27 Oct Anonymous Musings: October 27, 2017
The Prostate and Prostatitis
The prostate is an exocrine gland of the male reproductive system [exocrine glands are glands of the exocrine system that secrete fluid by way of a duct to a part of the body external to itself. Exocrine glands are one of two types of glands in the human body, the other being endocrine glands, which secrete their products directly into the bloodstream].
The prostate is about the size of a walnut and is located slightly above the male pelvic floor muscles. It surrounds the urethra just below the bladder and is adjacent to the rectum. Since the prostate is an internal organ, doctors cannot evaluate it directly by sight. However, as it lies in front of and adjacent to the rectum, a doctor or trained medical provider can insert a finger by way of the anus and feel the prostate through the rectal wall via a procedure called a digital rectal exam [DRE].
The function of the prostate is to secrete a slightly milky white fluid that in humans constitutes approximately 30% of the volume of the semen. The prostatic fluid is expelled at onset of ejaculation together with most of the sperm from the testis. Sperm that are expelled in prostatic fluid have better motility [move spontaneously and actively], better survival rates and better protection of the genetic material. The prostate contains smooth muscles that help it expel the semen during ejaculation.
So what is Prostatitis? The Prostatitis Foundation describes it simply as inflammation of the tissue of the prostate gland. Andrology Australia defines it exactly the same, but their definition also includes the main role of the prostate – “to make fluid that protects and feeds the sperm…the prostate makes about one third of the fluid that is ejaculated from the penis at orgasm”.
And what causes Prostatitis? Prostatitis can be caused by bacteria that leaks into the prostate gland from the urinary tract [the most common cause] and from lymphatic spread from the rectum. It can also result from various sexually transmitted organisms such as gonorrhea, chlamydia or human immunodeficiency virus [HIV]. Other organisms responsible for infection are the same found most frequently in urinary tract infections. In many instances however, no specific cause of prostatitis can be found.
According to one of the most respected medical research agencies in the world – the National Institutes of Health [HIH] in the United States, Prostatitis is classified into four distinct types:-
Type I: Acute Bacterial Prostatitis
- Severe symptoms of prostatitis, symptoms of systemic infection and acute bacterial urinary tract infection
Type II: Chronic Bacterial Prostatitis
- Chronic bacterial infection of the prostate gland with or without symptoms of prostatitis, usually with recurrent urinary tract infection caused by the same bacteria
Type IIIa: CP/CPPS [inflammatory subtype]
- Characterized by Chronic Pelvic Pain and possibly voiding symptoms with no bacterial infection
Type IIIb: CP/CPPS [non inflammatory subtype]
- Characterized by Chronic Pelvic Pain and possibly voiding symptoms with no bacterial infection; no evidence of inflammation
Type IV: Asymptomatic Inflammatory Prostatitis
- Evidence of inflammation without symptoms of prostatitis or urinary tract infection
Again, this categorization in itself intertwines Chronic Pelvic Pain with Prostatitis because of established stereotypes, but more so I would assume, the link is due to the proximity of both to the male prostate gland.
Popular thought, aided by social media, particularly Facebook with its specific forums on the topics of Chronic Pelvic Pain Syndrome and Chronic Prostatitis, has galvanized a consensus that men’s health is dealing with two very different disorders, with different causes, which separately and exclusively stress the pelvic floor area of the sufferer with somewhat similar symptoms.
In the case of the type IIIa and type IIIb classifications provided by the HIH, it is becoming more obvious that this category has little if anything to do with the prostate gland itself. So this begs the questions – why is there worldwide medical confusion [or is it reluctance] to approach each of these very important men’s health issues separately and exclusively?
Since it is not my intention, nor is it anywhere within my grasp, to scope all of the possible medical conditions and health complications associated with the prostate gland, I will try and focus discussion on possible reasons as to why Chronic Pelvic Pain and Chronic Prostatitis are often and incorrectly used in synchrony to describe the same thing.
The following commentary might provide some clues as to why clear and distinct definition has avoided us up until now.. (Coming next week!)
This story details the life journey of one individual and is not intended to be a substitute for competent medical advice and or professional treatment.
Some of the medical information contained in this story is not the original work of the author. As best as possible, original sources and web sites have been credited and referenced.
Other than the personal account, this story has been adapted from information which is freely available to the general public.