Chronic Prostatitis

Chronic prostatitis is an inflammation that affects the prostate and persists for at least three months. As mentioned in other posts, the prostate is a male gland under the bladder and surrounding the urethra. This condition can cause ongoing or recurring chronic discomfort and unpleasant symptoms but can be managed effectively with a combination of medical treatments, lifestyle modifications, and complementary therapies.

To simplify, we define two types of chronic prostatitis:

1. Chronic bacterial prostatitis;
2. NNonbacterialprostatitis (or chronic pelvic pain syndrome).

Symptoms

The symptoms of chronic prostatitis can be continuous or periodic and recurrent and can vary from person to person:

• Pain or burning during urination;
• Pain in the pelvic area, lower back, or genitals;
• Difficulty urinating or increased urinary frequency;
• Painful ejaculation;
• The sensation of incompleteness when urinating;
• Erectile dysfunction;
• Bleeding in the urine or semen.

Causes

The exact causes of chronic prostatitis are not always clear, but may include:

• Infections: in some cases, insufficient or incorrect treatment of acute prostatitis may result in chronic prostatitis; this is very common in my daily practice;
• Immune system problems: Changes in the immune system can make the prostate more susceptible to infection or cause inflammation without an apparent infectious cause. This overactive immune response may contribute to chronic prostatitis;
• Stress and psychological factors: Emotional and psychological stress can affect the functioning of the immune system and increase sensitivity to the symptoms of chronic prostatitis. In some cases, the chronic pain associated with prostatitis can lead to emotional stress, creating a vicious cycle;
• Muscle or nerve problems in the pelvic area: Compression of the nerves or muscles in the pelvic region can cause pain and chronic inflammation in the prostate. It can happen, for example, as a result of poor posture, chronic muscle tension, or nerve damage;
• Genetic factors: Some studies suggest that there may be a genetic predisposition to chronic prostatitis. However, research in this field is ongoing, and no specific genetic mutations associated with the condition have been identified.

Diagnosis and Evaluation

The diagnosis of chronic prostatitis usually begins with a physical examination during which the doctor discusses the patient's symptoms and medical history. During the physical exam, your doctor may perform a digital rectal exam to evaluate the size, texture, and tenderness of the prostate.

We perform the following diagnostic tests to confirm the diagnosis or rule out other conditions:

• Urine tests to look for signs of infection or inflammation
• Cultures of urine or semen to detect the presence of bacteria
• Transrectal ultrasound to evaluate the size and structure of the prostate
• Cystoscopy to examine the urethra and bladder
• Because stress and anxiety can contribute to the symptoms of chronic prostatitis, it is also essential to evaluate the patient's psychological state.

Treatment of Chronic Prostatitis

Treatment of chronic prostatitis may include:

• Antibiotics: if bacterial infection is present,
• Anti-inflammatory drugs: to reduce inflammation and pain;
• Alpha-blockers: to relax the prostate muscles and improve urinary flow;
• Hormone therapy: in some cases of nonbacterial prostatitis;
• Prostate massage: can help improve the flow of prostatic fluid and reduce inflammation;
• Pelvic floor exercises: to strengthen the muscles of the pelvic area and improve urinary symptoms;
• Stress reduction: through relaxation techniques such as yoga or meditation;
• Balanced diet: rich in fruit, vegetables, fiber, and water;
• Limitation of alcohol, caffeine, and spicy foods, which can irritate the prostate.

Prevention of Chronic Prostatitis

Maintain a healthy body weight;

• Avoid holding urine for prolonged periods;
• Have safe sex to prevent sexually transmitted infections;
• Regular Screenings: Men with a higher risk of developing chronic prostatitis should have regular checkups with their doctor;
• Stress Management: Learning stress management techniques can help prevent chronic prostatitis or reduce the severity of symptoms.

When to see a doctor

It is important to note that chronic prostatitis is a complex condition, and treatment may vary from person to person. Consulting a doctor is essential for a correct diagnosis and personalized treatment planning. Additionally, suppose you suspect you have acute prostatitis, which may be associated with severe bacterial infections and require immediate treatment. In that case, getting immediate treatment to prevent prostatitis from becoming chronic is crucial. Furthermore, effective management of chronic prostatitis can significantly improve the quality of life and prevent long-term complications.