Prostatitis and Prostate Pain

 Gordon Muir

 Erectile Dysfunction

Home 
Practice details 
Research News 
Publications 
Information 
Links 
Referrals 

 

 

 

 

email us

What causes the Discomfort?

What investigations are Required?

Treatment

. A common problem for men is the occurrence of pain in the region of the prostate and base of the bladder, sometimes caused by infection in the prostate.

Many men suffer a lot of anxiety due to these symptoms, since a definitive diagnosis is often difficult and treatment can seem to be less than perfect in many instances. A further worry may be that, in the absence of a firm diagnosis, more serious problems such as prostate cancer may have been overlooked.

What causes the Discomfort?

Pain from the prostate may take many forms, wither as spasmodic pain deep in the pelvis or else discomfort in the lower abdomen or testicles. The reason for the somewhat unusual distribution of the pain is due to the nerves which pass around the prostate giving "false signals" to the brain as to where the discomfort is coming from.

While in the acute stages of prostatitis or prostatic infection the diagnosis is easy to make and is nearly always associated with a high fever and germs in the urine, most men with persistent pain in the prostate will have neither of these. It is very common for prostatic discomfort to persist for months or more after a proven infection; the physical reason for this is not well understood.

What investigations are Required?

The problem determine firstly if there is any residual infection deep in the ducts of the prostate (antibiotics do not penetrate the prostate as easily as some other parts of the body) or whether the symptoms are due to pain not associated with infection.

Of course it is vital to make sure there is no sign of cancer within the prostate, which may be done either by an examination, a blood test or a biopsy of the gland. If no infection is found on repeat examination of the urine or semen the condition is referred to as "abacterial prostatitis" or "prostatodynia."

It may be necessary to examine the semen or to look at special urine samples in some cases if the diagnosis is in doubt. Rarely, an ultrasound examination may be needed to exclude a cyst or abscess.

Treatment

In most cases it is worthwhile considering a longish course of antibiotics even if no active infection is found, since some organisms which cause prostatic infection do not grow easily in the laboratory but can persist deep within the prostate despite short courses of antibiotics.

Vitamin E has been found to be of benefit by some specialists including myself, and may reduce the inflammation and tissue damage within the prostate. I usually recommend "Bio Anitioxidant" tablets, made by the company Pharma Nord, one tablet twice a day.

It is essential to avoid both constipation and infrequent emptying of the bladder, since both these situations may favour spasm in the pelvic muscles around the prostate.

In many men the pain is made worse by stress or worry, and certainly men with prostatic pain have higher tendency to anxiety than average. It is not clear whether stress actually brings the problem on or simply increases the manís focus onto the pain. In any event, avoidance or reduction of stress is helpful although not always possible in todayís society! However, relaxation therapy, massage and aromatherapy have all been reported as giving good results from this point of view. paramount here is the reassurance that the condition is not a malignancy and does not predispose to cancer development.

If symptoms persist despite the above methods, alpha blocking drugs, which relax the prostatic muscle, may be helpful under the supervision of a urologist.

Alternative therapies may be of benefit and are in most cases most unlikely to do harm. However it may be relevant to be aware that any practitioner offering an "instant cure" for this condition may be more interested in personal gain than the long term benefit of the patient! Overall it is important to realise that the problem will almost always disappear over time, so the place of surgical or other interventional therapy is limited and should be approached with extreme caution. 

[Gordon Muir][Erectile Dysfunction][Practice details][Research News][Publications][Information][Links][Referrals]

Copyright (c) 1999-2001 GH Muir. All rights reserved.
mail@london-urology.co.uk