Researchers say it doesn't work with most men because they have a form called chronic nonbacterial prostatitis, which is particularly hard to treat. But, as the latest edition of Harvard Medical School's Perspectives on Prostate Disease describes, urologists are changing their thinking about nonbacterial prostatitis and its treatments.
Chronic nonbacterial prostatitis -- more commonly known as chronic pelvic pain syndrome -- is not life-threatening. However, it can cause debilitating symptoms, including constant pain, difficulty urinating, and burning while urinating or ejaculating.
Harvard urologist Dr. Michael O'Leary notes that the broad range of symptoms suggests that these problems may not all be related to the prostate itself, but may in fact originate in the muscles, ligaments, and nerves around the prostate.
One of the new treatments Dr. O'Leary recommends is alfuzosin, an alpha blocker conventionally used for treating an enlarged prostate gland. The drug works on the whole pelvic floor, not just the prostate.
The latest issue of Perspectives on Prostate Disease describes this and other medications recommended by Dr. O'Leary. It also provides an in-depth look at the complexities of diagnosing and treating chronic pelvic pain syndrome and explains how it differs from other forms of prostatitis.
Prostatitis has been classified by the National Institutes of Health (NIH) into four categories. Category 1 is acute bacterial prostatitis. Category 2 is chronic bacterial prostatitis. Category 3 includes the conditions previously known as nonbacterial prostatitis, prostatodynia and chronic pelvic pain syndrome.
Category 4 is asymptomatic inflammatory prostatitis. Researchers at the Mayo Clinic say pain relievers and several weeks of treatment with antibiotic are typically needed for category 1 and 2 prostatitis, which are bacterial infections.
A variety of treatments as well as self-care measures also can provide relief. Treatment for category 3 prostatitis (nonbacterial) is less clear and mainly involves relieving symptoms. Category 4 prostatitis is usually found during examination for another reason and often doesn't require treatment.
Prostatitis can be difficult to diagnose, in part because its signs and symptoms often resemble those of other conditions, such as bladder infections, bladder cancer or prostate enlargement due to benign or cancerous growth of the prostate.
