Not only in the elderly, not always from infection: the urologist debunked 10 myths about prostatitis

According to studies, almost every second man faces symptoms of prostatitis during his life, and a third of patients are young people aged 20 to 40 years. Fear of a visit to a urologist and unwillingness to admit the presence of a problem cause men to postpone the examination for years. About what misconceptions about this disease it is time to stop believing, the correspondent of the agency “Minsk-Novosti” told urologist Anastasia Pavlyuk.

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Myth #1: Prostatitis is only for the elderly

- Prostatitis can occur at any age, but most often it is diagnosed in men from 30 to 50 years. In young patients, prostatitis is provoked by either bacterial infections (including sexually transmitted infections), or a sedentary lifestyle that violates the tone of the pelvic floor muscles.

In men older than 50 years, it is usually a completely different diagnosis - prostate adenoma (benign growth of organ tissues). The main signs of this pathology are difficult urination, frequent night urges and a feeling of incomplete emptying of the bladder.

Myth #2: Prostatitis is necessarily accompanied by pain

- Pain is one of the symptoms, but it is not necessary. There are forms of prostatitis that are asymptomatic or have atypical manifestations - for example, make themselves felt only by slight discomfort in the lower abdomen, burning in the perineum or a decrease in potency. Often, men of mature age come to the reception with the only complaint of discomfort when urinating. However, with a detailed history, other alarming signs are revealed that the patient previously did not pay attention to - for example, deterioration of urine pressure or discomfort during ejaculation.

Myth #3: Prostatitis is always linked to infection

- There is also nonbacterial, or abacterial, prostatitis, not associated with the inflammatory process. Risk factors in this case are autoimmune reactions, injuries or stagnation in the tissues of the organ. The bacterial form accounts for only about 10% of cases of visits to a urologist. For an accurate diagnosis, it is necessary to pass a general analysis of urine and the secretion of the prostate gland. It is for this purpose that doctors carry out the procedure of prostate massage, which many men are so afraid of - this manipulation is needed solely to take material and identify an infectious agent, and not at all to treat the disease.

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Myth No. 4: for the prevention of prostatitis, it is enough to have an active sex life

- Regular intimacy with a regular partner really helps reduce the risk of congestion in the prostate gland and supports male health. Regularity alone does not negate basic safety rules. If we are talking about new or accidental connections, the use of contraception comes first, because sexual infections can easily provoke acute inflammation. For prevention, a healthy diet, smoking cessation and regular physical activity are equally important, compensating for a sedentary lifestyle. Adequate exercise helps to avoid abdominal obesity, which increases the risk of cardiovascular disease and reduces the level of male sex hormones. With a deficiency of hormones, men usually complain of constant weakness, when fatigue is felt in the morning, as well as a drop in libido and a deterioration in erection.

Myth No. 5: benign prostatic hyperplasia (adenoma) necessarily degenerates into cancer

- That's a big misconception. Benign prostatic hyperplasia, or BPH, is a benign enlargement of the organ and does not belong to precancerous diseases. The risk of rebirth is extremely small, so in most cases the pathology is successfully treated conservatively. However, men with BPH are at risk for prostate cancer because of a common factor – age. For the purpose of early detection of oncology, doctors recommend an annual test for PSA (prostatic specific antigen) after 45 years. Unfortunately, today more and more cases of prostate cancer are already between the ages of 40 and 45 years. For this reason, urologists advise up to 40 years to visit a specialist at least once even in the absence of any complaints, and after 40 years to undergo a preventive examination every year.

Myth #6: All prostate problems are treated with pills

Drug treatment is effective in the early stages. Depending on the symptoms and test results, the urologist selects a complex scheme: antibiotics fight infection, anti-inflammatory drugs relieve swelling and pain, and alpha-blockers relax muscles and restore urine outflow.

When the disease is started, medications cease to help, and the patient requires surgery. In the practice of doctors, there are often cases when, due to fear of rectal examination, men do not go to the doctor for years. As a result, ultrasound reveals advanced changes to the organ, which can no longer be dealt with without surgery.

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Myth #7: Prostatitis inevitably leads to erectile diffusivity

- Prostate inflammation does cause erectile dysfunction in 20-30% of men, but this complication is not considered inevitable and can be restored. If erectile dysfunction is associated exclusively with the course of prostatitis, competently selected treatment completely eliminates the problem and returns a person to a normal sexual life.

Myth #8: Prostatitis cannot be cured completely

- Acute bacterial prostatitis is completely curable. If we talk about chronic discomfort, then it is important to distinguish gland inflammation from chronic pelvic pain syndrome. Previously, any discomfort in this area was automatically attributed to prostatitis and for years was treated unsuccessfully with antibiotics.

In fact, this condition is often associated with muscle spasm or pinched nerves, so it requires the joint work of a urologist, neurologist and rehabilitator. The syndrome is manifested by aching or burning pain in the perineum and scrotum, difficulties in urination, as well as numbness in the area of the thighs and buttocks. If the tests show the norm, and the symptoms persist, the problem lies not in the gland itself, but in pelvic pain.

Myth #9: Prostatitis affects male fertility

- By itself, prostatitis does not put an end to the possibility of becoming a father. The inflammatory process is indeed able to reduce the quality of ejaculate in 15-25% of men, but after undergoing a course of treatment, reproductive function is usually fully restored.

The real threat to fertility are hidden sexually transmitted infections. Even if they do not cause classical prostatitis, pathogens are able to imperceptibly affect the appendages of the testicles and cause obstruction of the vas deferens, provoking already persistent infertility.

Infection is possible with any form of unprotected contact, so barrier contraception remains the only reliable protection. Remember, prevention is disproportionately cheaper than long-term therapy, which leads to minute carelessness.

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Myth No. 10: with prostatitis, absolutely any physical activity is useful, but spicy food, coffee and alcohol are forever banned

- In matters of lifestyle, men often go to extremes, harming themselves. In fact, not every sport is useful for the prostate gland. For example, long cycling with a narrow rigid saddle, motorsport and lifting heavy weights without performing relaxing exercises often cause hypertonic pelvic floor muscles and pelvic pain.

Physical activity is useful for men's health, but it is important, if there are initial problems and pain, to coordinate possible exercises with your doctor.

As for nutrition, hot peppers, coffee or a glass of wine do not cause prostatitis by themselves. Spices and alcohol can increase the flow of blood and cause discomfort only during the period of active inflammation. In a state of remission, a lifelong fresh diet is absolutely not necessary, it is enough just to follow a reasonable measure.