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11 myths about prostatitis

The discussions on the causes, mechanisms and treatment of prostatitis are still under way. Dr Nickel (USA), a leading expert in prostatitis, considers prostatitis remains among the last major frontiers in urology, which is to be crossed in the 21st century. The latest research gave more information on the disease. However, there are still numerous myths about prostatitis. Below are the most popular ones:

Prostatitis affects elderly men

False. A chronic prostatitis is detected in 20-40 year old men. Men of 60 and older usually have benign prostatic hyperplasia or prostate adenoma, while prostatitis is a concomitant disease.

Prostatitis is due to sedentary lifestyle or excessive heat loss

False. Both an acute and chronic prostatitis is caused by infections. An acute prostatitis is caused by bacteria (E.coli, enterococci, etc.). A chronic prostatitis occurs when an infection (chlamydia, trichomonas, genital herpes, some other STDs) penetrates into the prostate tissue. Excessive heat loss, alcohol abuse and cold-related diseases may lead to the recurrence of the disease or development of latent genitourinary infections in men and women.

Prostatitis is caused by sexual abstinence

False. Prostatitis is not caused by sexual abstinence. Male body accommodates itself to such situation and adjusts the sexual function. On the contrary, an active sexual life or uncontrolled sexual behavior often cause prostatitis, because men may easily get STDs and, consequently, prostatitis.

Frequent urination and above pubis are symptoms of prostatitis

By no means always. Almost half of all patients with a chronic prostatitis do not complain of frequent urination or pain above pubis. A patient may have a red and burning balanus, itching urethra, erectile dysfunction (soft penis, coitus lasts less than one minute). Some men have no symptoms at all, but their partners have recurrent candidiasis or cystitis. A chronic symptomless prostatitis may also lead to infertility. The disease affects overall health. A patient may feel fatigue and weakness. Chlamydia and trichomonas may cause inflammation in joints, straight intestine and conjunctiva.

If tests detect no STDs, prostatitis is not caused by an infection

In most cases it is false. If a patient has already undergone any treatment for prostatitis, no signs of infection can be found in urethral swabs. In case of a chronic disease, pathogenic microorganisms move from the urethra to other organs (to the prostate). Thus, their amount in the urethra is very low. It means they may not be detected with the help of IFA or PCR techniques. To detect an infection, prostate secretion should be examined using bacterial culture techniques. However, very few laboratories carry out such tests.

Only a man should undergo treatment for prostatitis, because it is a non-contagious disease.

False. Both partners should undergo treatment for prostatitis since it is caused by STDs. Women, who have sex with prostatitis patients, often suffer from recurrent cystitis, inflammatory diseases of the ovaries and cervical erosions.

If a gynecologist prescribes treatment to a woman, her partner should undergo treatment only in case he has any symptoms

False. A chronic prostatitis is often detected in men, whose wives have chronic genitourinary diseases. A proper treatment of both partners is the key to positive outcomes.

If a female partner has a gynecological infection or any inflammatory disease, and a male partner has no symptoms or complaints, a gynecologist could prescribe him a preventive treatment with trichopol, while the woman would have to undergo a prolonged comprehensive treatment

False. A male partner should visit an urologist and undergo a thorough examination. Urologists often detect chronic prostatitis in such cases. To cure the disease, a comprehensive treatment is required. A chronic prostatits may be caused by trichomonas. According to the latest research, trichomonas infection is tolerant to the medications of metronidazole group in 50% of patients. If a doctor prescribes trichopol (1 pill 3 times a day for 5-7 days), the infection will progress and parasites will become even more tolerant to the medications. As a result, it will be much more difficult to diagnose and treat the disease. A patient may transmit the disease to other people. Besides, an improper treatment may worsen chronic prostatitis and cause other complications. The early a man visit a doctor, the more effective the treatment will be.

Prostatitis should be treated with antibiotics

Not always. Antibiotics (including intravenous and intramuscular injections) are used to treat an acute prostatitis. Doctors usually prescribe fluoroquinolones or cephalosporins. They affect bacteria, which cause inflammation in the gland. Antibiotic therapy for a chronic prostatitis usually gives a short-term effect. Antibiotics have an adverse effect in case of viral or protozoan infection of the prostate.

Prostatitis may be successfully treated with pills and injections

Pills and injections give a short-term effect. The disease may recur in one or two months. The site of inflammation influences the development of the diseases. As far as prostatitis is concerned, inflammation is usually located in the tissues and ducts of the prostate. Since antibiotics can hardly reach it, a doctor may prescribe injections into the site of inflammation, drainage of the prostate ducts and instillation into the posterior urethra with the help of catheter. Physiotherapy is also a viable solution, especially pulsed magnetic therapy (NeoControl). In most cases prostatitis is caused by is a mixed bacterial flora. Thus, a doctor may prescribe anti-inflammatory medications. It is also important to support the immunity. To sum up, a doctor shall decide on an individual treatment considering test results and a patient’s overall health.

Prostatitis is an incurable disease

Have being struggling with prostatitis for many years, a patient may conclude that the disease is incurable. However, the latest research proved it is curable. The main components of successful treatment are:

-          individual comprehensive treatment, including causal, local and systemic pathogenetic therapy;

-          human aspect. Treatment is a cooperation between a doctor and a patient. A patient should be aware that treatment for prostatitis is a long and complicated process. A treatment is considered to be effective if it relives pain, eradicates problems with urination and sex, improves the quality of sperm, overall health, working efficiency, and prevents the recurrence of the disease in patients and their partners. Evidence suggests that a chronic prostatitis may be successfully treated.

A. Gavrushev, PhD in Medical Sciences, Assistant Professor of the Department of Urology of Belarusian State Medical University