Prostatitis, Chronic Pelvic Pain and Cystitis

Prostatitis means inflammation of the prostate gland. These can be acute (febrile) or chronic, and can be of bacterial origin (infectious prostatitis) or non-bacterial origin (abacterial prostatitis). Sometimes, there are only symptoms originating from the prostate without any demonstrable inflammation or infection.

Prostatitis

Prostatitis is the inflammation of the prostate gland. This inflammation can be acute (febrile) or chronic and, in turn, can have a bacterial origin (infectious prostatitis) or a non-bacterial origin (abacterial prostatitis).

Sometimes, symptoms originate from the prostate without any evidence of inflammation or infection. This condition is called prostatodynia.

What is the treatment for prostatitis?

Treatment is pharmacological and will depend on the patient's needs and the intensity of the discomfort. Patients may take antibiotics, anti-inflammatories, or alpha-blockers (medication that relaxes the muscle fibers and neck of the bladder, thus reducing symptoms).

Other times, prostate pain gives rise to chronic pelvic pain or coexists with these conditions, which are difficult to treat and often produce a great alteration in the quality of life of the patients.

Chronic pelvic pain

Chronic pelvic pain is pain in the lower abdomen. It can be constant or intermittent (coming and going). In terms of intensity, it can range from a dull but constant discomfort in the pelvis to an intense, stabbing pain in the lower abdomen that prevents patients from performing everyday activities.

In men, it may be related to prostatitis or other urological or prostate problems. The situation is different for women, as they may experience these pains during menstruation or during sexual intercourse. This occurs when there is a problem in one of the pelvic organs (fallopian tubes, uterus, ovaries, vagina, etc.). Both men and women may experience inflammatory, urinary, digestive, genital, or musculoskeletal symptoms.

How is it detected? What tests are performed?

The main goal is to find the cause of the pain, so a pelvic examination will be performed, including a rectal and/or vaginal exam. Sometimes imaging or microbiological tests are necessary, although generally the specialist will recommend the tests needed to determine the origin of the problem.

How is chronic pelvic pain treated?

Depending on the intensity, frequency, and origin of the pain, the specialist will recommend one treatment or another. In any case, the treatment of chronic pelvic pain requires a multidisciplinary team that includes a pain management unit, a physiotherapy unit, neurophysiologists, and urologists. This team works together to treat the patient's pain and thus improve their quality of life.

  • Drug treatment: Pain relievers, muscle relaxants, antidepressants may be recommended…
  • Hormonal treatment: This type of treatment is recommended to alleviate pain associated with menstruation or endometriosis.
  • Physical therapy: This may include pelvic floor exercises, relaxation techniques, massage, or stretching. It is usually recommended for people whose pain originates from muscle activity.
  • Psychological therapy: Helps the patient cope with the symptoms.
  • Lifestyle: Sometimes it is recommended to change postural hygiene, make changes in diet and finally include exercise routines.
  • Surgery: As with everything mentioned above, it depends on the origin of the problem, and although its role is minimal, it can sometimes be necessary.

Within the group of pathologies associated with chronic pelvic pain is radiation cystitis, which is a type of problem that appears as a side effect of another cancer treatment.

Radiation cystitis

Cystopathy refers to any disease of the urinary bladder, and one of the pathologies within this group is radiation cystitis, a complication resulting from radiotherapy treatment. The treatment itself affects the bladder cells, causing pain, difficulty urinating, and even blood in the urine.

How is this condition treated?

There are three treatment options for this condition, and as always, they will depend on the patient, their symptoms and needs, and the specialist's recommendation.

  • Intravesical therapy: Intravesical instillations of hyaluronic acid are the most prominent treatment. In severe cases, endovesical aluminum or bladder formalin may be used.
  • Drug therapy: There are different treatments such as estrogen therapy, pentosan polysulfate, oral aminocaproic acid, or recombinant factor VIIa.
  • Physical therapies include internal iliac artery embolization, cystectomy, and balloon distension. Hyperbaric oxygen therapy is also included as a non-surgical treatment. Exposure to hyperbaric oxygen has proven effective in alleviating the symptoms of these patients.

Addiction

Dr. Daniel Zarza Luciáñez
Dr. Luis Llanes González

Addiction

Dr. Belén Carrero García
Dr. Rafael Medina
Dr. Belén Congregado Ruiz
Dr. Ignacio Osmán
Dr. José Miguel Arroyo Maestre

Treatments

Intraprostatic injection of antibiotics
Pelvic floor physiotherapy

Diagnostic tests

urodynamic study
Multiparametric nuclear magnetic resonance imaging of the prostate
WHAT IS PARURESIS OR SHY BLADDER SYNDROME?

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