The Relationship Between Chronic Prostatitis and BPH

Prostatitis (acute or chronic) is the third most common urogenital disease in men, after prostate cancer and benign prostatic hyperplasia (BPH). It is seen in 8% of men under the age of 50.

How does chronic prostatitis develop?

Although it can arise in different ways, the most common form of inflammation is lymphocytic infiltration into the stroma adjacent to the acini.

Factors that cause chronic prostatitis

• Structural disorders of the bladder neck and urethra — such as BPH and urethral stricture — that cause dysfunctional voiding and increase the pressure of the urine flow

• Urine reflux into the prostatic ducts is the most important factor.

• Immune changes

• Causes of cystitis

• Pelvic floor disorders

• Psychological causes

Classification of prostatitis

Category 1: Acute bacterial prostatitis

Category 2: Chronic bacterial prostatitis

3. Chronic pelvic pain syndrome

A) Inflammatory CPPS

1. B) Non-inflammatory CPPS

2. Asymptomatic inflammatory prostatitis

Treatment of Prostatitis

1. and the diseases in category 2 are mostly treated either in hospital or on an outpatient (at-home) basis with antibiotics and anti-inflammatory medications.

Asymptomatic inflammatory prostatitis in category 4 is a form of prostatitis that causes no specific symptoms; it may be associated with BPH, prostate cancer and infertility, and it has no specific treatment.

What are the signs of chronic prostatitis (chronic pelvic pain syndrome)?

In chronic pelvic pain syndrome, which belongs to category 3, the most frequent — and sometimes the only — key symptom is pain felt in the genital area. In most patients, the pain is accompanied by symptoms such as frequent urination, a sudden urge to urinate and an intermittent urine stream. Pain may also occur during or after ejaculation following sexual activity.

Treatment of chronic prostatitis (chronic pelvic pain syndrome)

Because it significantly affects patients' quality of life and often fails to respond to treatment, this condition has long been very challenging for both patients and urologists. Patients in this group have used a great number of antibiotics and anti-inflammatory medications over many years. In very difficult cases, alternatives have even gone as far as complete removal of the prostate.

Similarities between chronic pelvic pain syndrome and BPH

As mentioned above, chronic prostatitis (CPPS) shares common symptoms with what is popularly known as prostate disease — benign prostatic hyperplasia (BPH) — such as an intermittent urine stream, frequent urination, burning during urination and discomfort during ejaculation. Patients are often followed up for BPH for many years before receiving a diagnosis of chronic prostatitis.

Differences between chronic pelvic pain syndrome and BPH

Once a patient begins to notice BPH-related symptoms, he usually consults a urologist; despite undergoing the necessary tests, he is generally told that no abnormality has been found and is sent home. This scenario repeats itself countless times over the years. The patient continues to suffer from his complaints. He turns to many alternative approaches, and these are usually treatments intended as alternatives for BPH.

Chronic pelvic pain syndrome and today's technology

For these patients, shock wave therapy (ESWT) now offers a new-generation treatment protocol. It shows a high rate of success in relieving the symptoms of patients with chronic prostatitis and helping them regain their former lives. Patient feedback shows how important new blood vessel formation and tissue regeneration are in suppressing the inflammation seen in chronic prostatitis.

Chronic prostatitis (CPPS) and shock wave therapy (ESWT)

With the start of ESWT sessions, a rapid reduction in symptoms and a marked improvement in patients' psychological state begin to be seen at very early stages. As tissue healing is completed, patients regain control of their lives in the following period. Compared with the procedures applied to patients with advanced symptoms (such as prostate operations or injections into the prostate), it offers a treatment protocol that fits the natural flow of life very well and has a very high success rate. After painless sessions lasting 15-20 minutes, patients return to their daily activities immediately and enjoy the advantages of a complication-free treatment.

What should patients with urinary complaints do?

First of all, they should of course have their general examinations performed under the supervision of a urologist. If the findings reveal no specific condition (such as stones, BPH or cancer), they should be informed about chronic prostatitis (CPPS) in line with the severity of their complaints.