INTRODUCTION:
Chronic prostatitis (inflammation or infection of the prostate) is common to virtually all adult men. Not surprisingly,
Prostatitis is associated with virtually all cases of prostate cancer and present in every prostate biopsy, regardless of
other findings. According to Drs. Krieger and Berger, Urologists at the University of Washington, in Seattle, "All men
either have prostatitis or will get prostatitis in their lifetime." Interestingly, prostatitis has been termed the
"trucker's disease", based on the fact that truck drivers sit on their backsides, better stated, prostates, all day, while
driving a truck. While I can't change the historical reference, truckers manifest the signs and symptoms of prostatitis by
virtue of sitting all day long, driving mile after mile. The sitting position does not create the disease, but rather
allows the disease to be readily identified clinically. Just for the record, all men are equally likely to contract
prostatitis regardless of job description.
Chronic prostatitis may not cause significant symptoms in many men, but in others it can be a devastating disease that
severely affects the quality of life of those afflicted. For many Professionals, prostatitis is difficult to diagnose and
even more difficult to treat. A wide variety of therapies are available but few actually work in more than a small
percentage of cases. While none of the standard treatments available is able to improve the health and wellness of the
prostate long-term, a proven approach, with a patented formula, may be your best first step. We'll review the current
knowledge about Chronic prostatitis, your treatment options, and the science linking an inflammatory disease to prostate
cancer.
THE PROSTATE:
All men are born with a prostate that grows and enlarges throughout life based on various forms of stimuli. The prostate
gland (in health) is a spongy, walnut sized, mucus-producing organ that lies just below the urinary bladder and superior
to the rectal wall. The prostate surrounds the urethra, a channel through the prostate, which carries urine from the
bladder to the outside. The most significant growth of the prostate, associated with an increase in the number of cells,
begins in the early to mid 40s and is believed to be related to Dihydrotestosterone production. Inflammation or growth of
the prostate commonly causes difficulties in urination that should be addressed at the earliest sign. The only known
function of the prostate is to produce a secretion that nourishes and protects the sperm during reproduction. It has no
other known purpose.
THE DEFINITION:
Prostatitis is defined as inflammation or infection of the prostate. Simplistically, prostatitis can be divided into two
groups; bacterial and non-bacterial. Bacterial may be divided into acute and chronic while non-bacterial prostatitis is
generally recognized as chronic. The National Institute of Health developed and accepted the latest definition of
prostatitis primarily guided by the presence of chronic pelvic pain associated with the more traditional acute and chronic
clinical presentation. While I refer you to the formal paradigm presented by the NIH for a complete understanding, the
most common presentation is Type IIIA or non-bacterial, inflammatory prostatitis (reference Figure 1). While prostatitis
may be acute, (associated with systemic findings of fever, chills and rigors (shakes), most cases of prostatitis are
chronic and tend to be incurable, with relatively frequent recurrences despite optimal traditional treatment.
Unfortunately, traditional therapy involves the use of antibiotics, which are effective in less than 5% of cases, as a
remedy for non-bacterial prostatitis, although, antibiotics may improve symptoms temporarily secondary to an
anti-inflammatory mechanism.
NIH Classification and Definitions of Prostatitis
| I. |
Acute bacterial prostatitis: acute infection of the prostate |
| II |
Chronic bacterial prostatitis; recurrent infection |
| III |
Chronic abacterial prostatitis; chronic pelvic pain syndrome –
no demonstrable infection |
| IIIA |
Inflammatory CPPS: WBCs in semen/EPS/voided bladder urine (VB3) |
| IIIB |
Non-inflammatory CPPS: no WBCs in semen/EPS/VB3s |
| IV |
Asymptomatic inflammatory prostatitis: no subjective symptoms;
detected either by prostate biopsy or presence of WBCs in prostatic secretions during evaluation for other disorders |
THE CLINICAL PRESENTATION:
Symptoms of prostatitis (also common to EP or enlarged prostate) are the number one reason that men seek the advice of
their primary care physician or Urologist. The most significant symptom of chronic prostatitis is pelvic pain, followed by
various voiding symptoms, impotence and/or infertility. Referred pain from prostatitis is commonly located in the groin,
testicles, lower back, penis, circumferentially around the rectum, the perineum and/or in the suprapubic area above the
bladder. Additionally, pain is not uncommonly associated with ejaculation. Typical urinary symptoms produced by
prostatitis include getting up at night to void (Nocturia), frequency of urination, urgency of urination, incomplete
voiding, decreased force of the urinary stream, intermittency of the stream and a need to push or strain to void.
Impotency or erectile difficulties and/or male infertility are also commonly associated with prostatitis. (Please refer to
Figure 2 for a list of clinical presentation models and Figure 3 for all the signs and symptoms of prostatitis.
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