Prostatitis

Prostatitis is a benign condition. It is NOT prostate cancer. It is caused by inflammation of the prostate, which can feel sore and irritated. Prostatitis can occasionally be caused by an infection but in most case (>90%) no infection can be identified. Also prostatitis can occur acutely all of a sudden, but in most instances it is a chronic condition but the symptoms often fluctuate.

What are the symptoms of Prostatitis?

Prostatitis can cause a wide range of symptoms, which vary from man to man. Some common symptoms include:

• Discomfort, pain or aching in your testicles, or the area between your testicles and back passage (perineum), or the tip of your penis.
• Discomfort, pain or aching in the lower part of your stomach area (lower abdomen), your groin or your back.
• Pain or stinging during or after urinating.
• Painful ejaculation.
• Needing to urinate frequently or urgently.
• Feeling as if you’re sitting on a golf ball.
• Fever/chills - is often an indication of infection.
• Lack of energy.

How is Prostatitis diagnosed?

Prostatitis is diagnosed clinically after your doctor has taken a history and preformed a physical examination often including a digital rectal examination (DRE).

Additional investigations your doctor can order include

• A urine test to check for sign of infection.
• A blood test.
• PSA test.
• Cystoscopy - telescopic inspection of the urethra, prostate and bladder.

Often prostatitis is diagnosed after excluding other causes for your symptoms.

How is Prostatitis treated?

Treatment is specific to each case and some types of prostatitis can be harder to treat, especially if symptoms have present for a long time (chronic prostatitis).

Chronic prostatitis is not well understood which can make it difficult for doctors to know how to treat it- this can be frustrating for patients suffering from this condition. The treatments vary from man to man, and you’ll probably have a number of different treatments – it’s about finding what works best to control your symptoms.

Each man will respond to the treatments differently. If one thing doesn’t work, you should be able to try something else, and there are things you can try to help yourself.

If your symptoms are not improving with the treatment offered by your GP, you can ask them to refer you to a urologist who specialises in managing prostatitis.

Medicines

You’re likely to be given the following medicines:

• A course of antibiotics, which you’ll need to take for at least four to six weeks.
• Non-steroidal anti-inflammatory drugs (NSAIDs).
• Pain-relieving drugs, if you need them.

You might also be offered medicines to help you urinate if you are having difficulties:

• Alpha blockers (such as parzosin or tamsulosin).
• 5-alpha-reductase inhibitors (such as dutasteride or finasteride).

Other treatments

If you have prostatitis that goes on for a long time, you might be offered the following treatments. Although there is no strong scientific evidence for them, some men have found them helpful.

• Prostate massage. The doctor massages your prostate through the wall of the back passage. They will use gloves and gel to make it more comfortable.
• Surgery. Very occasionally, surgery is an option for men with CPPS. It usually involves removing the prostate gland or part of it. It isn’t often done because there is a risk it can make symptoms worse and cause a number of side effects.

You might also be offered the following to help with the effects of prostatitis.

• Anti-depressants. If your prostatitis affects your mood and you become very low, depressed or anxious, your doctor might suggest you try taking anti-depressants.
• Treatments for sexual problems. There is support available for sexual problems so do speak to your doctor or nurse about these. For example, your doctor can prescribe medications such as Viagra® or Cialis®.

Lifestyle changes

There are a number of things you can try which other men have found helpful.

• Watch what you drink. Drink plenty of water or other soft drinks (six to eight glasses a day) such as squash or fruit juice. Avoid alcohol, fizzy drinks and drinks containing caffeine, such as tea and coffee - they can irritate the bladder and make urinary symptoms worse.
• Watch what you eat. You might find certain foods bring on a flare-up - watch out for these so you can avoid them.
• Sit comfortably. If you need to sit for long periods during a flare-up, for example if you work in an office, take in a soft or inflatable cushion to make you more comfortable.
• Get active. Exercise can help some men feel better and reduce symptoms, including pain.
• Avoid cycling. Activities that put pressure on the area between your back passage and testicles (perineum), such as cycling, can make symptoms worse.
• Keep a diary. It can help you spot something that brings on a flare-up, and can be a useful way of showing your doctor what you’re experiencing. Record things like food, drink, exercise, how stressed you feel and your symptoms.
• Do pelvic floor muscle exercises. These muscles help control when you urinate. There are exercises you can do to strengthen them which can help with urinary symptoms. Speak to our Specialist Nurses for advice.

Complementary therapies and relaxation techniques

Although there isn’t much research behind them, some men find that complementary therapies can help them feel better about themselves and their treatment, and can help manage symptoms. They are used alongside conventional treatments, rather than instead of them.

• Complementary therapies. You could try acupuncture, massage or reflexology (a type of massage), aromatherapy or hypnotherapy, for example. They might help to relieve stress, making you feel more relaxed.
• Find ways to relax. Techniques such as deep breathing, relaxation tapes, meditation, taking a warm bath, yoga, or listening to music, can help you feel more comfortable and take your mind off any pain.
• Supplements or herbal remedies. Some men have found that the plant extracts Quercetin and saw palmetto, and a pollen extract known as cernilton, help with symptoms.

Speak to your doctor or nurse if you’re thinking of using complementary therapies or supplements, as they may be able to advise you.