Prostatitis

There are four types of prostatitis:
Acute bacterial prostatitis is a bacterial infection of the prostate gland that requires urgent medical treatment. It is the least common of the four types and its potentially life-threatening. Fortunately, it is the easiest to diagnose and treat effectively.
Chronic bacterial prostatitis is a bacterial infection that occurs repeatedly, it occurs when bacteria find a spot on the prostate where they can survive. Treatment with antimicrobials do not always cure this condition.
Chronic nonbacterial prostatitis, known as chronic prostatitis or chronic pelvic pain syndrome, is the most common form of prostatitis. It may be found in men of any age. Its symptoms go away and then returns without warning, and it may be inflammatory or noninflammatory.
Asymptomatic inflammatory prostatitis is the diagnose given when the patient does not complain of pain or discomfort but has infection-fighting cells in his prostate fluid and semen. It usually is found in prostate cancer tests.

Western conception:
1. Common causes of prostatitis：

• Bladder obstruction
• Bladder stones (mineral deposits in the bladder that travel to the urinary tract)
• Dehydration (loss of body fluids and electrolytes, which can be life threatening when severe and untreated)
• Kidney stones (mineral deposits in the kidneys that travel to the urinary tract)
• Pyelonephritis (kidney infection)

2. Other causes of prostatitis:

• Infections, including sexually transmitted diseases
• Pelvic trauma
• Tumor

TCM conception:

• Obstruction of heat(fire) and dampness in lower abdomen
• Obstruction ( or poor circulation) of blood and Qi in prostate - it can result from persistent erection, too much intercourses, sitting for long, etc.
• Dirty sexual intercourses (infections)

Risk factors for prostatitis include:

• Being a young or middle-aged man
• Having a past episode of prostatitis
• Having an infection in the bladder or the tube that transports semen and urine to the penis (urethra)
• Having a pelvic trauma, such as injury from bicycling or horseback riding
• Not drinking enough fluids (dehydration)
• Using a urinary catheter, a tube inserted into the urethra to drain the bladder
• Having unprotected sexual intercourse
• Having HIV/AIDS
• Being under psychological stress
• Having certain inherited traits - particular genes may make some men more susceptible to prostatitis

Prostatitis symptoms vary depending on the cause. They may include:

• Pain or burning sensation when urinating (dysuria)
• Difficulty urinating, such as dribbling or hesitant urination
• Frequent urination, particularly at night (nocturia)
• Urgent need to urinate
• Pain in the abdomen, groin or lower back
• Pain in the area between the scrotum and rectum (perineum)
• Pain or discomfort of the penis or testicles
• Painful orgasms (ejaculations)
• Flu-like symptoms (with bacterial prostatitis)

There are two steps involved in the diagnosis of prostatitis:

• Ruling out other conditions
• Determining which type of prostatitis you have

Diagnosis of prostatitis usually involves a complete medical history and physical examination, including a Digital Rectal Examination (DRE) to check the prostate for tenderness. A test may also be performed to detect white blood cells and/or bacteria in the urine and semen.
 

Treatment for prostatitis will depend on the underlying cause of the prostatitis. The bacterial forms of prostatitis are treated with antimicrobials and (or) fluids.
Acute prostatitis may be treated in an emergency setting for it can be a life-threatening. Commonly the treatment is with the appropriate antibiotics, such as Ciprofloxacin ( eg Ciproxin) and Dexycycline ( eg Vibramycin). A short hospital stay may be required.
The treatment may be longer for chronic bacterial prostatitis. The doctor may prescribe a low dose of antibiotics for 6 months to prevent recurrent infection. In some cases, surgery is needed if a patient has trouble emptying his bladder. However, recent report shows that sexual health would decline after prostate surgery.
Chronic nonbacterial prostatitis is the most common form of the disease. Patients have no bacteria in their urine, but may have other signs of inflammation. Thus the treatment of this condition is also aiming at disposing inflammation. Except for anti-inflammatory medicines and antibiotic medicine, pain medications and muscle relaxants are used in some cases. Massage and surgery are also optional.
Alternative treatment for chronic nonbacterial prostatitis is herbal medication. According to the causes in tcm comception, by clearing away heat and dampness in pelvic area, meanwhile promoting blood and Qi circulation, appropriate prescription is capable of completely curing chronic prostatitis. Such prescription is also available for chronic bacterial prostatitis if with "toxicides (refer to herbs which kill pathogens)", while short-term medication can be used for acute bacterial prostatitis.
No treatment is needed for asymptomatic inflammatory prostatitis.
 

• Infertility
• Prostate abscess
• Sepsis (life-threatening bacterial blood infection)
• Sexual dysfunction (eg. premature ejaculation, erectile dysfunction, impotence)
• Spread of infection (such as seminal vesiculitis, epididymitis, cystitis, etc.)