Let’s Talk About Chronic Prostatitis

Everybody talks about the diagnosis and treatment of prostate enlargement and prostate cancer? Why doesn’t everybody talk about the diagnosis and treatment of chronic prostatitis?

Prostatitis is loosely and simplistically divided into acute and chronic classes. Acute prostatitis is very often young man’s bacterial infection; it is usually easily treated with antibiotics. Acute prostatitis can recur but does not necessarily transform into the chronic condition, with many men having a few episodes that then stop recurring.

Chronic prostatitis is characterized by frequent episodic or sustained pain potentially so severe that some victims become suicidal. The pain can affect a broad range of sites – perineum, penis, rectum, lower back, lower abdomen, legs – and it is usually associated with coexisting ailments: fatigue, inability to think clearly, and depression. Specific triggers may include such normal events as ejaculation, but are often hard to identify. Because of its debilitating effects, chronic prostatitis interferes with professional responsibilities and with personal relationships; it has been blamed for social isolation, divorce, and lack of employment.

Chronic prostatitis is often not a bacterial infection; while antibiotics are usually prescribed, they are often useless. Patients thus face other treatment options and some indeed respond to a variety of strategies, some better validated than others: Massage, trigger point release, intra-prostatic injections of antibiotics, herbal supplements, hypnosis, acupuncture, and anti-inflammatory medications. But when these treatments do not work, men with chronic prostatitis then become the sort of patient few doctors want to see: The one who complains but for whom there is no remedy. They become the patient whose problem is “all in his head.”

So is there any hope? In 2007, a prostatitis patient named David had lost hope after dutifully seeking cure for 8 years of severe symptoms. At the “end of my rope,” he asked to have his prostate removed. After extensive discussion about lack of scientific proof and all kinds of risk, he had a laparoscopic radical prostatectomy, a common treatment for prostate cancer, which immediately, completely, and durably eliminated his symptoms: It has been 3 years and he is completely asymptomatic and fully functional.

In response to the experience with David, the Krongrad Institute, which did his surgery, is conducting a clinical trial to quantify the effect of laparoscopic radical prostatectomy on the symptoms of chronic prostatitis.  The idea is to see if David was an exception or the rule. It is also to allow tomorrow’s patients to make informed decisions about the role of surgery.

Chronic prostatitis can last decades and destroy all semblance of normal life. It affects thousands of men and their families. We need to talk about chronic prostatitis. For more information, readers are encouraged to check out the Prostatitis Surgery web site and the Prostatitis Blog.

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Blurb about today’s Guest Blogger:

Arnon Krongrad, MD is a urologist who specializing in the use of laparoscopic surgery in the treatment of prostate cancer and severe, treatment-resistant chronic prostatitis.