Hello, verretro-ga!
I have to applaud you for your diligence in seeking medical treatment
even though your symptoms are seemingly very mild and infrequent. I
wish more of us, male and female alike, would be as in-tune with our
bodies and opt for a doctor's visit when things didn't seem "quite
right"!
It does "appear" that the preliminary diagnosis provided by the
urologist is the probable cause of your discomfort. Prostatitis, or
inflammation of the Prostate Gland, is a relatively common condition
among men your age. However, I am not a doctor and in no position to
offer a diagnosis (or even an informed medical opinion) about your
condition.
Since prostatitis can mimic or exist concurrently with other
urological disorders, your intention to seek the opinion of a second
urologist who can re-evaluate the original diagnosis and start you on
an appropriate course of treatment is a wise one.
I have provided some information which should help you understand the
different types of prostate inflammation and conditions that can mimic
prostatitis so that you can be well-informed when you visit the
doctor.
===================
THE PROSTATE GLAND
===================
"The prostate is a gland of the male reproductive system that is
located in front of the rectum and just below the bladder. The
prostate is small and weighs about 15 to 25 grams. It is about the
same size and shape as a walnut. The prostate is wrapped around a tube
called the urethra, which carries urine from the bladder out through
the tip of the penis."
"The prostate is made up largely of muscular and glandular tissues.
Its main function is to produce fluid for semen, which transports
sperm. During the male orgasm (climax), muscular contractions squeeze
the prostate's fluid into the urethra. Sperm, which are produced in
the testicles, are also propelled into the urethra during orgasm. The
sperm-containing semen leaves the penis during ejaculation."
From the Urology Home Page at Columbia University.
http://cpmcnet.columbia.edu/dept/urology/prostatitis.html
=====================
WHAT IS PROSTATITIS?
=====================
Prostatitis is an inflammation of the prostate gland. It is the most
common prostate problem affecting men under the age of 50. The
symptoms can be very mild or extremely unpleasant, depending on the
type and severity of the condition.
==
"At some time in their lives, nearly half of all adult males will
develop prostatitis, a condition that can produce flu-like symptoms,
various types of groin pain and urination difficulties and other
urologic problems. Prostatitis prompts some 2 million office visits in
the United States each year, according to an article in the July 25,
2001 Journal of the American Medical Association. Prostatitis
typically affects men between the ages of 35 and 50, but certain
prostatitis types are common in men older than age 50."
"Prostatitis involves inflammation of the prostate gland, a small mass
of spongy tissue that is part of the male reproductive system. Located
between the pubic bone and rectum and roughly the size of a
marshmallow, the prostate gland makes and stores seminal fluid, the
milky liquid that helps transport sperm-initially via the prostatic
ducts-out of the body during orgasm. When the prostatic ducts become
inflamed, irritated or blocked for any reason, prostatitis may
develop."
"The prostate gland surrounds the upper part of the urethra, the
slender tube that leads from the bladder through the penis and that is
used during ejaculation and urination. Thus, an inflamed prostate
gland can cause a variety of urologic symptoms that affect a man?s
quality of life: significant pain in the groin and surrounding areas,
a burning sensation during urination, difficulty urinating, and sexual
dysfunction -
** often manifested as pain after ejaculation."
"Prostatitis is not a well understood condition. It can be caused by
bacteria, meaning that the condition is an infection and treatable
with antibiotics. However, most cases are nonbacterial in origin and
in these situations, diagnosis and treatment can be tricky. Once it
develops, prostatitis can become a chronic condition."
(An overview of the four common types of prostatitis are included)
Read "Prostatitis - A Common But Poorly Understood Urologic Disorder."
The Cleveland Clinic Information Center.
http://www.clevelandclinic.org/health/health-info/docs/2900/2972.asp?index=10702
====
"The term prostatitis actually encompasses four disorders:
1. Acute bacterial prostatitis
-------------------------------
is the least common of the four types but also the easiest to diagnose
and treat effectively. Men with this disease often have chills, fever,
pain in the lower back and genital area, urinary frequency and urgency
often at night, burning or painful urination, body aches, and a
demonstrable infection of the urinary tract, as evidenced by white
blood cells and bacteria in the urine. It is treated with an
appropriate antibiotic.
2. Chronic bacterial prostatitis
--------------------------------
is also relatively uncommon. It is acute prostatitis associated with
an underlying defect in the prostate, a focal point for bacterial
persistence in the urinary tract. Effective treatment usually requires
identifying and removing the defect and then treating the infection
with antibiotics. However, antibiotics often do not cure it.
3. Chronic prostatitis/chronic pelvic pain syndrome
--------------------------------------------------- -
is the most common but least understood form of the disease. It is
found in men of any age; symptoms go away and then return without
warning. Chronic prostatitis/chronic pelvic pain syndrome may be
inflammatory or noninflammatory. In the inflammatory form, urine,
semen, and other fluids from the prostate show no evidence of a known
infecting organism but do contain cells the body usually produces to
fight infection. In the noninflammatory form, no evidence of
inflammation, including infection-fighting cells, is present.
4. Asymptomatic inflammatory prostatitis
-----------------------------------------
is the diagnosis when the patient does not complain of pain or
discomfort but has infection-fighting cells in his semen. Doctors
usually find this form of prostatitis when looking for causes of
infertility or testing for prostate cancer."
From "Prostatitis: Disorders of the Prostate."
http://kidney.niddk.nih.gov/kudiseases/pubs/prostatitis/index.htm
===============================================
HOW DOES IT DEVELOP AND WHAT ARE THE SYMPTOMS?
===============================================
"Acute and chronic infectious prostatitis are not usually considered
sexually transmitted diseases. The way in which the prostate becomes
infected is not well understood and is the subject of many research
endeavors. Bacteria that cause prostatitis probably get into the
prostate from the urethra by backward flow of infected urine into the
prostate ducts or from rectal bacteria. Certain conditions or medical
procedures increase the risk of contracting prostatitis. You are at
higher risk for getting prostatitis if you recently have had a medical
instrument, such as a urinary catheter or tube, inserted during a
medical procedure, engage in rectal intercourse or oral sex, have an
abnormal urinary tract, have had a recent bladder infection, have an
enlarged prostate or have a voiding dysfunction."
Symptoms:
---------
"The symptoms of prostatitis are nonspecific and mimic many other
urologic and nonurologic diseases. You may experience no symptoms or
symptoms so sudden and severe that they cause you to seek emergency
medical care. Symptoms, when present, can include any of the
following: fever, chills, urinary frequency, frequent urination at
night, difficulty urinating, burning or painful urination, perineal
(referring to the perineum, the area between the scrotum and the anus)
and low-back pain, joint or muscle pain, tender or swollen prostate,
blood in the urine, or painful ejaculation."
Other conditions that can mimic prostatitis:
--------------------------------------------
"The symptoms of prostatitis resemble those of other infections or
prostate diseases. Thus, even if the symptoms disappear, you should
have your prostate checked. For example, benign prostatic hyperplasia
(BPH), a noncancerous enlargement of the prostate that is common in
men over age 40, may produce urinary tract symptoms similar to those
experienced with prostatitis. Often, lower urinary tract symptoms
(LUTS) are generally attributed to BPH, but this chronic condition can
be misdiagnosed as chronic noninfectious prostatitis. Similarly,
urethritis, an inflammation of the urethra (often caused by an
infection), may also give rise to many of the symptoms associated with
prostatitis. Another condition that mimics the symptoms of
prostatitis--when prostatitis is not present (no inflammation) --is
prostatodynia (painful prostate). This problem is not well understood,
but may be related to a voiding dysfunction involving the spasm of
muscles involved with the voiding process. Patients with prostatodynia
have pain in the pelvis or in the perineum. Such pain may result from
a prostate problem, but the pain can have a variety of different
causes including muscle spasms from other musculoskeletal conditions.
Because of the connections between the urethra, the bladder, and the
prostate, conditions affecting one or the other organ have similar or
overlapping symptoms. In addition, these conditions may occur
concurrently in the same patient complicating diagnosis and treatment.
A thorough evaluation and accurate diagnosis is important in
establishing treatment in these situations."
Distinguishing between the types of Prostatis
----------------------------------------------
"Acute infectious prostatitis is the easiest of the three conditions
to diagnose because it comes on suddenly and the symptoms require
quick medical attention. Not only will you have urinary problems, but
you may also have a fever and pain and, frequently, blood in your
urine."
"Chronic infectious prostatitis is associated with repeated urinary
tract infections, while noninfectious prostatitis is not. In fact, if
you do not have a urinary tract infection or a history of one, you
probably do not have chronic infectious prostatitis. Other symptoms,
if any, may include urinary problems such as the need to urinate
frequently, a sense of urgency, burning or painful urination, and
possibly perineal and low-back pain."
"Noninfectious prostatitis is more common than infectious prostatitis.
It may cause no symptoms, or its symptoms may mimic those of chronic
infectious prostatitis. If you have noninfectious prostatitis, it is
unlikely that you have a urinary tract infection."
From "Prostatitis at the Prostate Center." Columbia University.
http://cpmcnet.columbia.edu/dept/urology/prostatitis.html
=======================
DIAGNOSING PROSTATITIS
=======================
You have already had a digital rectal examination which is the first
step in examining a patient for prostatitis. The purpose of the exam
is to determine whether the prostate is enlarged or has lumps or other
areas of abnormal texture and tenderness. The exam certainly elicited
a response from you......a 10 on a scale of 1-10!!!!
If a prostate infection is suspected, the urologist will likely
utilize another diagnostic technique called Prostate Massage.
Prostate Massage:
----------------
"While performing the digital rectal examination, your doctor may
vigorously massage the prostate to force prostatic fluid out of the
gland and into the urethra. One may feel some discomfort depending on
the sensitivity of your prostate. The prostatic fluid is then analyzed
under a microscope for signs of inflammation and infection. The
three-glass urine collection method is used to measure the presence of
white blood cells and bacteria in the urine and prostatic fluid. You
will be asked to collect two urine samples separately: the first ounce
of the urine you void (urine from your urethra) and then another
sample of flowing, midstream urine (urine from your bladder). You will
then almost empty your bladder by urinating into the toilet. At this
point, your doctor will massage your prostate and collect on a slide
any secretions that appear. You will then collect in a third container
the first ounce of urine that remains in your bladder."
"Examination of these samples will help your physician determine
whether your problem is an inflammation or an infection and whether
the problem is in your urethra, bladder, or prostate. If an infection
is present, your doctor will also be able to identify the type of
bacteria involved so that the most effective antimicrobial medication
can be prescribed."
From "Prostatitis at the Prostate Center." Columbia University.
http://cpmcnet.columbia.edu/dept/urology/prostatitis.html
==
Other medical tests which may be ordered to rule out more serious
conditions can include blood tests, MRI's, biopsies and different
types of ultrasound. To read more, please refer to "Medical Tests for
Prostate Problems."
http://kidney.niddk.nih.gov/kudiseases/pubs/medtestprostate/index.htm
================
CAUSES AND CURES
================
The medical community has not reached a clear consensus about the
cause of prostatitis or the most effective means of dealing with the
condition.
The Urology Department at Columbia University provides the following
information concerning treatment depending on the type of prostatitis.
http://cpmcnet.columbia.edu/dept/urology/prostatitis.html
"If you have acute infectious prostatitis, you will usually need to
take antimicrobial medication for 7 to 14 days. Almost all acute
infections can be cured with this treatment. Analgesic drugs to
relieve pain or discomfort and, at times, hospitalization may also be
required."
"If you have chronic infectious prostatitis, you will require
antimicrobial medication for a longer period of time--usually 4 to 12
weeks. About 60 percent of all cases of chronic infectious prostatitis
clear up with this treatment. For cases that don't respond to this
treatment, long-term, low-dose anti-microbial therapy may be
recommended to relieve the symptoms. In some cases, surgical removal
of the infected portions of the prostate may be advised."
"If you have noninfectious prostatitis, you do not need antimicrobial
medication. Depending on your symptoms, you may receive one of a
variety of treatments. These may range from medication to surgery, and
may even involve behavioral therapies such as biofeedback to correct
certain voiding dysfunctions associated with prostatitis."
"In addition, it is common to find patients who have recurrent
episodes of infectious and noninfectious prostatitis over a long
period of time. These patients may actually be suffering from an
underlying voiding abnormality that may be functional or structural
that predisposes them to these episodes of prostatitis. Correcting
these abnormalities may cure or at least decrease the episodes of
these recurrent events. This is a subject of research at our Prostate
Center."
"You may find that tub baths or changes in your diet may help to
alleviate your symptoms. While there is no scientific evidence proving
that these "home remedies" are effective, they are not harmful and
some people experience relief from symptoms while using them."
======
** The Prostatitis Foundation also provides some good information
about possible causes and conventional as well as alternative methods
of treatment on their website:
Causes of Prostatitis
http://www.prostatitis.org/causes.html
Methods of treating your prostatitis
http://prostatitis.org/methods.html
===
Also read "Causes and Management of Prostatitis." Urology Health.
http://www.urologyhealth.org/print/index.cfm?topic=115
****************************
I hope the information I have provided is helpful and serves to allay
some of your worries. It is important that you maintain the proactive
approach you have already displayed in getting the proper diagnosis
and treatment for your specific condition.
If I can clarify the information I have provided any further, please
don't hesitate to ask. I will do my best to help.
Wishing you the best of health!
umiat
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