Chronic Prostatitis/Chronic Pelvic Pain Syndrome

What is prostate?

The prostate is an organ located under the bladder and through which urine passes. In young males, it is the size and shape of a large chestnut. The prostate is a gland and its main function is to contribute volume to the semen containing sperm.

What is chronic prostatitis?

Although chronic prostatitis (CP) is defined as inflammation of the prostate gland; Clinically, it refers to a condition in which very different symptoms are observed and the cause is not fully understood.

How common is conical prostatitis?

The incidence of the clinical picture, also known as “chronic prostatitis/chronic pelvic pain syndrome”, is approximately 8% and it is a condition as common as ischemic heart disease and diabetes in society.

CP, which seriously impairs the quality of life and whose risk of recurrence increases with age, is generally seen in people under the age of 50. In fact, it can be said that it is the most common urinary system disease seen under the age of 50.

What kind of complaints does chronic prostatitis cause?

The most important complaint and diagnostic feature is dull (non-stinging) pain that has been present for three of the last six months. Pain, which can be seen in the perineum, penis, lower abdomen, waist area and anus, may fluctuate from day to day. In addition to urination symptoms such as burning during urination, frequent urination, and difficulty in initiating urination, sexual problems such as erectile dysfunction and painful ejaculation (orgasm) may also be present. In addition, there may be constipation, pain during and after defecation, and a feeling of fullness in the rectum (anus). These complaints are progressive and seriously affect the quality of life. On top of this, the fear of not being able to fully diagnose the disease or not being understood by the physician causes serious anxiety in patients.

What diseases and conditions can it be confused with?

In the diagnosis of chronic prostatitis, complaints must be carefully evaluated and it must be determined that there is no other underlying problem. The differential diagnosis includes benign prostate enlargement, urinary tract infection, genitourinary system cancers, urinary system stone disease, sexually transmitted diseases (urethritis, etc.), chronic epididymitis, urethral stenosis, and neurological diseases that may affect the bladder.

How is chronic prostatitis diagnosed?

Unfortunately, the diagnosis of chronic prostatitis is not easy and is based mainly on the patient’s complaints. The American National Institute of Health (NIH) Chronic Prostatitis Symptom Form is used to objectively reveal these complaints and evaluate the results of the treatments given. After this form is filled out by the patient and the complaints are presented; A physical examination, including digital prostate evaluation, is performed, followed by a urinalysis and urine culture. In addition, a urine sample should be taken after prostate massage for laboratory evaluation of the prostate. If your doctor at Uropark deems it necessary, the urinary tract can be evaluated with urinary system ultrasonography. In case of suspicion of sexually transmitted disease, through the urinary tract in the penis

A swab sample may be taken and related blood tests may be performed.

In addition to all these, urodynamics, transrectal ultrasonography, cystoscopy (evaluation of the prostate and bladder with a camera imaging system) can be performed when necessary. Additionally, if there is a familial risk factor for prostate cancer or an abnormal condition is detected in the prostate examination, additional tests, especially serum prostate specific antigen (PSA) value, may be performed.

How is chronic prostatitis treated?

The treatment of chronic prostatitis is medical treatment under the supervision of Urologists. In rare cases, surgical treatment is required. However, when necessary, a multidisciplinary approach is planned, including physical therapy and rehabilitation, algology (the scientific discipline dealing with pain) and psychiatry consultations.

How is chronic prostatitis treated in our clinic?

Appropriate treatment is planned by UROPARK physicians as a result of careful and detailed evaluation, depending on the severity and type of treatment complaints. Treatment includes painkillers and anti-inflammatory drugs (non-steroidal anti-inflammatory drugs), drugs that relax the prostate (alpha-blockers) or pelvic floor, antibiotics, herbal treatments (phytotherapy), neuropathic pain medications (gabapentin), ESWT, acupuncture, intraprostatic BOTOX treatment. Traditional and/or modern methods are used. Three of these are especially recommended by Uropark physicians, along with other methods, to suitable patient groups.

1-Treatment with extracorporeal shock waves (ESWT): Apiş

It is a sound wave therapy applied with a special device. This treatment provides significant benefits to patients with its anti-inflammatory, analgesic and muscle spasm-preventing effects in a wide range of areas.

2-Pelvic Rehabilitation: Especially in suitable patients with tension in the pelvic musclesphysiotherapy can help these muscles relax and thus reduce complaints.

3-Botilinum toxin A (Botox) injection into the prostate: Especially in patients with pain symptoms, botox treatment applied to the prostate is beneficial by causing a shrinkage and a decrease in contraction of the prostate gland.