Prostatitis is an inflammation of the prostate caused by bacteria. It can be episodic or prolonged. This type of prostatitis occurs in approximately one in ten cases. Men are much more often worried about another form of prostatitis - chronic abacterial, which is not associated with infection. They must be little known about it, and most urologists do not consider it a real diagnosis. But most problems are related to it, including sexual problems. Chronic prostatitis is also called chronic pelvic pain syndrome (CPPS).
The pain eases and eases
Men with chronic prostatitis are concerned about the following symptoms:
- discomfort or pain in the perineum, lower abdomen, groin, scrotum, penis;
- changes in urination: difficulty urinating, frequent emptying of the bladder in small portions, feeling of incomplete emptying;
- Some men experience difficulty achieving an erection, discomfort during ejaculation, and increased pain after sex. Discomfort can reduce a man's ability to get or stay aroused.
Such problems can occur in men of any age, and according to statistics, they affect 10-15% of the male population of the United States, most often in men between the ages of 30 and 50. Unlike "classic" prostatitis, chronic prostatitis cannot be cured with antibiotics, and its symptoms can bother a man for months or even years. They can come and go and have varying degrees of severity.
David Lonergan was diagnosed with chronic prostatitis and it wasn't until three years later that he found a way to live with it. He took antibiotics for the first year, but they did not help (antibiotics do not help chronic abacterial prostatitis). Here's what David has to say about his feelings in an interview with Vice:
"At a certain point I started experiencing wild sensations throughout the pelvic area. At first I had a slight burning sensation in my rectum when I sat. Then the pain became acute and spread throughout the pelvis. Finally, it felt like hundreds of razor blades were stabbing my urethra. On a scale of 1 to 10, I would rate the pain an 11.
Ejaculation became excruciatingly painful. At first I felt pleasure from orgasm and relief afterwards, but it was followed by hours of pain and when the pain got worse, I stopped having sex. The doctor prescribed me prostate massage (the benefits of prostate massage have not been proven) and also told me to have sex and ejaculate. But since sex didn't bring me pleasure, I decided to try masturbating once a day. It was a big mistake to do this twice a day - the pain was off the charts (no need for sex and masturbating from the pain, it doesn't make you feel better). My wife and I have been seeing a therapist for individual and couples therapy. In many ways, he was the one who helped us overcome all our sex problems. "
Most men diagnosed with chronic prostatitis, or CPPS, see improvement in their symptoms within six months. In one study, a third of men experienced complete resolution of symptoms after one year. In another large study, one-third of men's conditions improved within two years.
Chronic prostatitis has been poorly studied
Chronic prostatitis has not been studied enough. Experts believe there are many possible causes, including autoimmune diseases, genetic predisposition, damage to the nerves or muscles near the prostate, and hormonal imbalances. Another risk factor can be psychological stress. However, the specific cause can be difficult to determine. Treatment usually involves lifestyle changes and medications to relieve symptoms. Prostatitis cannot be prevented.
Daria Chernysheva is a urologist:
- Chronic prostatitis is just a combination of words that can hide pelvic venous congestion syndrome, chronic pelvic pain syndrome, interstitial cystitis, pudendal neuropathy and other conditions. According to the chief urologist of our country, Dmitri Puskar, this is a rubbish diagnosis, which the doctor gives to the patient when he does not want to understand what is happening to him. Inflammatory changes in the prostate can only be confirmed with a four-glass test (an analysis in which multiple doses of urine and prostate secretions are taken). Everything else is a distant diagnosis, there is no cure. To prevent inflammation of the prostate, there is a universal recommendation - regular sex: ejaculation should be at least once every four days, regardless of how it is achieved.
Symptoms of prostatitis can be eased with a few simple things, such as a warm bath or heating pad, and avoiding alcohol, caffeine, and spicy or acidic foods (these can irritate the bladder).
If you have problems urinating, your doctor may prescribe alpha blockers - these help relax the bladder and muscle fibers at the junction of the prostate and bladder. Chronic pain is treated with painkillers. If you have problems with sex, your doctor may refer you to a psychotherapist or sexologist.
Sexual problems are not associated with chronic prostatitis
Urologist Artem Loktevexpresses the following thoughts: Modern Aspects of Evidence-Based Medicine for Thinking Patients" writes that advertising and the media attribute erectile problems to prostatitis, which is why many men make the connection. But this is not true. An erection can be maintained even ifif the prostate is completely removed. According to many well-known urologists, erectile dysfunction in patients with chronic prostatitis is caused by psychological problems. Men's erections often decrease immediately after the following sentence is announced: "You have prostatitis".
Sexologist, psychotherapist, psychiatrist Dmitry OrlovI am also sure that chronic prostatitis does not affect sex life:
"If something happens to the prostate, it can affect urination and perineal sensations, but it has nothing to do with sex. Unfortunately, many men and some urologists agree that prostate problems can affect sex because the prostate is located near the genitals. The prostate gland has a specific function: it produces fluid - one of the components of sperm. He is not involved in anything else. "
According to Dmitry Orlov, doctors in world practice almost never diagnose "chronic prostatitis". This is more of a regional diagnosis that has no pathophysiological basis, only a theoretical concept, based on which a person is prescribed treatment. A man hears the diagnosis and begins to worry, that it can affect his sexual function. During intimacy, he does not enjoy the process, but observes how good his erection is. Focusing on the erection can reduce its quality and lead the man to see a connection between the diagnosis and the problems that have arisen. But the reasonpurely emotional.
If you feel pain and discomfort during sex, you need to understand the reason. It is better to consult a urologist who insists on an evidence-based approach to medicine.
Dmitry Orlov adds: "If a doctor advises you to have sex more often or not to have sex at all, there must be a medical reason for this. I know of no disease in which increasing sex leads to a cure. Most often, such a recommendation is due to the fact that the specialist does not know how to help. There is no need to limit or completely eliminate sex and masturbation, because regular sexual release has a beneficial effect on the health of the prostate and the psyche.
The path from the urologist's office to the sexologist's office is the usual path for men over 35-40 years of age. If a man has erectile difficulties or other sexual problems, he first consults a urologist, as he considers this to be his specialty. If the urologist finds nothing or diagnoses "chronic prostatitis", then the only thing left is the sexologist's office. The sexologist can help the patient with a wide range of techniques: he can recommend the elements of sex therapy, if necessary, he can also perform psychotherapy or prescribe medication. Statistically, this is aefficient working model - the problem is solved within a month on average. "