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Paging Dr. Frischer - Prostatitis
WRITTEN BY :   Dr. Alan Frischer

Today’s topic will be of particular interest to my male readers. Your prostate gland is walnut-sized and located directly below the bladder. It produces fluid (semen) that nourishes and transports sperm. Prostatitis is the swelling and inflammation of the prostate, and can affect men of all ages. In fact, chronic prostatitis is the #1 reason why men under the age of 50 visit a urologist.
It often isn’t clear how the prostate becomes infected. At one time, prostatitis was believed to be a sexually transmitted disease, but more recent research suggests that only a small number of cases are related to sexual activity. Bacterial infections are the cause in only 5 to 10% of cases, and because the bacteria are common strains, those cases are generally the easiest to treat. This type of infection may start when bacteria are carried in urine that leaks into the prostate. In most cases of prostatitis, however, the cause is never identified.

Possible symptoms of prostatitis vary, depending on the cause. They include:
*blood in the urine
*pain or burning when urinating
*difficulty urinating (dribbling or hesitant urination)
*frequent urination, particularly at night
*urgent need to urinate
*pain in the abdomen, groin, lower back, penis or testicles
*painful orgasms
*flu-like symptoms of general fatigue and achiness

What puts a man at risk for prostatitis? Being young or middle-aged; having a history of prostatitis; a bladder infection; a pelvic trauma such as an injury from bicycling or horseback riding; not drinking enough fluids; using a urinary catheter; having an STD or HIV/AIDS; psychological stress; or having an inherited susceptibility. Note that both prostatitis and prostate cancer can cause higher levels of the PSA lab test. Fortunately, there is no direct evidence that prostatitis leads to prostate cancer.
Chronic prostatitis is not contagious. While an STD can be a cause of prostatitis, you can live your life normally and continue sexual relations (once you have resolved the STD!) without passing it on.
Prostatitis may come on gradually or suddenly. It may get better quickly, either on its own or with treatment. Sometimes it lasts for months or even keeps recurring (chronic prostatitis). There are a number of treatments. As mentioned above, antibiotics will treat those cases that are bacterial. When there is difficulty urinating, alpha blockers can help to relax the bladder neck and the muscle fibers where the prostate joins the bladder. For symptom relief, anti-inflammatory pain relievers (aspirin, ibuprofen) can help. Alternative treatments include biofeedback (to teach a patient how to manage the discomfort), and acupuncture (for pain relief). There have been no good scientific studies supporting the use of herbal remedies and supplements.
If you find yourself relating personally to this article, I urge you to seek the help of your physician. Good health to you all!
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.

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Published: February 28, 2013 – Volume 11 – Issue 46



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