Prostatitis

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Latest Edit: Hector 2014-05-14 (EDT)

Prostatitis affects 1 in 2 men at some point during their lifetime. Although the term prostatitis suggests an inflammatory nature, inflammation and infection are not always present. Prostatitis can be defined into several categories including acute bacterial, chronic bacterial, chronic abacterial, inflammatory, noninflammatory, and asymptomatic.[1]

Prostatitis
Causes Environmental Chemicals, Smoking, Infections, Dietary Factors, Stress, Physical Inactivity
See Also Men's Health, BPH, Erectile Dysfunction, Liver Cirrhosis, Hypertension, Urinary Tract Infection
Books Books on Men's Health
Articles Articles on Men's Health

Naturopathic Assessment

Causal Factors

In order to stimulate the innate ability of the body to heal the causes of disease must be identified and addressed. With prostatitis, the causes are variable and include Infections and environmental factors. A detailed assessment is required to determine which factors are contributing to the development and progression of prostatitis.

Lifestyle

  • Food intolerances may trigger or aggravate symptoms of prostatitis.
  • A diet high in fruits and vegetables, and a moderate consumption of soy products are associated with decreased risk of prostatitis.[1]

Environmental

  • UTI-associated microbes
  • Several gram-negative and gram-positive bacteria associated with urinary tract infections are also implicated in acute and chronic bacterial prostatitis. Bacterial causes of prostatitis include E. coli, Pseudomonas aeruginosa, Serratia species, Klebsiella species, Enterobacter aerogenes, Staphylococcus saprophyticus, and Staphylococcus aureus.[2]
  • Sexually Transmitted Infections
  • Men with prostatitis have a higher rates of Chlamydia trachomatis, but the role chlamydia may play in prostatitis is unclear.[2]
  • Candida, aspergillosis, and coccidioidomycosis have been implicated in prostatitis in immune compromised individuals.[2]

External

  • Exposure to chemical irritants may be associated with the development of bacterial prostatitis.[1]

Diagnostic Testing

  • A CBC, urinalysis, and urine culture are routinely performed in cases of acute and chronic prostatitis. A blood culture may be performed in immunosuppressed individuals.
  • A semen analysis may be indicated if an individual also suffers from infertility.
  • PSA monitoring is indicated in chronic prostatitis.
  • Imaging Studies [3]
  • Transrectal ultrasonography (TRUS) can be useful in diagnosis and to differential prostatitis from an abscess.
  • CT scan may be used to rule out other pelvic pathologies.
  • Biopsy may be required to rule out prostate cancer.

Related Symptoms and Conditions

Conditions related to prostatitis include:[3]

Characteristics

Prostatitis presentations can be subdivided into the following categories:[1]

Article The Emerging Diagnosis of Lower Urinary Dysfunctional Epithelia: Comparison with Prostatitis and Interstitial Cystitis, NDNR, 2011 November
Article Prostatis: Follow-Up to ‘A Ball of Fire’, 2010 October NDNR
  1. Acute bacterial accounts for up to 5% of cases and is attributed to an identifiable urinary pathogen. Acute in nature and involves systemic symptoms.
  1. Chronic bacterial accounts for up to 5% of cases and is attributed to an identifiable urinary pathogen. Chronic in nature with no systemic symptoms.
  1. Chronic abacterial accounts for up to 90% of cases and is not attributed to any identifiable urinary pathogen.
Inflammatory white blood cells are present in semen, prostatic secretions, or urine.
Noninflammatory essentially no white blood cells in semen, prostatic excretions, or urine.
  1. Asymptomatic inflammatory has no apparent symptoms, white blood cells incidentally found in secretions.

Common Symptoms

Signs and symptoms of prostatitis include:[3]

  • Perineal, penile, testicular, and/or hypogastric pain
  • Dysuria
  • Painful ejaculation
  • Incomplete voiding
  • Fever
  • Chills

Naturopathic Treatment

The goal of naturopathic treatment is to support and work in tandem with the healing power of the body and to address the causal factors of disease with individual treatment strategies.

It is always advisable to work with a naturopathic doctor before engaging in any treatment plan.

Home Care

Home Care strategies include:

  • Quit smoking
  • Avoid wearing restrictive clothing especially around the waist or legs.
  • Prostatic massage and/or regular ejaculation may be an effective adjunct to therapy in some patients.[2]

Lifestyle

Lifestyle recommendations include:

  • Tomatoes and spicy foods are common triggers.
  • Adding garlic to the diet may be beneficial.
  • Consume a diet that focuses on whole unprocessed food (whole grains, legumes, vegetables, nuts and seeds).
  • A low purine diet may be able to beneficial.[4]
  • Increases fruit and vegetable intake, as well as intake of soy products can reduce inflammation associated with prostatitis.[1]
  • Regular exercise has been shown to improve symptoms of prostatitis. [1]
  • Stress may worsen prostatitis symptoms. Appropriate stress reduction and relaxation techniques can help to reduce overall stress levels.[1]

Naturopathic Therapies

Naturopathic Therapies for prostatitis include:

  • Acupuncture- Studies have shown that acupuncture is safe and effective when used to reduce pain associated with prostatitis.[7]
  • Sitz Bath- Sitz baths may help to increase blood flow to the prostate, may reduce inflammation and increase immune function.[1]
  • Prostatic massage- Prostate massage is most effective in cases of chronic bacterial prostatitis when accompanied by antibiotic therapy.[8]
  • Physical Therapy- pelvic floor reeducation, biofeedback, and relaxation techniques may all help to reduce the pelvic pain associated with prostatitis.[9]

References

Reviewed by Iva Lloyd, BScH, RPE, ND [1]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 McClure MW (2007) Rakel: Integrative Medicine 2nd ed Chap 60 Chronic Prostatitis Saunders
  2. 2.0 2.1 2.2 2.3 Nickel CJ (2011) Wein: Campbell-Walsh Urology 10th ed Chap 11 Prostatitis and Related Conditions, Orchitis, and Epididymitis Saunders
  3. 3.0 3.1 3.2 3.3 3.4 Ramakrishnan K (2010) Prostatitis: Acute and Chronic Prim Care; 37(3):547-563
  4. 4.0 4.1 Motrich RD, Olmedo JJ, Molina R, et al (2006) Uric acid crystals in the semen of a patient with symptoms of chronic prostatitis. Fertil Steril 85(3):751 PMID:16500353
  5. Murray Michael 1996 Encyclopedia of Nutritional Supplements, The Essential Guide for Improving Your Health Naturally Prima Publishing
  6. Hershoff Asa 2000 Homeopathic Remedies, A Quick and Easy Guide to Common Disorders and their Homeopathic Treatments, Avery Publishing Group, New York
  7. Lee et al (2008) Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain Am J Med ;121(79):1-7.
  8. Nickel JC, Downey J, Hennenfent B (1999) Repetitive prostatic massage therapy for chronic refractory prostatitis: The Philippine experience. Tech Urol:5:146-151
  9. Clemens JQ, Nadler RB, Schaeffer AJ, et al (2000) Biofeedback, pelvic floor re-education, and bladder training for male chronic pelvic pain syndrome Urology 56:951-955