By Dr. Loretta Lanphier, ND, CN, HHP, CH

If you were to ask most men, I think that you would find  they are aware that they have a prostate gland, but unless it causes trouble, it is not something they think about very often. Prostate trouble is often linked in our minds to a likely consequence of aging that the majority of men will just have to deal with. However, inflammation of the prostate is an issue that can cause a multitude of health problems for men of all ages. There is much that can be done in the way of proactive lifestyle choices to prevent this malady and minimize its symptoms.

What is Prostatitis?

Prostatitis literally means “inflammation or the prostate gland.”  This is a condition found often in adult males, and is in fact one of the most common reasons that men visit a urologist. The main function of the prostate gland is to manufacture semen, the fluid that nourishes and transports sperm. An inflamed prostate can cause numerous health problems including painful urination, pelvic and lower back pain, and infertility.

Although most prostate troubles are associated with middle-aged and older men from 40-60, prostatitis is actually quite common in younger men under the age of 40. The prostate gland is located between the rectum and the pubic bone. It starts out as a pea-sized gland in newborn males. Little change takes place during childhood, but it usually undergoes rapid growth after a boy reaches puberty.  By the time a man reaches the age of twenty, the prostate is fully mature, and has grown to about the size of a walnut.

Prostatitis occurs in several different forms, both acute and chronic. Acute prostatitis can be a medical emergency that requires immediate intervention. The chronic form is usually less intense, but is often harder to treat. However, there are many lifestyle changes and self-care therapies that are typically very effective.

What Are the Symptoms of Prostatitis?

There are three major types of prostatitis, and each has distinct symptoms associated with it:

  • Type I:  Acute Bacterial Prostatitis Acute prostatitis often comes on rapidly, and should be treated as an emergency. Common signs include:
    • Fever and chills
    • Flu-like symptoms
    • Pain in the prostate gland, lower stomach, lower back, in the penis and/or testicles, and possibly in the perineum (the area between the scrotum and the anus).
    • Pain upon ejaculation
  •  Type II:  Chronic Bacterial Prostatitis Chronic prostatitis manifests itself slowly over time, it often appears in cycles of attacks followed by remission or a lessening of signs. The symptoms are usually considerably less intense than those found with acute prostatitis, and commonly include:
    • Painful or burning sensation upon urination (dysuria).
    • Prostate pain
    • Lower back pain
    • Pain in the genital area
    • Blood in the semen and/or urine (hematuria).
    • Increased need to urinate, sometimes urgent
    • Difficulty starting urination
    • Decreased urine output
    • Increased need to urinate at night (nocturia).
    • Low-grade fever
    • Persistent bladder infections
    • Pain upon ejaculation
  • Type III:  Chronic Nonbacterial (abacterial) Prostatitis

    Abacterial prostatitis is the most common of all forms of prostatitis. Symptoms are very similar to chronic bacterial prostatitis, with the possible exception of the fever. In testing, no bacteria will be found in your urine or prostate gland fluid. However, a common sign that tips off Type III is the presence of white blood cells in your urine and/or semen. In some forms of Type III, pus may also be found in the urine.

    There is also technically a fourth type of prostatitis known as Type IV or asymptomatic inflammatory prostatitis. This form does not usually require any treatment or intervention.

What Causes Prostatitis?

While not officially a part of the urinary system, the prostate gland plays a big role in the overall health of your urinary tract. Because of its location, the prostate has the potential to negatively affect the urethra, which is the tube that transports urine from the bladder, when it becomes swollen or infected. This is why there are so many urinary symptoms that accompany prostatitis. But what causes the prostate to become inflamed? The answer to that depends on the type of prostatitis we are talking about:

  • The cause of acute bacterial prostatitis is pretty straightforward. It is thought to be caused by infectious bacteria that are usually found in the intestines or urinary tract. Most often, these bugs directly attack the prostate and cause it to become the primary source of infection. Sometimes, however, the infections start in the bladder or urethra, and then spread to the prostate.
  • The cause of nonbacterial prostatitis is more of a mystery, but there appear to be certain triggers that may be associated with tripping it:
    • Heavy lifting of objects when you have a full bladder may cause urine to back up into your prostate, causing inflammation. Some researchers believe this is one explanation for some cases of nonbacterial prostatitis.
    • Certain kinds of exercise are thought to aggravate or bring on prostatitis. The two most common culprits are jogging and bicycling. Jogging causes problems due to vibration, and it is thought that biking leads to irritation of the prostate because of the way most bicycle seats are shaped, and the contact they have with the prostate area. By no means am I discouraging exercise. Just use common sense. There are special types of bicycle seats known as “split seats” that can alleviate this problem.
    • Certain occupations that subject your body to lots of vibrations are also thought to aggravate the prostate and lead to inflammation. Examples might be operating a jack hammer, a chain saw, or driving a truck.
    • Sometimes structural abnormalities of the urinary tract can cause inflammation of the prostate. Anything that constricts flow of urine, such as an abnormally narrow urethra, can cause urine to back up and result in prostatitis.
    • Pelvic muscle spasm is a phenomenon that can occur when a man urinates with a tightened sphincter muscle that is not relaxed. This can create pressure in the prostate and lead to prostatitis.

Whatever the reason, the mechanics of the inflammation are very similar. The irritation causes the prostate to swell, and the tiny ducts within the gland become plugged with infectious material, making matters even worse. Some patients will pass tiny stones about the size of a grain of sand that are composed of calcium, and are visible in the urine.

  • Other causes include:
    • Poor hygiene
    • Complications from surgery
    • Swimming in polluted water
    • Sexual relations with a woman who has a bacterial infection of the vagina.
    • Prostatodynia: A type of prostatitis caused by abnormalities of nerves or muscles in the prostate area. This is a very painful condition.
    • Complications of the sexually transmitted disease (STD) gonorrhea
    • Infections of the prostate caused by parasites and/or fungi
    • Some think that certain viruses may cause prostatitis, but there is not strong clinical proof for this
    • Granulomas, which are clumps of microscopic cells, are sometimes associated with prostatitis that is not caused by any other known microorganism. Their presence is often found in the prostates of men with prostatitis.

What Are the Possible Complications Associated with Prostatitis?

There are several common complications that can occur if prostatitis is allowed to advance without intervention:

  • There is no solid evidence that prostatitis poses a risk for increased prostate cancer, but there is some cause for concern, because prostatitis has been linked to increased levels of prostate-specific antigen (PSA) in the blood stream. PSA is a substance that is naturally produced by the prostate gland, and increased levels are sometimes associated with prostate cancer. If you have taken steps to control or eliminate your prostatitis, it is a good idea to have your PSA level checked after your prostatitis is better. If the PSA is still high without the presence of prostatitis, it could indicate possible prostate cancer.
  • Untreated prostatitis can lead to infertility. The prostate is closely linked to semen production and ejaculation function. Therefore, prostatitis can affect both the quality of the sperm, and their ability to reach the egg for fertilization. Symptoms such as painful ejaculation can also discourage men from having relations.
  • Urinary tract problems are a common complication of prostatitis. In extreme cases, the tract may be completely blocked, and urination becomes impossible. Surgery is often recommended in this situation, and may be one of those times when it is totally justified and appropriate.
  • A rare but serious complication from prostatitis is a bacterial infection of the blood called bacteremia.Also known as “blood poisoning” or “toxemia,” this condition can become very serious, literally spreading infections to many organs throughout the body simultaneously. Consequences can be life threatening, and bacteremia should be dealt with as soon as possible.
  • Prostatitis can also lead to infections within the prostate called prostatic abscesses. These are localized pockets of infection that can cause serious consequences if they are not treated.
  • Kidney infections are also a possible complication from prostatitis. These are usually associated with chronic prostatitis.

What Treatments Are Available for Prostatitis?

If prostatitis has advanced to the point where there is a serious bacterial infection involved, the usual recommendation is antibiotics. In some situations, this may be the only way to stop severe infections. However, if your prostatitis is not well advanced, or it you would like to learn how to prevent prostatitis or treat it in a more natural way, there are some very effective options:

  • Hot sitz baths: Taken from the German word sitzen, which means “to sit,” this is nothing more than a fancy term for a good old-fashioned hot bath. Soaking the lower half of the body in hot or warm water, with special focus on the perineum, is probably the most affective treatment available for relief from prostatitis symptoms.
  • Prostate massage is accomplished by means of inserting your gloved finger into your rectum, and gently massaging your prostate gland. As uncomfortable as this may sound, it is actually very helpful to some men. An added bonus is that you can learn to feel the condition of your prostate, and thereby monitor it yourself for other prostate conditions that can occur. One word of warning though:  Do not get too rough in your massage. If your prostate is infected, over doing it can release bacteria into the blood stream and possibly cause blood poisoning. Make sure that your proctologist is aware of this too, before he does a digital rectal exam.
  • Diet is important too. Avoid overly spicy foods, alcohol, and caffeine. Drink abundant amounts of pure, clean water. A diet high in fiber is helpful to keep your bowel movements regular too. Constipation tends to aggravate any prostate condition, including prostatitis.  

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