Long term pelvic pain in men- could it be prostatitis?

Movember tradition has raised awareness of men’s health and concerns.

This has historically been a tricky area for men to discuss and consult on. Breaking through these barriers and raising awareness will improve early diagnosis and better management.

A common condition that we see in General practice is Prostatitis, which is inflammation of the prostate. This is a gland that is present in men, just below the bladder. The prostate helps to make semen.

It is the most common urological diagnosis in men aged under 50 years, and the third most common urological diagnosis in men aged over 50 years. 

Prostatitis can present acutely (suddenly) or be a chronic condition (lasting more than 3 months)

Symptoms:

1. Pain:

Pain or discomfort in multiple urogenital regions including perineum, testicles, penis (especially penile tip pain), suprapubic region. This can come and go in the chronic form of prostatitis

It also can affect your lower back, abdomen, groin and rectum (painful to pass stool)

2. Lower urinary tract symptoms:

Voiding symptoms with a weak sand difficult to initiate urination

Urinary storage symptoms with passing urine more frequently, painful and possible incontinence issues

Discharge from the penis (mainly in the acute form with sexual transmitted infections)

3. Sexual dysfunction:

Erectile dysfunction, ejaculatory dysfunction (premature, delayed or painful), erectile, decreased libido

Blood in sperm

4. Other:

Fever and feeling unwell especially in the acute form of prostatitis

Investigations:

• Urine testing for infection (STI or urinary tract infection).
• PSA blood tests (Prostate specific Antigen).
• Imaging of the prostate (Ultrasound or MRI).
• If suspicious, might need a prostate biopsy to rule out cancer

Treatment:

• Antibiotics – especially if the cause is a urine infection or STI
• Pain killers.
• Alpha blockers – a medicine used to relax the muscle tissue of the prostate
• Other medicines – such as Stool softeners: to help with painful defecations
• Stress management – to help with long term pain
• Shock wave treatment – new evidence showing that this can help for long term pain that is not responding to conventional treatment.
• No man should suffer in silence. If you are affected by any of these symptoms, please get in touch with us so we can help.

If you have any questions we do encourage you to get in touch with one of our specialists.

For more info:

https://prostatecanceruk.org/prostate-information/further-help/prostatitis

References

1. Coker, T.J. and Dierfeldt, D.M. (2016) Acute bacterial prostatitis: diagnosis and management. American Family Physician93(2), 114-120.