Prostatitis is inflammation of the prostate gland caused by bacteria. It can be episodic or prolonged. This type of prostatitis occurs in about one in ten cases. More often, men worry about another form of prostatitis - chronic abacteremia, which is not associated with infection. Little is known about it for sure, and most urologists do not consider it a true diagnosis. But with it most problems are associated, including problems with sex. Chronic prostatitis is also called chronic pelvic pain syndrome (CPPS).
The pain is decreasing
With chronic prostatitis, men are concerned about the following symptoms:
- discomfort or pain in the perineum, lower abdomen, groin, scrotum, penis;
- changes in urination: difficulty urinating, frequent emptying of the bladder in small portions, feeling of incomplete emptying;
- Some men experience difficulty getting an erection, discomfort during ejaculation, and increased pain after sex. The discomfort can reduce a man's ability to become or stay aroused.
Such problems can occur in men of any age and, according to statistics, affect 10 to 15% of the US male population, most often men between the ages of 30 and 50. Chronic prostatitis cannot be cured with antibiotics, unlike "classic" prostatitis, and the symptoms can bother men 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. In the first year he took antibiotics, but they did not help (antibiotics do not help with chronic abacterial prostatitis). Here's what David had to say in an interview with Vice about his feelings:
"At one point I started experiencing wild sensations in the entire pelvic area. At first I had a slight burning sensation in my rectum every time I sat down. Then the pain became acute and spread throughout the pelvis. Finally it felt like hundreds of razors stabbing inin my urethra. On a scale of 1 to 10, I would rate the pain an 11.
Ejaculation becomes very painful. At first, I felt the pleasure of orgasm and relief afterwards, but it was followed by hours of pain, and as the pain intensified, I stopped having sex. The doctor gave me a prostate massage (the benefits of prostate massage have not been proven), and also told me to have sex and ejaculate. But since sex didn't bring any pleasure, I decided to try masturbating once a day. It is a big mistake to do this twice a day - the pain is off the charts (no need to have sex and masturbate through pain, this will not improve your well-being). My wife and I go to a therapist for individual and couples therapy. In many ways, he is the one who helped us overcome all our problems in sex. "
Most men diagnosed with chronic prostatitis, or CPPS, experience an improvement in symptoms within six months. In one study, one-third of men experienced complete resolution of symptoms after a year. In another large study, one-third of men's conditions improved within two years.
Chronic prostatitis has not been studied much
Chronic prostatitis has not been sufficiently studied. Experts believe there are several potential causes, including autoimmune diseases, genetic predisposition, damage to nerves or muscles near the prostate gland and hormonal imbalances. Another risk factor may be psychological stress. However, the specific cause may be difficult to determine. Treatment usually involves lifestyle changes and medications to relieve symptoms. Prostatitis cannot be prevented.
Urologist Daria Chernysheva:
- Chronic prostatitis is just a combination of words that can hide pelvic venous congestion syndrome, chronic pelvic pain syndrome, interstitial cystitis, pudendal neuropathy and other conditions. According to the chief urologist of our country, Dmitry Pushkar, this is a garbage diagnosis that a doctor gives to a patient when he does not want to understand what is happening to him. Inflammatory changes in the prostate can only be confirmed by a four-glass test (an analysis in which several portions of urine and prostate secretions are taken). Everything else is a made-up diagnosis with no cure. To avoid inflammation in the prostate gland, there is a universal recommendation - regular sex: ejaculation should be at least once every four days, no matter how it is achieved.
Prostatitis symptoms can be relieved with a few simple things, such as a warm bath or heating pad, and avoiding alcohol, caffeine, and 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 junction of the prostate and bladder. Chronic pain is treated with painkillers. If you have problems with sex, your doctor may refer you to a psychotherapist or sex specialist.
Sexual problems are not associated with chronic prostatitis
Urologist Artem Loktevexpresses the following thoughts: Modern aspects of evidence-based medicine for thinking patients" writes that advertising and the media associate erectile problems with prostatitis, which is why many men associate it. But that is not true. An erection can be maintained even after the prostate is completely removed. According to many well-known urologists, erectile dysfunction in chronic prostatitis patients is caused by psychological problems. Often men's erections decrease immediately after the sentence is uttered: "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 this has nothing to do with sex. Unfortunately, many men and some urologists believe that prostate problems can affect sexual life because the prostate is located close to the genitals. The prostate gland has a specific function: it produces fluid - a component of sperm. He is not involved in anything else. "
According to Dmitry Orlov, doctors almost never make a diagnosis of "chronic prostatitis" in world practice. It is more of a regional diagnosis, which has no pathophysiological basis, but only a theoretical concept on the basis of which a person is given treatment. A man hears the diagnosis and begins to worry that this may affect his sexual function. During intimacy, he does not enjoy the process, but monitors how good his erection is. Focusing on the erection can reduce its quality and lead a man to see the connection between the diagnosis and the problem that arises. But the reason is purely emotional.
If there is pain and discomfort during sex, you need to understand the reason. It is best to consult with a urologist who adheres to an evidence-based approach to medicine.
Dmitry Orlov added: "If the doctor advises to have sex more often or not to have sex at all, then there must be a medical reason for this. I do not know a single disease that increasing the amount of sex will lead to recovery. Often, such recommendations are due tothe fact that experts do not know how to help. Nor is it necessary to limit or completely eliminate sex and masturbation, because frequent sexual release is beneficial for the health of the prostate gland and psyche.
The path from the urology office to the sexology office is the standard path for men over 35–40 years of age. If a man has difficulty with an erection or other problems in sex, he first goes to a urologist, because he considers this his area of expertise. If the urologist finds nothing or diagnoses "chronic prostatitis, " then the only thing left is the sexology office. The sexologist has various techniques that can help the patient: he can recommend elements of sex therapy, can engage in psychotherapy or prescribe medication if necessary. Statistically, this is an effective working model - on average, the problem is solved within a month. "