Wednesday September 27, 2017
The prostate gland already has a bad reputation (did you know approximately 40% of men over 70 have Benign Prostatic Hyperplasia!), and unfortunately today's blog post will only further worsen it. While prostate cancer and BPH usually affect the older male population, one condition that can affect men of any age is prostatisis.
At London Doctors Clinic, all issues on the spectrum of prostate disorders will be dealt with by a private GP, no matter how big or small the problem. Got a concern? Don't just bury your head in the sand - one quick, efficient and discrete appointment at LDC could provide the reassurance you need. No queues, no registration, simply book an appointment, pop in and problem solved...
Prostatitis is a painful inflammation of the prostate gland, which is a gland located between the penis and the bladder in men.
Many prostate diseases that are well known (such as an enlarged prostate or prostate cancer) occur mostly in older men, but prostatitis can occur in men of any age.
Types of Prostatitis
There are several types of prostatitis. These are:
Chronic Non-Bacterial Prostatitis:
It is estimated that 3/20 men will have this form of prostatitis at some point in life. In this condition symptoms seem to last a long time, but there doesn’t appear to be an infection. This can be a challenging condition to treat, as it is not responsive to antibiotics (as many infections would be).
This is a rare condition (affecting 1/10000 men), that is sudden and severe. It is caused by a bacterial infection, and it must be treated quickly with antibiotics to avoid damage to the prostate and the surrounding areas.
Chronic Bacterial Prostatitis
About 1-2% of men will develop a long lasting bacterial infection of the prostate. In these cases, the bacteria can spread out of the prostate and into surrounding structures, such as the kidneys, bladder and urethra (tube that urine passes through). Men with this condition tend to develop regular urinary tract infections.
Causes of Prostatitis:
It is not known exactly what causes many cases of prostatitis, although we do know that bacterial infections are responsible for some cases. Often, infections cannot be found in the prostate, despite investigation. Some postulated causes include:
- Problems with the immune (defence) system
- Problems with the nervous system
- An infection with an unknown virus or bacteria
Sudden severe cases of prostatitis (the acute prostatitis that we have described above) are usually caused by bacteria residing in the urinary tract entering the prostate.
Theories as to the causes of chronic bacterial prostatitis include spread of bacteria from the bowel or urinary tract to the prostate, creating a small but highly concentrated area of bacteria covered by a sticky protective surface on the prostate.
Symptoms of Prostatitis
Chronic types of prostatitis usually present with the following symptoms:
- Pelvic pain
- Pain when urinating
- Pain when ejaculating
The acute (sudden and severe) type of prostatitis presents with the same symptoms, but they are more severe. Watch out for:
- Severe pain in the pelvis, buttocks, lower back, and genitals
- Fever (high temperature)
- Urgency (frequent need to urinate) and pain on urination
- A change in how you urinate
- Such as a slow starting stream, or a “stop-start” quality
- Pain when ejaculating
Your GP is a great place to start if you think you might have prostatitis. Your doctor will want to ask you lots of questions about your symptoms, and your background health history. Other tests may be performed, but which ones you will undergo will depend on the type of prostatitis you are suspected to have.
A urine test can be done to determine if you have bacterial or non-bacterial chronic prostatitis.
You may have a rectal examination (exam of the back passage), which will help rule out other causes of prostate problems, such as bowel or prostate cancer.
Undergoing blood tests and providing a stool sample which can be tested for hidden blood coming from the bowel are other ways to determine the cause of your symptoms.
An instrument called a cystoscope is a flexible tube passed through the urethra (the tube that urine leaves the body thorough) into the bladder, and can check the health of your bladder. This will be done by a specialist, who is experienced in doing these types of tests.
Treatment of Prostatitis
The treatment you receive will depend on the type of prostatitis you are diagnosed with, and we discuss these three types in more detail below.
Chronic Bacterial Prostatitis
This is treated with a four week course of antibiotics. Another tablet called an alpha blocker (which relaxes the muscles of the bladder, making urination easier).
When you finish your course of antibiotics, another urine test will confirm if all the bacteria in the urine are gone. If some bacteria are still present, another course of antibiotics may be prescribed.
You can treat the pain associated with prostatitis with pain relief (such as paracetamol) purchased from your local pharmacy
Chronic Non-Bacterial Prostatitis
This type of prostatitis is also treated with antibiotics, alpha blockers, along with pain relief provided by medications such as paracetamol.
Some other medications might be of use in treating this condition. These are:
- Finasteride: this is a medication used to treat an enlarged prostate, and it belongs to a class of drugs which inhibit the enzyme that converts testosterone to another form called DHT
- Fluoxetine: this drug is often used in the treatment of mood disorders, and it belongs to a class of medications known as Selective Serotonin Reuptake Inhibitors
- Mepartricin: this drug is usually used to treat fungal infections
Acute prostatitis will be treated as an emergency with antibiotics. Most people will find that their symptoms pass within two weeks, but you will use the whole course of tablets. Pain relief will be prescribed in line with how much pain the condition is causing you.
If you're experiencing any of the above prostate-related symptoms, don't hesitate in booking a private GP appointment at London Doctors Clinic. We have nine central London clinics, with fully qualified GPs. If you would feel more comfortable seeing a male doctor, simply let us know this preference when booking by phone, and we'll be happy to accommodate.
By Melissa Dillon