Other Prostate Conditions
- Prostatitis
- Symptoms of prostatitis
- Diagnosing prostatitis
- Erectile Dysfunction
- Current Treatments for Erectile Dysfunction
Prostatitis
To put it simply, prostatitis is inflammation of the prostate gland.
There are three main classifications of prostatitis:
Acute bacterial prostatitis - acute infection of the prostate gland, usually occurs in men aged 40 to 60 years.
Chronic bacterial prostatitis - recurrent infection of the prostate, occurs in men aged 50 to 80 years. It is associated with chronic urinary infection and, commonly, calcifications in the prostate (prostatic stones). In the cases of bacterial prostatitis, the culprit usually is a bacteria known as Escherichia coli. The cause of bacterial prostatitis is not well--defined, but one theory suggests a reflux of urine from the bladder into prostatic ducts. This reflux of urine may lead to prostatitis.
Nonbacterial prostatitis - inflammation without any evidence of infection present, occurs in men aged 30 to 50 years. The cause of chronic nonbacterial prostatitis is unknown.In addition, there is another condition termed prostatodynia. The symptoms are similar to prostatitis, but there is no evidence of prostate inflammation.
Symptoms of prostatitis
Each form of prostatitis has a slight variation in signs and symptoms.
Acute bacterial prostatitis
- Sudden onset of fever and chills
- Pain in lower back or rectum
- Irritative or obstructive urinary symptoms
- Prostate is warm, swollen, and tender upon examination
Chronic bacterial prostatitis
- Relapsing urinary tract infections
- Painful urination or other voiding problems
- Ejaculatory pain
- Pelvic or genital pain
Some men may not have any symptoms
Nonbacterial prostatitis
- Chronic pelvic pain (testicular, penile, lower abdominal, ejaculatory)
- Persistent inflammation of the prostate
- Absence of infectious bacteria in urine
Diagnosing prostatitis
The gold standard for diagnosing prostatitis would be to perform a biopsy of the prostate, but this is rarely done. Instead, doctors may diagnose prostatitis by examining prostatic secretions for bacteria. To do this, a "four-cup" test may be conducted. To start, the patient must have a full bladder. The doctor will clean the glans penis with soap and water and will then collect two cups of urine. Next, the prostate will be massaged by a digital rectal examination (DRE) to allow prostatic fluid to travel through the urethra. Two more cups of urine will be collected, and the expressed prostatic secretion (EPS) in the urine is examined for the presence of bacteria. Some physicians may not perform the "four-cup" test, and may just obtain urine before and after massaging the prostate. Sometimes EPS secretions from the urethra can be collected from the tip of the penis after massaging the prostate. After the physician collects these secretions, they can be examined under a microscope.Nonbacterial prostatitis is more difficult to diagnose. With these patients, the EPS will have evidence of inflammation, but bacteria will not be present. The lack of recurrent urinary tract infections distinguishes nonbacterial prostatitis from chronic bacterial prostatitis.
Erectile Dysfunction
Erectile Dysfunction (ED) is a significant and common medical condition. Erectile Dysfunction can be defined as the inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity. Health professionals in general prefer the term "Erectile Dysfunction," which more precisely defines the nature of the condition than does an older word that is sometimes used -- "impotence" -- because the later implies weakness to many people. It is estimated that as many as 100 million men worldwide suffer from ED. However, more than 85% of men with ED don't seek treatment. Among the reasons are the incorrect assumptions that ED is a normal consequence of aging and that there is no treatment available. The truth is that the likelihood of ED does increase with age because the prevalence of the underlying conditions that are associated with ED increases with age. The failure of sufferers to seek treatment is especially unfortunate because ED is a treatable condition and may be a symptom of another underlying medical problem that needs to be treated as well.
Myth: Erectile Dysfunction is uncommon.
Fact: A large health survey in the U.S.A. found 52% of men aged 40 to 70 years had some degree of difficulty achieving and/or maintaining an erection. Approximately 35% had moderate or complete ED.
Myth: The majority of cases of Erectile Dysfunction are psychologically caused.
Fact: Although ED was commonly thought to be linked to psychogenic causes, studies suggest that only 10% to 30% of ED cases are caused by purely psychogenic factors. In the remainder, an organic component, e.g., vascular disorders, structural abnormalities, neurologic damage, or endocrinologic disorders, can be identified. However, psychological factors such as self-confidence, anxiety, and partner relationship problems may also be involved.
Myth: Erectile Dysfunction is a condition affecting only elderly men.
Fact: By age 50, approximately half of all men experience some degree of ED. In general, the prevalence of ED increases with age, but men retain their erectile ability well beyond their eighties. Age-related conditions and medications used to treat various medical conditions increase the likelihood that ED will occur.
Myth: Erectile Dysfunction is complex to diagnose and treat. Patients should always be referred to a specialist.
Fact: Most cases of ED can be diagnosed and treated. However, a lack of information about ED among the public and health professionals and reluctance by physicians and patients to discuss sexual matters has resulted in patients being denied the benefits of treatment.
Myth: Men must learn to live with ED.
Fact: Effective and well-tolerated treatments are available.
CAUSES OF ED
Many people incorrectly believe that ED is a purely psychological problem. Erectile Dysfunction is primarily physical in origin, but psychological factors, alone or in combination with physical factors, can cause ED.
Among the conditions associated with ED are:
Hypertension
Diabetes
Hardening of the arteries and other vascular disorders that interfere with the flow of blood to the penis and the mechanism of erection
High cholesterol
Trauma, including injuries to the pelvis or spinal cord
Certain types of surgery and radiation therapy
Multiple sclerosis and other nervous system disorders
Depression
Habits that worsen vascular disorders (e.g., abusing alcohol or smoking)
Current Treatments for ED
Various treatment alternatives are available and you should discuss them with your doctor. A primary care doctor can give a preliminary diagnosis of ED based on a patient history and a physical examination, but may refer a patient to a specialist, such as a urologist. Current treatments for ED include:
Oral medication
Intraurethral suppositories
Injectable drugs
Vacuum devices
Penile implants
Counseling and sex therapy
These methods have varying degrees of effectiveness and tolerability, and are used to treat ED caused by physical or psychological conditions.
