Prostatitis is an inflammation of the prostate caused by bacteria. It can be episodic or last longer. This form of prostatitis occurs in about one in ten cases. Much more often, men are worried about another form of prostatitis - chronic abacterial prostatitis that is not accompanied by infection. Certainly little is known about this and most urologists do not consider it a true diagnosis. But this is where most problems come from, including problems with sex. Chronic prostatitis is also called chronic pelvic pain syndrome (CPPS).
The pain waxes and wanes
With chronic prostatitis, men are worried 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, difficulty ejaculating, 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. Unlike "classic" prostatitis, chronic prostatitis cannot be cured with antibiotics and its symptoms can bother a man for several months or years. They can come and go and vary in severity.
David Lonergan was diagnosed with chronic prostatitis and just three years later 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 said about his feelings in an interview with Vice:
"At one point I started feeling wild sensations throughout my pelvic area. At first I had a slight burning sensation in my rectum every time I sat. Then the pain became acute and spread throughout the pelvis. Finally, it felt like hundreds of razor blades were stabbing my urethra. On a scale of 1 to 10 I would rate the pain an 11.
The ejaculation became unbearably painful. At first I felt pleasure from the orgasm and relief afterward, but hours of pain followed, and as the pain increased, I stopped having sex. The doctor prescribed me a prostate massage (the benefits of prostate massage have not been proven) and also asked me to have sex and ejaculate. But since sex wasn't pleasurable, I decided to masturbate once a day. It was a big mistake to do this twice a day - the pain was excessive (there is no need to have sex and masturbate because of the pain, this will not improve your well-being). My wife and I went to a therapist for individual and couples therapy. In many ways, she was the one who helped us overcome all of our sex problems. "
Most men diagnosed with chronic prostatitis (CPPS) experience improvement in symptoms within six months. In one study, a third of men experienced complete disappearance of symptoms after one year. In another large study, a third of men improved within two years.
Chronic prostatitis is little researched
Chronic prostatitis has not been adequately studied. Experts believe there are several possible causes, including autoimmune diseases, genetics, damage to nerves or muscles near the prostate and hormonal imbalances. Another risk factor can be psychological stress. However, it can be difficult to determine the specific cause. Treatment usually includes lifestyle changes and medication 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 diseases. According to the chief urologist of our country Dmitry Pushkar, this is a garbage diagnosis that the doctor gives to the 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 prostatic secretion are taken). Anything else is a far-fetched diagnosis with no cure. To prevent prostate inflammation, there is a general recommendation - regular sex: ejaculation should occur at least every four days, no matter how it is achieved.
The symptoms of prostatitis can be relieved by a few simple things, such as taking a warm bath or heating pad, and avoiding alcohol, caffeine, and spicy or acidic foods (these can irritate the bladder).
If you have problems urinating, your doctor may prescribe alpha-blockers - they help relax the bladder neck and the muscle fibers at the junction of the prostate and bladder. Chronic pain is treated with painkillers. If you have problems having sex, your doctor may refer you to a psychotherapist or sexologist.
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 media attribute erection problems to prostatitis, which is why many men associate them with it. But that is not the case. An erection can be maintained even if the prostate is completely removed. According to many renowned urologists, erectile dysfunction in patients with chronic prostatitis is due to psychological problems. Often a man's erection subsides immediately after the phrase 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 it can affect urination and sensation in the perineal area, but it has nothing to do with sex. Unfortunately, many men and some urologists believe that prostate problems can affect sex life because the prostate is located near the genitals. The prostate has a special function: it produces fluid - a component of sperm. She is not involved in anything else.
According to Dmitry Orlov, in world practice, doctors almost never make the diagnosis of "chronic prostatitis". Rather, it is a territorial diagnosis that has no pathophysiological basis, but simply a theoretical concept, on the basis of which treatment is prescribed to a person. A manhears the diagnosis and worries that it may affect his sexual function. During intimacy, he does not enjoy the process, but monitors how good his erection is. Concentrating on an erection can affect its quality and cause a manrecognizes a connection between the diagnosis and the problems that occurred, but the reason is purely emotional.
If pain and discomfort occur during sex, you need to understand the reason behind it. It is better to consult a urologist who follows an evidence-based medical approach.
Dmitry Orlov adds: "If a doctor advises having sex more often or not having sex at all, then there must be a medical reason for it. "I don't know a single disease in which more sex would lead to recovery. Most often such a recommendation is due to the fact that the specialist does not know how to help. There is also no need to limit or completely eliminate sex and masturbation, because regular sexual development is beneficial for both prostate health and the psyche.
The path from the urologist's office to the sexologist's office is the standard route for men over 35-40 years old. If a man has erection difficulties or other problems during sex, he first goes to a urologist as he considers this his specialty. If the urologist finds nothing or diagnoses "chronic prostatitis", the only option left is the practice of a sexologist. A sexologist has a wide range of techniques that can help the patient: he can recommend elements of sexual therapy, seek psychotherapy, or"Prescribe medication if necessary. Statistically speaking, this is an effective working model - on average, the problem is resolved within a month. "