Daily Mail. http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=513778&in_page_id=1774
The agonising male 'cystitis' that affects half of all men
Four years ago, Phil Goswell began to experience lower back pain and thought he'd overdone his training for the London Marathon. The 49-year-old company director took a couple of days off work but the pain actually worsened.
Are you sitting comfortably? Men who suspect they have prostatitis must keep on at their GP about it before the condition becomes chronic
"It went from an ache in my lower back to an agonising stabbing sensation in my pelvic area, groin and testicles - and would come and go without warning," he recalls.
During one such flare-up, Phil made an appointment to see his GP in Camberley, Surrey. "But by the time I got there, the pain had completely gone. I felt a fraud wasting his time." He was told to rest, take ibuprofen and return if it worsened.
Phil managed to complete the marathon, but as the months passed, he experienced frequent painful flare-ups. "They would start in the morning with a dull ache, then as the day went on it would turn into stabbing pains in my groin and testicles.
"Eventually, I would be doubled up in agony and would have to go to bed. Then I'd wake up a few hours later to find the pain had gone, thinking 'what was that all about?'."
Over the next year, Phil returned to his GP's surgery several times but none of the practitioners was able to shed light on the problem.
Phil managed to keep it from his workmates and didn't even tell his wife until after one attack when he was at home alone. "I experienced a burning sensation and lost control of my bladder completely.
"I was frightened, embarrassed - and in excruciating pain.
"When it happened again half an hour later, I was convinced I had something terrible like prostate cancer."
His wife Trish insisted he see the GP immediately. "I was shocked when he said my prostate was enlarged," says Phil. He was told it was probably from an infection and prescribed strong painkillers and antibiotics.
Phil also underwent blood, urine and prostate secretion tests. These revealed he had chronic bacterial prostatitis - "a condition I'd never even heard of".
The good news was that it was treatable and not life-threatening. The bad news was that it would continue to flare up for the rest of his life.
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Putting you in the picture: A scan showing the position of the prostate in a man's pelvic region, centre. Prostatitis can severely affect quality of life, triggering anxiety, depression and stress
Prostatitis, or inflammation of the prostate gland, is one of the most common complaints of the urinary system in men. The prostate is the walnut-sized gland which helps to produce sperm.
Symptoms of prostatitis include chronic pain in the pelvic area or perineum (the area between the scrotum and rectum), difficulty urinating, urinating more frequently and discomfort during and after intercourse.
The condition often goes undiagnosed - but even with treatment can become chronic. This may cause problems with fertility, as well as recurrent pain.
What's worrying is that the disease is becoming more common. More than 30,000 new cases are diagnosed each year, and experts say 50 per cent of all men will experience at least one episode of prostatitis in their lifetime.
"Prostatitis is not a well-understood condition," says Professor Roger Kirby, director of the Prostate Centre in London and chair of the charity Prostate UK. "You could call it the men's equivalent of cystitis. But, unlike cystitis, which can usually be cured with antibiotics, it's far more troublesome to get rid of."
Some cases of prostatitis, such as Phil's, are caused by bacteria and respond to antibiotics. However, antibiotics don't work for the most common form of prostatitis, which affects 90-95 per cent of patients.
"It's very difficult to treat, and a frustrating disease both for doctor and patient," says Professor Kirby.
While the exact cause of this form is not known, Professor Kirby believes reflux of urine into the prostate could trigger the inflammation.
Usually, urine leaves the bladder and passes down the urethra. His theory is that in some cases urine diverts sideways into the prostatic ducts and into the prostate.
Stress may also play a part. "The prostate is a vulnerable organ," says Professor Kirby. "Like irritable bowel syndrome, prostatitis can be triggered and exacerbated by stress."
There is no miracle cure for this common form of prostatitis, so treatment involves controlling the symptoms with anti-inflammatory drugs, such as ibuprofen or voltarol, painkillers, muscle relaxants and pelvic floor relaxation - which all allow the inflammation to subside.
Even when bacterial infection is the cause, it may be difficult to eradicate, says Professor Kirby.
Prostatitis most commonly affects younger men aged 18-50. Chronic infection in the prostate can lead to inflamed cells and scarring, which can affect the quality of the sperm produced.
Some experts even believe that prostatitis promotes cell changes which may increase the risk of prostate cancer.
Not surprisingly, the effects of prostatitis extend beyond the physical. "This disease can seriously impair quality of life - triggering anxiety, depression and stress and undermining confidence," explains Professor Kirby.
"Patients are desperate for help. But it's difficult to find a cause and a cure. In those situations, all you can do is manage the pain."
Many men suffer in silence for years before finally seeking help - by which time the condition is even harder to treat. Despite the vast number of men affected, lack of awareness is a major problem.
Last month, experts from all over the world were in London at a conference hosted by Prostate UK to focus on the condition.
"We now hope to come up with a way forward for more research, better treatment, and raised awareness among the public and medical profession," says Professor Kirby. "We need to increase the number of urology experts in this country, and ultimately help to stop this condition from ruining lives."
In terms of prevention, the charity Prostate UK recommends maintaining a healthy lifestyle, with good diet and exercise, and practising safe sex.
It's important to see your GP straight away if you have symptoms of a urinary tract infection, such as a burning sensation when urinating, or cloudy, malodorous urine.
But the overall message is don't suffer in silence. Ignoring symptoms until they are chronic means they become much harder to treat. Prostatitis can certainly be treated and alleviated - especially if it is diagnosed early.
"If you suspect you have symptoms and are unhappy with treatment from your doctor, ask for a second opinion or referral to a urologist," says Professor Kirby.
Meanwhile Phil has recently become a father for the second time. "I was amazed and delighted that my fertility wasn't affected," he says.
Today, he manages his condition with rest, relaxation and a healthy diet. "I would urge anyone who even suspects he has a problem to have it checked out - and keep asking for help."