Prostatitis

Anatomy

Sagittal section of prostate showing relationship to bladder and rectum[/caption]Sagittal section of prostate showing relationship to bladder and rectum The prostate is a gland of the male reproductive system that is located in front of the rectum and just below the bladder. The prostate is small and weighs about 15 to 25 grams. It is about the same size and shape as a walnut. The prostate is wrapped around a tube called the urethra, which carries urine from the bladder out through the tip of the penis.

The prostate is made up largely of muscular and glandular tissues. Its main function is to produce fluid for semen, which transports sperm. During the male orgasm (climax), muscular contractions squeeze the prostate’s fluid into the urethra. Sperm, which are produced in the testicles, are also propelled into the urethra during orgasm. The sperm-containing semen leaves the penis during ejaculation.

Pathophysiology

Although not technically part of the urinary system, the prostate gland is important to the urinary health. That’s because the prostate surrounds the top portion of the tube that carries urine from the bladder (the urethra). Normally, the location of the prostate gland isn’t a problem. But infection or inflammation can cause the gland to swell, squeezing the urethra and affecting the ability to urinate. That’s exactly what happens in prostatitis, although the cause of the inflammation depends on the type of prostatitis.

Prostatitis Types

There are four types of prostatitis, Acute Bacterial Prostatitis, Chronic Bacterial Prostatitis, Nonbacterial Prostatitis, and Prostatodynia.

Acute Bacterial Prostatitis (ABP)

It is inflammation of the prostate gland caused by bacteria such as Escherichia coli and Klebsiella. Severe complications may develop if not promptly treated. ABP can be fatal if the bacterial infection is untreated and travels to the bloodstream (sepsis).

Chronic bacterial prostatitis (CBP)

It is a recurrent infection and inflammation of the prostate and urinary tract. Symptoms are less severe than those associated with acute bacterial prostatitis.

Nonbacterial prostatitis Prostatodynia

It is sometimes called chronic pelvic pain syndrome (CPPS), is the occurrence of prostatitis symptoms, without inflammation or bacterial infection.

Prostatitis Causes

Risk factors include bladder outlet obstruction (e.g., stone, tumor, BPH), diabetes mellitus, a suppressed immune system, and urethral catheterization (i.e., small tube inserted into the bladder through the urethra to drain urine). Some sexually transmitted diseases (STDs; e.g., non-gonnococcal urethritis, gonorrhea) increase the risk for developing bacterial prostatitis. Unprotected anal and vaginal intercourse can allow bacteria to enter the urethra and travel to the prostate.

Acute Bacterial Prostatitis

Bacterial prostatitis is caused by the growth of bacteria that are normally found in prostatic fluid, such as Escherichia coli and Klebsiella. Approximately 80% of organisms causing ABP are aerobic gram-negative organisms (e.g., Escherichia coli, Enterobacter, Serratia, Pseudomonas, Enterococcus, and Proteus species). Urine that flows back into the urethra (urine reflux) that enters the prostate can also cause the condition.

Chronic Bacterial Prostatitis

Sometimes bacteria remain in the prostate following acute prostatitis. Catheter tubes used to drain the urinary bladder, trauma to the urinary system or infections in other parts of the body can sometimes be the source of the bacteria.

Chronic Nonbacterial Prostatitis

  • Heavy lifting: Lifting heavy objects when the bladder is full may cause urine to back up into the prostate.
  • Certain occupations: Occupations that subject the prostate to strong vibrations, such as driving a truck or operating heavy machinery, may play a role. Though biking is a good exercise for the rest of the body, it may irritate the prostate gland.
  • Structural abnormalities of the urinary tract: Narrowing (stricture) of the urethra may elevate pressure during urination and cause symptoms. Sometimes prostatitis is caused by a sexually transmitted organism, such as Chlamydia. However, most cases are caused by infections that are not sexually ransmitted. These infections can’t be passed on to sexual partners.

The acute form of prostatitis is the least common, but is also the most severe. Symptoms are often sudden, and the condition may require hospitalization. Symptoms of chronic prostatitis tend to develop more slowly and aren’t as severe as those of acute prostatitis.

Symptoms of Acute Bacterial Prostatitis (ABP)

Symptoms of acute bacterial prostatitis (ABP) include the following:

  • Fever
  • Chills
  • Frequent urination
  • Painful urination (dysuria)
  • Incomplete emptying of bladder
  • Sensation of having to urinate immediately, often accompanied by bladder pain or spasm (urgency)
  • Pain in penis, testicles, and area between the scrotum and the rectum (perineum)
  • Painful ejaculation
  • Lower back pain
  • Joint pain (arthralgia)
  • Muscle pain (myalgia)
  • Tender, swollen prostate

Symptoms of Chronic Bacterial Prostatitis (CBP)

Symptoms of chronic bacterial prostatitis (CBP) and nonbacterial prostatitis are generally less severe than those of ABP and include the following:

  • Blood in semen (hematospermia)
  • Discomfort in genital area and perineum
  • Dysuria: Pain or a burning sensation when urinating
  • Fever
  • Lower back pain
  • Pain in lower abdomen
  • Painful ejaculation
  • Recurring urinary tract infection (UTI)
  • A frequent and urgent need to urinate
  • Pain in the prostate
  • Excessive urination during the night (nocturia)

Symptoms of Chronic Nonbacterial Prostatitis

Chronic nonbacterial prostatitis is the most common form, yet it’s also the least well understood. Researchers aren’t even sure of the cause.

In general, the signs and symptoms of nonbacterial prostatitis are similar to those of chronic bacterial prostatitis, although fever is generally absent. The major difference, however, is that tests won’t detect any bacteria in the urine or in fluid from the prostate gland. But there may be white blood cells in the urine and semen. Patients with prostatodynia have symptoms of prostatitis but there is no evidence of infection or inflammation.

Prostatitis Diagnosis

A digital rectal examination (DRE) is used to determine if the prostate gland is tender or swollen. To perform a DRE, the physician inserts a lubricated, gloved finger into the patient’s rectum to feel the surface of the prostate gland through the rectal wall and assess its size, shape, and consistency.

A three-part urinalysis is the standard diagnostic tool. Two urine specimens are collected and analyzed, followed by prostate massage and a third urine sample is collected that contains prostatic fluid.

During prostate massage, the physician inserts a lubricated, gloved finger into the rectum to massage the surface of each lobe of the prostate gland, resulting in the release of prostate fluids. Prostate massage should not be used if ABP is suspected because massage may encourage the spread of bacteria.

Urinalysis determines the presence of white blood cells (leukocytes) in the urine. Leukocytes help the body to fight infection; a high number indicates a bacterial infection. A

urine culture is performed to identify bacteria.

Nonbacterial prostatitis is diagnosed when tests reveal no bacteria in the urine or prostatic secretions. There is no test to diagnose:

Prostatodynia: it is diagnosed after eliminating other probable causes (e.g., kidney stones, interstitial cystitis, urethral cancer).

Prostatitis may increase the level of Prostate-specific antigen (PSA) in the blood. PSA is a substance naturally produced in the prostate gland, and high levels in the blood may sometimes – but not always – be a sign of prostate cancer. For that reason, if there is elevation of PSA level and the patient also has acute prostatitis, he should be rechecked after he has been treated with antibiotics.

Videourodynamics: In cases where there is a history of chronic prostatitis, evaluation of potential contributing factors or underlying causes is done. Videourodynamics is a special examination that analyzes bladder function and the flow of the urine in the urinary tract. For instance, in patients with chronic prostatitis, this test can be helpful to find out whether any structure is producing blockage of the urinary tract.

Benign Prostatic Hyperplasia (BPH) or Prostate Enlargement

Prostate enlargement is as common a part of aging as gray hair. As life expectancy rises, so does the occurrence of BPH. BPH is not a life-threatening disorder, but its symptoms can be quite troublesome and distressing.

What is Benign Prostatic Hyperplasia (BPH)?

BPH is a non-cancerous enlargement of the prostate gland. BPH stands for benign prostatic hyperplasia (also known as Benign Enlargement of Prostate or BEP). As age advances, the prostate gland slowly grows bigger (or enlarges). The word “benign” means the enlargement that it isn’t cancerous. The word “hyperplasia” means enlargement. Because the prostate surrounds the urethra, when it gets bigger, it may press on the urethra. This may pose difficulty in passing urine. The individual usually seeks medical advice for these urinary problems rather than complaints of prostate per se.

Incidence

BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90% in their seventies and eighties have some symptoms of BPH.

What happens in BPH?

As the prostate enlarges, the capsule or membrane surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. As a result, the bladder has to work harder to empty the urine. Thus the gland becomes thicker and prone to excessive contractions. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Over the time, this extra effort causes the bladder muscle to weaken and lose the ability to empty itself. As a result urine remains in the bladder even after urination. The combination of these problems leads to the discomfort and complications associated with an enlarged prostate.

Common Symptoms of an Enlarged Prostate

Most symptoms of BPH start gradually over the time. Many symptoms of BPH stem from obstruction of the urethra and gradual loss of bladder function. The symptoms of BPH vary, but the most common ones are as follows:

  • Urinary frequency (especially at night)
  • Urinary urgency
  • Decreased force of stream
  • Difficulty in starting to pass urine (Hesitancy)
  • Sensation of incomplete emptying
  • Dribbling of urine especially at the end of the stream.
  • Burning on urination; chills and fever whenever infection has set in.
  • Overflow incontinence or total retention: As the condition worsens, the bladder cannot expel urine and it becomes distended. This can cause swelling and pain in the abdomen. If the pain is severe or if only a few drops of urine can be passed, this is called acute urinary retention and needs immediate medical treatment.

What Causes BPH?

It is still uncertain as to what causes BPH, but it may be linked to changes in hormone levels caused by the ageing process.

Throughout their lives, men produce testosterone, an important male hormone, and small amounts of estrogen, a female hormone. As men ages, the amount of active testosterone in the blood decreases, leaving a relatively higher proportion of estrogen. Studies done have suggested that BPH may occur because the relatively higher amount of estrogen, which within the gland increases the activity of substances that promote cell growth.

It appears that some cases of BPH may be forms of prostatitis. Patients with the same symptoms are often diagnosed with prostatitis if they are under 50 and with BPH if they are older. There is also speculation that untreated prostatitis can eventually become BPH.

How the Condition is Diagnosed?

One may first notice symptoms of BPH himself, or the doctor may find that the prostate is enlarged during a routine checkup. Several tests help the doctor confirm the problem. The tests vary from patient to patient, but the following are the most common

  • History
    As a first step in diagnosis, the doctor will ask a set of questions to rate the severity of urinary symptoms.
  • A rectal exam is the next step
    It is called as Digital Rectal Examination (DRE). Since the prostate is an internal organ, the physician cannot look at it directly. However, the prostate lies in front of the rectum and the doctor can feel it by inserting a gloved finger into the rectum. This exam gives the doctor a general idea of the size, shape, and consistency of the gland.
  • Urine Flow Study
    Sometimes the doctor will ask a patient to urinate into a special device, which measures how quickly the urine is flowing. A reduced flow often suggests BPH.
  • Intravenous Pyelogram (IVP)
    IVP is an x-ray of the urinary tract. In this test, a dye is injected into a vein, and the x-ray is taken. The dye makes the urine visible on the x-ray and shows any obstruction or blockage in the urinary tract. One of the extensions of this test is Post-voiding cystogram. In this the patient is asked to void or empty the bladder completely and then X-ray is taken to see how much urine is left in the bladder following voiding.
  • Cystoscopy
    In this exam, the doctor inserts a small tube through the opening of the urethra in the penis. This procedure is done after an anesthetic solution is applied inside of the penis so all sensation is lost. The tube, called a cystoscope, contains a lens and a light system, which help the doctor see the inside of the urethra and the bladder. This test allows the doctor to determine the size of the gland and identify the location and degree of the obstruction.If the prostate gland is enlarged it can be either due to BPH or prostate cancer. Diagnosis of BPH can be confirmed by ruling out possibility of prostate cancer. To do so the doctor may do following tests.
  • Prostate Specific Antigen (PSA) Blood TestIn order to rule out cancer as a cause of urinary symptoms, the doctor may recommend a PSA blood test. PSA, a protein produced by prostate cells, is frequently present at elevated levels in the blood of men who have prostate cancer.
  • Rectal Ultrasound
    If there is a suspicion of prostate cancer, doctor may recommend a test with rectal ultrasound. In this procedure, a probe inserted in the rectum directs sound waves at the prostate. The echo patterns of the sound waves form an image of the prostate gland are seen on a display screen.

In addition urine will be tested for infections and a blood test may be needed to check the function of the kidneys.

Prognosis

Approximately one third of men with enlarged prostates progressively worsen and require medical or surgical intervention. But one good point is that it is not cancer and there is no proof that it can lead to cancer.

Complications

If the bladder does not empty completely, urinary retention can lead to potentially serious complications. The stagnant urine is a prime location for the growth of bacteria, which makes urinary-tract infection common. Also, urinary stones can form in the bladder lining due to an accumulation of debris and chemicals. Other problems include blood in the urine from broken blood vessels, of the prostate. Unchecked, urinary retention can become so severe that urine backs up into the kidneys, potentially leading to kidney malfunction.

It is possible to avoid surgery….

In cases of BPH decades-long notion is to remove the gland. However homoeopathy can treat these problems gently, effectively, without using knife. As now perceived BPH is thought to be related to aging process and hormonal deviations associated with it. Homeopathy, which works at deep, constitutional level, brings back these deviations to normal, thus preventing further enlargement. To certain extent it can shrink the enlarged gland. Moreover relief of symptoms associated with urinary problems obtained with homoeopathy is without the side effects of surgery.

The common conventional practice followed for treatment of BPH is surgery, which is of course not without side-effects. However, it is possible to avoid surgery with timely administered homeopathic medicines.

Homeopathy for Prostate Diseases

The system of homeopathic medicine has a promising role to offer for the treatment of various diseases associated with prostate gland, inclusive of all its variants. Homeopathy, a branch of alternative medicines, can address majority of these problems effectively, gently and without using knife.

Homeopathic Approach towards Prostate Diseases

The unique feature of Homeopathy philosophy is that Homeopathy aims at treating the patient who is diseased rather than merely treating the diseased organs of the patient. ‘Treat the patient, not the disease’ is a dictum practiced by homeopaths over 200 years. This simply means that the disease should not be treated superficially as if it is an independent entity in the body. Instead it is perceived that every disease is a result of the dysfunction of the whole body, as every system in the human body is interlinked. When we approach the patient with the idea of ‘treating the patient and not the disease,’ it is important to note that the disease gets automatically treated when the ‘patient as a whole’ is treated.

This holds true with prostate diseases also. Whether it is prostatitis or prostate enlargement Homeopathy perceives this as total affliction of body and not of the prostate gland alone.

The basic approach in homeopathy is to evaluate the diseases of prostate in its whole extent, whereby a lot of emphasis is given to the patient as a whole besides minutely studying various aspects of the prostate disorders. This is called as totalistic approach.

Moreover, homeopathy firmly believes in enhancing body’s own curative power to maintain the healthy status. The homeopathic approach is to enhance body’s own healing capacity so that the deep-rooted maladies can be removed from the roots.

Constitutional Approach

As per the classical homeopathy, we believe in constitutional prescribing. It can be easily perceived that no two individuals are identical. Out physique, emotions, life styles vary so much from one another. Same holds true with disease. Everybody experiences same disease in different ways. This calls for individual case study in every case of Prostate disease. There is no single specific remedy for all the cases of Prostate disorders. To make it simple Homeopathy provides tailor-made solution to suit one’s unique constitution.

What is the Constitutional Approach?

What we understand by the Constitutional Approach in homeopathy is nothing but analysis and evaluation of various factors affecting the human constitution to determine the disease diagnosis and the exact treatment in turn. Every case of prostate malady calls for study of the patient’s constitution, which includes various aspects of his physical ailments as well as the in-depth study of the mental sphere, such as emotions, psychosocial background, and behavior and personality pattern.

Homeopathy case analysis for Prostate Disorders

Every patient of Prostate disease is evaluated as an individual case and treated as such. While making the case analysis of patient having prostate affliction patient’s minutest of the details about the presenting complaints are noted carefully, as regard to the severity of pain, various urinary complaints, associated complaints, triggering factors, extent of enlargement of the gland or elevations in PSA levels of blood, etc. Besides, a grater deal of emphasis is given to patient’s individual features such as eating habits, food preference, thermal attributes, and sleep pattern. The study of the patient’s mind and emotional spheres is conducted meaningfully. Furthermore, patient’s history of past diseases and that of the family diseases is understood to know the miasmatic background of the patient.

Role of Homeopathy Medicines

After putting all the vital information together, and fine evaluation process carried out, an individualist medicine is determined. This constitutional medicine, which when administered in the correct dose treats the patient at an inner level and brings about harmony at the constitutional level.

In patients of prostatitis, the Homeopathy medicines help reduce the inflammation of the gland and surrounding structures. The pain associated with this condition usually subsides with Homeopathic medication. In cases of acute prostatitis Homeopathy can be the best substitute to antibiotics. More over problems of ‘resistance of bacteria’ as faced by antibiotic do not exist with Homeopathy This is because Homeopathy rather than killing bacteria by itself enhances body’s own immunity so that body can kill bacteria.

In cases of non-infectious chronic prostatitis and prostatodynia where the exact cause cannot be pinpointed Homeopathy has definitely upper hand over conventional mode of treatment. With recent advances these conditions are believed to be allergic or autoimmune in nature. As Homeopathy can bring deviations of immune system back to normalcy, the problem is taken care of without suppressing body’s defense system, as done by conventional immunosuppressive drugs. Moreover Homeopathy truly understand role of psyche at the root of various conditions including prostatitis. The rightly chosen Homeopathic medicine makes an individual emotionally stronger to bear stress of life more positively.

In cases of BPH decades-long notion is to remove the gland. However Homeopathy can treat these problems gently effectively without using knife. As now perceived BPH is though to be related to aging process and hormonal deviations associated with it. Homeopathy, which works at deep, constitutional level, brings back these deviations to normal, thus preventing further enlargement. To certain extent it can shrink the enlarged gland. Moreover relief of symptoms associated with urinary problems obtained with Homeopathy is without the side effects of surgery.

There is an important consideration while starting treatment for prostate cancer in early lesions, which are entirely a symptomatic and discovered incidentally. Many of these patients may be very old and the treatment if too radical could have possibly more side effects and risks, which could outweigh the possible benefits the patient would derive from it. It is possible to mange such cases efficiently with Homeopathy Moreover Homeopathy can be the best option to produce palliative treatment.

Homeopathy Medicines

There are over 3000 medicines in homeopathy used for a range of problems. About twenty or more are often indicated for the cases of prostate disorders. It should be noted that there is no single specific medicine for prostate diseases. For every individual medicine is selected to the basis of constitutional approach.

General Management

The Scope of Homeopathic Treatment in BPH

There is good scope of improvement of the symptoms with Homeopathic treatment in the following cases of BEP:

How to get started with the Treatment?

  1. Homeopathy is very effective in all stages and variants of prostate diseases.
  2. It is possible to manage prostatic enlargement with Homeopathy rather than undergoing surgery.
  3. In chronic prostatitis and prostatodynia Homeopathy can be the best substitute to conventional treatment.
  4. Considering the old age at which prostate cancer is diagnosed and potential harmful effect of conventional aggressive treatment, Homeopathy can be the best possible palliative treatment.
  5. It may be taken along with traditional medicines prescribed by physician.
  6. It helps arrest further progress of disease and hence deterioration caused by disease.
  7. It significantly helps to reduce the relapse and recurrence of condition. It treats the disease from root and not merely superficially.
  8. It is absolutely safe, harmless, and non-toxic. It does not interfere with other medicines.
  9. Duration of Homeopathy treatment varies from person to person and depends on extent of the disease, since how long the patient has the problem, general state of health of the patient, size of the gland etc.

General Management

  • Self care: Drink plenty of water.
  • Limit or avoid alcohol, caffeine and spicy foods
  • Urinate at regular intervals.
  • If you’re a cyclist, use a “split” bicycle seat, which reduces the pressure on your prostate.

The scope of Homeopathic Treatment in BPH

There is good scope of improvement of the symptoms with Homeopathic treatment in the following cases of BEP:

  • Cases in which the residual urine is usually less than 90 to 100 ml
  • Cases in which the weight of the prostate gland is not more than 60-70 gms
  • Cases in which malignancy of the prostate gland has been ruled out

Best Homeopathic Doctor & Treatment for Prostatitis in India. Just Call at +91 8264408264 and make an appointment. Get homeopathic treatment with Dr. Vikas Singhal. At Dr. Singhal Homeo, you can get an online video consultation in India, as well as in Lithuania, France, Spain, Italy, Macau, Thailand, Hong Kong, Nigeria, Australia, the United States, the United Kingdom, Scotland, Austria, Canada, and Singapore.