One of the most common problems I see in my practice is prostatitis. This is inflammation of the prostate gland that results in pain and swelling. As a result patients suffer with pain, urinary problems, sexual dysfunction and it can lead to feeling tired and depressed.
The prostate gland sits just under the bladder and the urethra runs through it. The gland produces semen.
Due to the position of the gland, prostatitis symptoms can be very vague ranging from a slight deep perineal discomfort, sensitive back of the legs, lower back pain, penile tip pain, feeling that something is “not quite right down there”, are often symptoms. However it can also be quite uncomfortable and effect urinating and ejaculation.
Prostatitis is very difficult to diagnose and is really a diagnosis by exclusion. It is important to check for STI’s such as chlamydia, gonorrhoea, mycoplasma, ureaplasma and trichomonas and to exclude these infections. A urine culture should be sent to exclude a urine infection and sometimes a PSA (prostate) blood test is done to see if levels are elevated. It is also sometimes necessary to perform a digital rectal examination to feel the size and shape of the prostate and to see if it is tender.
A diagnosis of prostatitis will be broken down into non-bacterial, acute and chronic. If this is a first episode it is best to treat as soon as possible to try keeping it from becoming chronic. However, even with the correct treatment this can still happen.
In most patients no bacterial infection can be found, but guidelines are to treat the condition with an antibiotic. Usually we have to treat for 4-6 weeks, as the prostate gland is hard to penetrate with antibiotics. I also suggest taking an anti-inflammatory top try reduce the swelling and thereby the symptoms. Keeping well hydrated and ejaculating frequently will also help.
Many patients with chronic prostatitis will get to know what triggers an attack. Usually this will be things like excessive alcohol intake, sitting down for prolonged periods, irregular sexual activity, dehydration and so forth, so it is important to try and avoid the triggers.
Acute bacterial prostatitis has more severe symptoms of pain frequent urination and fever.
As there could be more sinister causes for the above symptoms it is best to see your doctor as soon as possible to try and establish a diagnosis.
Chronic prostatitis can be a cause of Chronic Pelvic Pain Syndrome, which can be extremely distressing. Often times stress and psychological issues will have a role in this and managing these causes trough counselling can help improve symptoms.
I have over 14 years experience providing sexual health screening and I offer a completely confidential, professional, non judgemental service from start to end. If you are not sure if you have been at risk, then I offer a normal consultation to discuss the possible risks and whether screening would be appropriate. We discuss and agree all costs beforehand so you know exactly where you stand and I will always provide you with clear and accurate advice based on current British Association for Sexual Health and HIV (BASHH )guidelines.