Your Private GP and Sexual Health Clinic in Canary Wharf
Dr Wayne Cottrell:
The prostate gland helps in the production of semen and sits just under the bladder with the urethra running through it.
Prostatitis symptoms can be very vague ranging from a slight deep perineal discomfort, back of the legs feeling sensitive, lower back pain, penile tip pain and a feeling that something is “not quite right down there”, are often symptoms. It can also be very 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.
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.
Prostatitis is classified as non-bacterial (inflammatory), acute and chronic. It is best to treat as soon as possible to try keeping it from becoming chronic. However, even with the correct and speedy treatment this is still a risk.
In most patients no bacterial infection can be found, but guidelines advise to treat the condition with an antibiotic. We usually have to treat for 4-6 weeks, as the prostate gland is difficult to penetrate with antibiotics. I also suggest taking an anti-inflammatory to 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.
Chronic prostatitis can lead to Chronic Pelvic Pain Syndrome. This can be very painful and distressing. Often times stress and psychological issues will have a role in this and managing these causes trough counselling can help improve symptoms.