If you have prostatitis, you're not alone. Prostatitis usually affects men in their early 40s, and it is one of the leading reasons why men visit a urologist. In this Health Alert, Johns Hopkins explains why chronic prostatitis is so difficult to treat.
There are two kinds of prostatitis -- bacterial and nonbacterial. Nearly 95% of patients are thought to develop prostatitis from nonbacterial causes, which have yet to be identified.
While the causes of bacterial prostatitis are obvious and easy to detect, researchers are unsure why men develop the more prevalent, nonbacterial form. Some men find that stress, emotional problems, or even coffee may trigger flare-ups. Other possible culprits include zinc deficiency, tight urinary sphincter muscles, infrequent ejaculation, and dehydration.
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Some experts suggest that nonbacterial prostatitis is not really a prostate problem at all. Rather, flare-ups could be the result of a pelvic muscle spasm or some other cause that mimics symptoms originating in the prostate. Another theory under investigation is that prostatitis is caused by an autoimmune disorder, in which the immune system mistakenly attacks healthy prostate tissue and promotes inflammation -- not unlike the way rheumatoid arthritis targets the joints. Indeed, researchers recently found that men with chronic prostatitis had increased levels of the same pro-inflammatory molecules that are elevated in the joint tissue of people with rheumatoid arthritis.
If you have bacterial prostatitis, your treatment options are fairly straightforward : a course of antibiotics for a period of 4 to 16 weeks. Indeed, b acterial prostatitis is the most curable form of the disease, although some patients may not respond to treatment, or symptoms may reappear once the antibiotics are stopped.
Treatment of nonbacterial prostatitis is more difficult, and no one treatment has been proven to improve symptoms for most men. It may take some trial and error to find a combination of therapies and self-care techniques to obtain symptom relief. While antibiotics typically are reserved only for bacterial diseases, many patients with nonbacterial prostatitis receive antibiotics and a prostate massage, followed by high doses of alpha-blocker drugs.