Symptoms of Chronic Prostatitis can be
classified as follow:
 Pain
Urinary disorders
Sexual disorders
Reproductive disorders
 
This is usually the earliest symptom and easily
leads the urologist to diagnose prostatitis. Some types of pain are undoubtedly specific.
See for example mono or bilateral testicular soreness, painful heaviness in the perineum
and occasionally a lancing burning pain and a feeling of something extraneous in the anus
or ampulla of the rectum. Other less frequent but no less indicative symptoms are mono- or
bi- lateral inguinal pain, a sensation of tight underpants, suprapubic heaviness, pain in
the buttocks or at the base of the spinal column. Sometimes patients
complain of pain,burning or over-sensitivity on the inside of one or
both thighs which spread toward the perineum. The mesomeric cutaneous
projection of prostate inflammation accounts for all these symptoms. Special mention must be made of burning
at the tip of the penis at the beginning and/or end of micturition or during ejaculation.
The tip of the penis must be considered as the external projection of the bladder neck. An
inflamed bladder neck makes itself felt when it opens or closes during micturition or
ejaculation because of the high pressure which is exerted on it.
On the other hand pain or burning along the lower tract of the penis which is continuous
or felt only during micturition is a symptom of acute urethral inflammation which may or
may not be complicated by prostatitis. One frequent symptom, which can
perhaps only be explained by acupuncture meridians, is the pain or
burning on the sole of the foot( usually left)which is felt during
micturition or ejaculation.
All these symptoms may improve, worsen or remain unchanged after ejaculation
or bowel movement. They may
worsen or reappear with the change of season, particularly when autumn changes to winter
or winter to spring.
When urinary
disorders are present, age is the
only factor which differentiates prostatitis from BPH. The
patient with prostatitis is usually a young man while the patient with BPH is generally
elderly. Often passing small quantities of urine (pollakuria), nocturnal micturition
(nicturia), hesitation at the start of micturition and the annoying final dripping are
linked to bladder muscle hyperactivity in both groups of patients. Inflammation is the
cause in cases of prostatitis and obstruction in cases of BPH. However, as I have already
stated, obstruction due to congenital or post-inflammatory bladder neck rigidity (bladder
neck sclerosis or dysectasia) can sometimes be found
in young men.
These are
usually found in patients with a long history of prostatitis and from the medical point of
view are the hardest to cure because of overlapping psychological difficulties such as
performance anxiety, need for self-defense after a poor performance etc. The most frequent
symptoms are premature ejaculation, blood in the sperm (hemospermia), loss of libido and erectile
dysfunction. The first two are easily
explained and cured if they are caused by prostatitis. In a 1994 study on 115 patients of
ours ultrasound scans visualized one or more fibrous calcifications near the veru montanum in patients affected by
premature ejaculation. As we know the veru montanum
regulates the times of orgasm. Hemospermia is often associated with stone formation in the
ejaculatory ducts. Insufficient erection, loss of libido and more rarely refusing to have
intercourse or being unable to reach orgasm (anorgasmia) are often present. In our
experience psychotherapy is usually required for these patients particularly if the
disturbances started at an early age. We work in collaboration with a specialist in
psycho-sexual counseling.
Erectile dysfunction and abnormal penile sensitivity
need to be considered separately from the symptoms discussed above as
they are closely linked and are related to erigens nerves which run from
the prostate capsule to
the dorsal lateral section of the penis. Chronic
prostatic oedema can cause chronic compression of these nerve bundles
and be the underlying cause of the erectile dysfunction.
As we have already seen after ejaculation prostate fluid
serves to nourish and propel spermatozoi towards the egg. If the prostate fluid is
abnormal or contains blood because of inflammation the spermatozoa may lose mobility
(astenospermia) or even become completely immobile and have a shortened life-span.
When the Chalmydia Tracomatis is present they will be markedly deformed. If the ejaculatory ducts are also inflamed due to direct
obstruction or to pressure exerted by surrounding prostate tissue the sperm will contain
fewer spermatozoa (oligospermia) and will be ejaculated with little force into the vagina.
Difficulties will ensue in trying to overcome the barrier of the female cervical mucous.
If the seminal vesicles are infected symptoms will be more severe and more evident. |
