• What is Prostatodynia?
  
• Causes and Risk Factors of Prostatodynia
  
• Symptoms of Prostatodynia
• How to Address the Symptoms of Prostatodynia
  
• Facts About Prostatodynia
  
• Resources for Prostatodynia
  

 

What is Prostatodynia?

There are various types of prostatitis, one of which is Prostatodynia (or Prostadynia). Sometimes called Noninflammatory Chronic Pelvic Pain Syndrome, it is the occurrence of prostatitis symptoms, without inflammation or bacterial infection. Currently, the National Institute of Health refers to Prostatodynia as Category IIIb.

Doctors understand very little about why some people - often young, otherwise healthy men - develop this problem. Theories to explain prostatodynia include an abnormal buildup of pressure in the urinary tract, irritation resulting from an autoimmune or chemical process, or pain generated in the nerves and muscles within the pelvis. There may be a link between prostatodynia and increased stress, because this condition is often found in men with "Type A" personalities in high-stress situations.

The main symptom is pain in the pelvis or perineum (the area between the scrotum and the anus.) However, many of the nonbacterial prostatitis symptoms may be present, such as fever, pain in the lower back, pain in genital area, general body aches, burning or pain on urination, increased urinary frequency, urgency, pain or discomfort during or after ejaculation, decreased libido, and occasionally visible blood in the urine.

 

Causes and Risk Factors of Prostatodynia

There are many theories about the cause of nonbacterial prostatitis: fungi, viruses, trichomonads, and obligate anaerobic bacteria have been suspected. Irritation caused by a reflux of urine flowing into the prostate may also be a cause.

Up to 65% of patients with chronic prostatitis have the nonbacterial form. The disorder is seen in 5 of every 10,000 outpatient visits by men.

 

Symptoms of Prostatodynia

The common symptoms associated with Prostatodynia include:

The symptoms of Prostatodynia are the same as those of Chronic Bacterial Prostatitis.

 

How to Address the Symptoms of Prostatodynia

Prostatodynia or Noninflammatory Chronic Pelvic Pain Syndrome is difficult to treat because it is not clear what causes this form of prostatitis. The primary goal of treatment is to relieve symptoms. Nonnarcotic pain medications, muscle relaxers, and alpha-blockers are used.
MEDICAL CARE:
Prostatic massage (therapeutic)

• The role of prostate massage in providing symptomatic relief is controversial.
• With little evidence-based medicine to commend it, regularly repeated prostatic massages have been recommended in the past, particularly for patients with a large, congested gland.
• Some patients find that massage provides temporary relief worth the awkwardness and discomfort of the maneuver itself.

Therapeutic ejaculation

• The role of frequent ejaculation in either producing or reducing CPPS symptoms remains controversial.
• Patients with enlarged, symptomatically congested glands are often advised that regular sexual intercourse may alleviate their symptoms.
• While little objective evidence substantiates this claim, most patients find this recommendation more attractive than serial prostate massages by their local urologist.
• Whether frequent sexual intercourse relieves or actually exacerbates the condition seems to vary idiosyncratically from patient to patient.

SURGICAL CARE:
For instances of severely disabling CPPS, transurethral resection of the prostate (TURP) and even radical prostatectomy have been undertaken.

Transurethral resection of the prostate (TURP)

• A widely held opinion among urologists is that TURP should be reserved for those patients who have experienced extreme, persistent symptoms over a protracted period, with no relief from nonoperative interventions.
• Reserve TURP as a rarely employed approach of last resort, offered only by experienced resectionists, and, even then, with the clear understanding that symptomatic relief is not guaranteed.
• Indeed, a risk exists that symptoms might even become worse and includes the added burdens of impotence and urinary incontinence.
• When TURP is undertaken, completing a thorough resection of all tissues, down to the capsule, is essential. The concern is that residual tissue, partially coagulated, with obstruction of the ductal drainage from prostatic acini might exacerbate the patient's symptoms (Smart, 1975).

Radical prostatectomy

• This is an extreme measure.
• Consider this treatment only in the most desperate of cases, if at all (Davis, 1990).

DIET:

• The influence of diet on this condition is variable.
• Traditionally, these patients have been warned to avoid excessive intake of prostate irritants, such as coffee, tea, soda (cola drinks and diet drinks may be especially irritating), spicy foods, and alcohol.
• Alkalinization of the urine seems to help some patients. A teaspoonful of baking soda (sodium bicarbonate) in a tall glass of warm water taken at bedtime may help reduce nighttime symptoms. However, caution patients regarding the risk of an excessive sodium load with higher oral intakes, especially in those under treatment for hypertension, fluid retention, or congestive heart failure. A potassium-based alkalinizer, such as potassium citrate (Urocit K), may prove more efficacious under these circumstances. Stephen Leslie, MD, reports anecdotally that he has found some patients to have very alkaline urine, which can also be irritating and result in discomfort and dysuria.

ACTIVITY:

• Sitz baths may provide partial relief from acute exacerbations.
• Rather than a shallow, perineal dip, a deep tub bath in water as hot as can be comfortably tolerated seems to provide better overall temporary relief and relaxation.

 

Facts About Prostatodynia

• Many patients respond to treatment while others are not relieved despite multiple treatment attempts.
• Symptoms often recur after treatment and may eventually not be treatable.
• Unresolved symptoms of nonbacterial prostatitis may cause significant changes in lifestyle and emotional well-being related to sexual and urinary problems.

 

Resources for Prostatodynia

National Institute of Diabetes and Digestive and Kidney Disorders
Office of Communications and Public Liaison
Building 31, Room 9A04
Center Drive, MSC 2560
Bethesda, MD 20892-2560
Phone: (301) 496-3583
Fax: (301) 496-7422
http://www.niddk.nih.gov/

American Foundation for Urologic Disease
1000 Corporate Blvd., Suite 410
Linthicum, MD 21090
Phone: (410) 689-3990
Toll-Free: (800) 828-7866
Fax: (410) 689-3998
http://www.auafoundation.org/

Prostatitis Foundation
1063 30th St.
Box 8
Smithshire, IL 61478
Toll-Free: (888) 891-4200
Fax: (309) 325-7184
http://www.prostatitis.org/

www.ChronicProstatitis.com
http://www.ChronicProstatitis.com/