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Alpha Blocker Improves Symptoms of Chronic Prostatitis

Recent findings show that treatment with a specific alpha blocker helps reduce symptoms and improve quality of life for men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).  This alpha-blocker, called silodosin, works by selectively relaxing the muscles in the neck of the urinary bladder and prostate.  It has been approved in Canada, the United States, the EU and Japan to treat symptoms of another prostate gland condition, benign prostatic hyperplasia, which is commonly referred to as an enlarged prostate.

Although CP/CPPS is the most common form of prostatitis, it is the most misunderstood and difficult to treat because the symptoms are very similar to other conditions and requires a significant amount of testing and screening to identify.

Curtis Nickel, a professor in the Department of Urology, practicing urologist at Kingston General Hospital and Canada Research Chair in Urologic Pain and Inflammation, emphasized that antibiotics are commonly used as a treatment, but they are not typically effective.  This could be because CP/CPPS does not seem to be caused by a bacterial infection.

CP/CPPS is a debilitating condition; patients with this condition suffer from discomfort in the lower pelvic area including the bladder area, testicles, and penis.  Symptoms may be severe and can include painful and frequent urination and difficult or painful ejaculation.  The cause of CP/CPPS is not known.

In Dr. Nickel’s study, about 60 percent of men reported feeling better after treatment with silodosin as opposed to 30 percent of participants who were given a placebo.  These results for patients feeling better is higher than a similar study he conducted several years ago that tested the effects of a different alpha blocker.

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Chronic Pelvic Pain Syndrome (CPPS)

Although prostatitis is often described as an infection of the prostate, it can also be an inflammation with no sign of infection.  In fact, only 5% to 10% of cases are actually caused by bacterial infection. It does not raise the risk of getting prostate cancer.

The condition affects men of all ages. According to the National Institutes of Health, prostatitis may account for up to 25% of all office visits for complaints involving the genital and urinary systems from young and middle-aged men. It is  the number-one reason men under the age of 50 visit a urologist.

The most common form of Prostatitis is Chronic nonbacterial prostatitis/chronic pelvic pain syndrome  which accounts for 90% of the cases. The condition is marked by urinary and genital pain for at least three of the past six months. Patients have no bacteria in their urine, but may have other signs of inflammation. The condition can sometimes be confused with interstitial cystitis (a chronic inflammation of the bladder).

Treatments for chronic noninfectious prostatitis may include the use of the alpha blocker drugs which relax the muscles of the prostate and bladder to improve urine flow and alleviate symptoms.  Some people may benefit from lifestyle changes including avoiding spicy foods, caffeine or acidic drinks. Activities  such as bicycling which aggravate the condition, may need to be eliminated as well.

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Definition of Prostatitis

Prostatitis: Inflammation of the prostate gland, a very common health concern, accounting for up to 25% of all medical office visits by young and middle-age men for problems relating to the genital and urinary systems.

The prostate is a small organ about the size of a walnut that is situated below the bladder (where urine is stored) and surrounds the urethra (the tube that carries urine from the bladder). The prostate normally produces a fluid that becomes part of the semen, the white fluid that contains the sperm.

There are 4 types of prostatitis:

•           Acute bacterial prostatitis is the least common type. It often causes chills, fever, pain in the lower back and genital area, body aches, burning or painful urination, and the frequent and urgent need to urinate. The urinary tract is infected, witness the white blood cells and bacteria in the urine. Treatment is with antibiotics.

•           Chronic bacterial prostatitis is also relatively uncommon. It is acute prostatitis superimposed on a defect in the prostate, which becomes the focal point for the persistent bacterial infection. Effective treatment requires identification and correction of the defect in the prostate and then antibiotics.

•           Nonbacterial prostatitis is the most common and least understood form of prostatitis. It is a chronic, painful condition. Symptoms go away and then come back without warning. The urine and fluid from the prostate show no evidence of a known infecting organism, but the semen and other fluids from the prostate contain cells that the body usually produces to fight infection. Treatment with antibiotics and drugs that relax the muscles of the prostate gland often fails. This form of prostatitis can be associated with other diseases, such as Reiter syndrome.

Prostatodynia is similar to nonbacterial prostatitis with regard to symptoms, age of patients, and ineffectiveness of treatment. However, there are no objective findings, such as the presence of infection-fighting cells, in the urine of men who suffer from prostatodynia.

Article courtesy of Medicinenet.com

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