some patients report low libido and increased pain when sitting.
In addition to physical complaints, prostatitis often results in psychological problems and anxiety that are triggered by hopelessness and a feeling of desperation when therapies don’t have the desired effect or no medical cause for the discomfort can be found.
INVESTIGATION
Course & Diagnosis of Prostatitis
Bacterial prostatitis is relatively easy to diagnose with a urine or blood test that reveals the presence of bacteria.
With non-bacterial prostatitis, when doctors conclude that bacteria are not the cause, they can assess whether previous medical conditions or the patient’s medical history has impacted the symptoms. Nevertheless, no definitive diagnostic tests are available for nonbacterial prostatitis (CPPS).
The duration of prostatitis can vary from person to person. While bacterial prostatitis lasts until it’s medically treated, the symptoms of nonbacterial prostatitis can wax and wane.
Men affected by nonbacterial prostatitis often go through a long period of suffering. In 60% of cases, the symptoms disappear at some point by themselves for unknown reasons. However, for 40% of sufferers, a nonbacterial prostatitis diagnosis can last for several years.
COMPLEXITY
Causes & Difficulties of Prostatitis
The difficulty with prostatitis lies in the general terminology. In medicine, the term ‘prostatitis’ is unfortunately used very generally to describe a bacterial infection of the prostate, even though bacteria account for only 5% of prostatitis diagnoses.
In the case of acute prostatitis, where no infection can be found, a loop of muscle tension in the pelvic area and heightened neurological irritation is one of the most common causes. The cause of this chronic muscle tension is difficult to pinpoint, but it may be related to posture, muscle damage, or previous infections.
The main difficulty is that the treatment has to be administered in an interdisciplinary manner by different specialists at the same time, and single physicians often lack the time or capabilities for such a holistic approach.
START HEALING
Prostatitis Treatment
Bacterial prostatitis can be treated relatively easily. Usually, a physician prescribes a course of appropriate antibiotics based on the bacteria causing the infection.
As mentioned, however, the majority of men suffer from non-bacterial prostatitis/CPPS. In recent years, the prognosis has improved greatly, with promising chances of healing using a multimodal treatment.
Today, science supports a combination of physical therapy for pelvic floor such as stretches and techniques to release overtensed muscles in the pelvic, bladder, or anal area (trigger points); psychological therapy such as paradoxical and progressive relaxation techniques to reduce causative stress; and neuropathic irritation, which can help to cure or reduce causes and symptoms.