Prostatitis is an inflammation of the prostate gland caused by bacteria. It can be episodic or long-term. This type of prostatitis occurs in about one in ten cases. More often, men are bothered by another form of prostatitis - chronic bacterial, not related to infection. There is little accurate information about this, and most urologists do not consider it a real diagnosis. However, most of the problems are related to problems including sexual intercourse. Chronic prostatitis is also called chronic pelvic pain syndrome (CPPS).
The pain waxes and wanes
Men with chronic prostatitis are concerned about the following symptoms:
- discomfort or pain in the perineum, lower abdomen, groin, scrotum, penis;
- changes in urine: difficulty urinating, frequent emptying of the bladder in small portions, feeling of incomplete emptying;
- Some men experience difficulty in erection, discomfort during ejaculation, and increased pain after intercourse. Anxiety can reduce a man's ability to stay awake or stay awake.
Such problems can occur in men of any age, and according to statistics, it affects 10-15% of the US male population, with the highest incidence in men between the ages of 30 and 50. Unlike "classic" prostatitis, chronic prostatitis cannot be treated with antibiotics, and its symptoms can bother a man for months or years. They may come and go and vary in severity.
David Lonergan was diagnosed with chronic prostatitis and only three years later he found a way to live with it. He took antibiotics for the first year, but it did not help (antibiotics do not help in chronic abacterial prostatitis). Here's what David had to say about his feelings in an interview with Vice:
"Suddenly I began to experience wild sensations in my pelvic area. At first, every time I sat down, I had a slight burning sensation in my rectum. Then the pain became sharp and spread throughout my pelvis. Finally, it felt like hundreds of razors were being inserted into my urethra. From 1 to 10I would rate the pain an 11 on the scale.
Ejaculation became excruciatingly painful. At first I enjoyed my orgasm and after that I felt relief, but then I had pain for hours and after the pain got worse I stopped having sex. The doctor prescribed prostate massage (prostate massage has not been proven to be beneficial) and told me to have sex and ejaculate. But I decided to masturbate once a day because I didn't enjoy sex. Doing it twice a day was a big mistake - the pain was off the charts (no need to have sex and masturbate through pain, it won't improve your well-being). My husband and I went to a therapist for individual and couples therapy. In many ways, he was the one who helped us overcome all our problems with sex.
Most men diagnosed with chronic prostatitis, or CPPS, see improvement in symptoms within six months. In one study, one-third of men experienced complete resolution of symptoms after one year. In another large study, a third of the men's condition improved within two years.
Chronic prostatitis is poorly studied
Chronic prostatitis has not been sufficiently studied. Experts believe there are several potential causes, including autoimmune diseases, genetic predisposition, nerve or muscle damage near the prostate gland, and hormonal imbalance. Another risk factor may be psychological stress. However, it can be difficult to determine the specific cause. Treatment usually involves lifestyle changes and medication to relieve symptoms. Prostatitis cannot be prevented.
Urologist Daria Chernysheva:
- Chronic prostatitis is just a combination of words that can mask pelvic venous occlusion syndrome, chronic pelvic pain syndrome, interstitial cystitis, pudendal neuropathy, and other conditions. According to Dmitry Pushkar, the chief urologist of our country, this is a garbage diagnosis given by the doctor when he does not want to understand what is happening to the patient. Inflammatory changes in the prostate can be confirmed only by the four-glass test (an analysis in which several parts of urine and prostate secretions are taken). Everything else is a distant diagnosis with no cure. There is a universal recommendation to prevent inflammation in the prostate gland - regular sexual intercourse: no matter how the ejaculation is achieved, it should be at least once every four days.
Prostatitis symptoms can be relieved by doing some simple things, such as taking a warm bath or heating pads, avoiding alcohol, caffeine, spicy or acidic foods (these can irritate the bladder).
If you have trouble urinating, your doctor may prescribe alpha-blockers—they help relax the bladder neck and muscle fibers at the prostate-bladder junction. 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 Loktev"Contemporary aspects of evidence-based medicine for thinking patients" writes that advertising and the media associate erectile problems with prostatitis, so many men associate them. But this is not true. Even if the prostate is completely removed, erections can continue. ManyAccording to reputable urologists, erectile dysfunction in patients with chronic prostatitis is caused by psychological problems. Many times, a man's erection decreases immediately after the sentence "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 gland, it can affect urination and sensation in the perineal area, but it has nothing to do with sex. Unfortunately, many men and some urologists believe that because the prostate is located close to the genitals, prostate problems can affect sex life. they join the concept. The prostate gland has a special function: it produces fluid - a sperm component. It has no other work to do. "
According to Dmitry Orlov, in world practice, doctors almost never diagnose "chronic prostatitis". It is rather a territorial diagnosis, which is a theoretical concept without any pathophysiological basis, where only one person is prescribed treatment. A man hears the diagnosis and begins to worry that it may affect his sexual function. During intimacy, he doesn't enjoy the process, he watches how good his erection is. Focusing on the erection can reduce its quality and cause the man to see a connection between the diagnosis and the problems that arise. But the reason is purely emotional.
If you have pain and discomfort during sex, you need to understand the reason. It is best to consult a urologist who adheres to an evidence-based approach to medicine.
Dmitry Orlov adds: "If a doctor advises to have sex more often or not to have sex at all, there must be a medical reason for this. I don't know of a disease where increasing sex leads to recovery. Often such a recommendation is because the specialist does not know how to help. There is also no need to limit or completely eliminate sex and masturbation, as regular intercourse is beneficial for both prostate health and the psyche.
The path from the urologist's office to the sexologist's office is a standard path for men over 35-40 years old. If a man has difficulty in erection or other problems in sexual intercourse, he first consults a urologist, because he considers it his specialty. If the urologist finds nothing or diagnoses "chronic prostatitis", then the only thing is the sexologist's office. A sexologist has a wide range of methods that can help the patient: he can recommend elements of sex therapy, engage in psychotherapy or, if necessary, prescribe medication. According to statistics, this is an effective business model - on average, the problem is solved within a month. "