It
is said that prostatitis is the most common chronic infection in men. Some people
say sinus infections are the most common, so no one knows for sure, but prostatitis
does affect many millions of American men every year.
There
are several types of prostatitis, but to simplify things, prostatitis is either
associated with bacteria, or with other, frequently unknown, causes. Symptoms
can include pain in the rectum, penis, bladder, testicles and even the thighs.
Sometimes there is pain with urination and changes in the urinary stream.
Sometimes fever and blood in the urine can occur.
The
diagnosis is not always easy to make, especially when it comes to determining
whether bacterial infection is involved. Examination of the prostate, urinalysis,
cultures and other techniques can be used. Occasionally cystoscopic examination
of the bladder and prostate may be necessary. It still can be frustrating for
both patient and physician.
In
patients with prostatitis, antibiotics will nearly always be used even if a
definite bacteria cannot be identified. The reason for this is that even with
negative findings for bacteria, they still may be the cause, but just difficult
to isolate. Prolonged treatment, weeks, and even months of antibiotics are sometimes
needed. There are a number of other medications that are used to try to alleviate
the symptoms and promote healing. These can include alpha blockers and Proscar(see
BPH), anti-inflammatory drugs such as Ibuprofen, Vioxx and Celebrex. Medications
for urgency and frequency can be used such as Detrol and Ditropan. Surgery such
as microwave thermotherapy (see BPH) can be used. In severe cases the InterStim
implant is used (see incontinence). One thing to remember is that these prostatitis
conditions usually eventually cease to be a problem in almost all men, although
this may take a good long time. In addition, there is no apparent association
between prostatitis and prostate cancer…..this issue does worry some men….don’t
worry, there is no increased risk.