Prostatitis is an inflammation of the prostate gland caused by bacteria. It can be episodic or prolonged. This type of prostatitis occurs in approximately one in ten cases. Much more often, men worry about another form of prostatitis - chronic bacterial, which is not accompanied by infection. Little is known for sure about it, and most urologists do not consider it a true diagnosis. But it is with him that most problems are connected, including problems with sex. Chronic prostatitis is also called chronic pelvic pain syndrome (CPPS).
The pain lasts and subsides
With chronic prostatitis, men are concerned 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, a feeling of incomplete emptying;
- Some men experience difficulty in erection, discomfort during ejaculation and increased pain after sex. Embarrassment can reduce a man's ability to become aroused or 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. Chronic prostatitis cannot be cured with antibiotics, unlike "classic" prostatitis, and its symptoms can bother a man for months or years. They may come and go and vary in severity.
David Lonergan was diagnosed with chronic prostatitis and only three years later he found a way to live with it. During the first year he took antibiotics, but they did not help (antibiotics do not help with chronic abacterial prostatitis). Here's what David says in an interview with Vice about his feelings:
"At one point I started experiencing wild sensations in the entire pelvic area. At first I had a slight burning sensation in the rectum whenever I sat down. Then the pain became acute and spread throughout the pelvis. Eventually I feltlike hundreds of razors were being stabbed into my urethra. On a scale of 1 to 10, I would rate the pain as an 11.
Ejaculation became extremely painful. At first I felt pleasure from the orgasm and relief after it, but then I suffered for hours of pain and when the pain intensified, I stopped having sex. The doctor gave me prostate massage (the benefits of prostate massage have not been proven), and also told me to have sex and ejaculate. But since sex did not bring pleasure, I decided to try masturbating once a day. It was a big mistake to do this twice a day - the pain was off the charts (no need to have sex and masturbate through pain, it will not improve your well-being). My wife and I went to a therapist for individual and couples therapy. In many ways, it was what helped us overcome all our problems in sex. "
Most men diagnosed with chronic prostatitis, or CPPS, experience improvement in symptoms within six months. In one study, one-third of men experienced complete resolution of symptoms after one year. In another large study, a third of the men's condition improved within two years.
Chronic prostatitis has been little studied
Chronic prostatitis has not been sufficiently studied. Experts believe there are several possible causes, including autoimmune diseases, genetic predisposition, damage to the nerves or muscles near the prostate gland, and hormonal imbalance. Another risk factor can be psychological stress. However, the specific cause can be difficult to determine. Treatment usually involves lifestyle changes and medications 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 conditions. According to the chief neurologist of our country, Dmitry Pushkar, this is a garbage diagnosis that the doctor makes to the patient when he does not want to understand what is happening to him. Inflammatory changes in the prostate can only be confirmed with a four-cup test (an analysis in which some parts of urine and prostate secretions are taken). Everything else is a distant diagnosis without a cure. To prevent inflammation in the prostate gland, there is a universal recommendation - regular sex: ejaculation should be at least once every four days, regardless of how it is achieved.
Prostatitis symptoms can be relieved by some simple things, such as 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 muscle fibers at the junction of the prostate and bladder. Chronic pain is treated with painkillers. If you have problems with sex, your doctor may refer you to a psychotherapist or sexologist.
Sexual problems are not related to chronic prostatitis
Urologist Artem Loktevexpresses the following thoughts: Modern aspects of evidence-based medicine for thinking patients" writes that advertising and the media attribute erectile problems to prostatitis, so many men associate them. But this is not true. An erection can also be maintainedif the prostate is completely removed. According to many reputable urologists, erectile dysfunction in chronic prostate patients is caused by psychological problems. Often a man's erection diminishes immediately after the sentence: "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 gland, it can affect urination and sensation in the perineal area, but that has nothing to do with sex. Unfortunately, many men and some urologists accept the concept that prostate problems can affect sex life becausethe prostate is located near the genitals. The prostate gland has a specific function: it produces fluid - a component of sperm. It is not involved in anything else. "
According to Dmitry Orlov, doctors almost never make a diagnosis of "chronic prostatitis" in world practice. It is rather a territorial diagnosis, which has no pathophysiological basis, but only a theoretical concept on the basis of which a person is prescribed treatment. A man hears the diagnosis and begins to worry that it may affect his sexual function. During intimacy, he does not enjoy the process, but monitors how good his erection is. Focusing on an erection can decrease its quality and lead a man to see a connection between the diagnosis and the problems that have arisen. But the reason is purely emotional.
If there is pain and discomfort during sex, you need to understand the reason for this. It is best to consult a urologist who adheres to an evidence-based approach to medicine.
Dmitry Orlov adds: "If a doctor advises to have sex more often or not to have sex at all, then there must be a medical reason for this. I do not know of any disease in which increasing the amount of sex would lead to a cure. Moreoften, such a recommendation is due to the fact that the specialist does not know how to help. Also, there is no need to limit or completely eliminate sex and masturbation, because regular sexual release is beneficial both for the health of the prostate gland and for the psyche.
The path from the urologist's office to the sexologist's office is the standard path for men over 35-40 years old. If a man has difficulties with erection or other problems in sex, he first goes to the urologist, because he considers this his area of expertise. If the urologist finds nothing or diagnoses "chronic prostate", then the only thing left is the sexologist's office. A sexologist has a wide range of techniques that can help the patient: he can recommend elements of sex therapy, can be involved in psychotherapy or prescribe medication if necessary. Statistically, this is an effective working model - on average, the problem is solved within a month.