A few weeks ago we spoke about acute prostatitis or a swelling of the prostate gland caused by an infection. This week I will discuss chronic prostatitis. Most people think of “chronic” to mean bad or worse than acute. This is not so; the words acute and chronic tell different things about the same disease. Acute means of recent onset, usually less than two weeks and chronic means that it has been going on for some time, usually more than six weeks.{{more}}

An acute episode of any disease can become chronic if the disease was missed, misdiagnosed and hence mistreated, or not properly treated. These scenarios tend to occur more often in men than women, who are usually too busy to take care of themselves and when they do visit a doctor they want a quick fix. Doctors therefore tend to take more risks with men, compared to women. This can lead to misdiagnosis, mistreatment or undertreatment. Some men are so busy that they miss or mistake the lower back pain, perineal pain and fever for the “flu” and so never get treatment. Fortunately, most acute episodes of prostatitis will resolve with proper treatment, but some, for reasons outlined above, will become chronic.

Chronic prostatitis is characterized by lower back and perineal pain and urinary symptoms. The urinary symptoms usually involve slowing of the urine stream, urgency and frequency of the urine and sometime burning of the urine. The burning is not usually as bad as in acute prostatitis and is not usually accompanied by fever. Some of the men may have swollen or painful testes. The most important symptom is usually quality of life. Most of these men say that their symptoms make them miserable: the going to pee often, especially at nights, the slow stream and the lower back pain with the heaviness in the groin.

The treatment of chronic prostatitis is best done by a specialist, as there are things specific to this condition that only urologists can detect. Things like how to collect specimens and what specimens are taken to determine the presence of infection, to how long to treat with antibiotics, to what type of antibiotics. The need for other additional treatment like anti-inflammatory medication, alpha blockers and the use and interpretation of the blood test called the PSA.

Generally speaking, a pre and post-massage urinalysis should be compared and urine cultures ordered as necessary. Antibiotics should be for at least four weeks, sometimes six, eight or 12, based on symptoms and the bug that started the infection. The resolution of the infection can be monitored by how the patient feels, the urinalysis, PSA blood tests and ultrasound, among other things. This condition is very difficult to treat and if not done properly can cause a lot of pain and suffering.

Obviously, men suffering from chronic prostatitis will have sexual issues, as ejaculation is usually painful, even though most of these men will have some form of impotence or premature ejaculation. Besides if you are having chronic lower back and perineal pain, painful urination and other urinary symptoms, sex is usually the last thing on your mind!

For comments or question contact:
Dr Rohan Deshong
Tel: (784) 456-2785
email: deshong@vincysurf.com