Prostatitis can be frustrating condition for both patient and physician
Urologists are far too familiar with prostatitis — one of the more common conditions that bring men to their offices. Both physicians and patients are frustrated by the fact that very few cases of prostatitis can be clearly explained or effectively treated.

“It’s difficult to help patients understand prostatitis when physicians don’t understand it either,” says Dr. Richard Berger, professor of urology at the School of Medicine. “There is a lot of misunderstanding about the condition.”

Prostatitis is characterized by a range of symptoms that include pain in the pelvic area and problems related to the urinary tract — such as painful urination, difficulty urinating and urgency.

Prostatitis can be broken down into two major classifications: bacterial and non-bacterial.

“Approximately 5 percent of prostatitis is caused by an infection that can be diagnosed and treated,” Berger points out. “However, the remaining 95 percent is idiopathic — the exact cause is unknown.”

As the name implies, bacterial prostatitis is linked to a bacterial infection and associated with inflammation of the prostate. Cases may be acute or chronic. Acute cases, which are rare, include symptoms of fever and chills. These can be treated easily and effectively with antibiotics. In chronic cases, bacterial infections are more long-term, with symptoms easing with antibiotic treatment only to return later.

Non-bacterial prostatitis occurs when a patient suffers from symptoms of prostatitis — most predominantly pain — but does not have a bacterial infection.

This condition is now being referred to as chronic pelvic pain syndrome (CPPS).

Treating CPPS is best done through careful, selective management of a patient’s problems.

Possible treatments for CPPS, which may be used alone or combined, include antibiotics, muscle relaxants, analgesics, relaxation exercises, lifestyle changes or massage. Berger cautions patients against the use of surgery for the condition, since surgical treatments have not been proven effective.

“Chronic pelvic pain syndrome can have a great impact on a patient’s quality of life,” Berger says. “Different treatments may work better for different patients, so it’s important for physicians to spend time identifying what works best for each individual.”

Despite the lack of understanding, there are some things physicians do know about prostatitis: it’s not sexually transmitted and it doesn’t lead to cancer or other more serious medical conditions.

In an attempt to help solve some of the mysteries behind prostatitis, Berger and colleagues are involved in several studies to help determine possible causes and effective treatments. Berger explains that the condition could possibly be a nerve disorder, an autoimmune disease or linked to other problems besides the prostate itself.

“We’re hoping to target the cause of this condition and find places we can intervene,” he says.

Men with symptoms of prostatitis should see their physician to rule out an infection or other health problem such as prostate or bladder cancer. ¶

Julie Rathbun