Immunosuppression for Prostatitis

Immunosuppression for Prostatitis

What Is Immunosuppression for Prostatitis?

Immunosuppression is a rarely used treatment for chronic prostatitis/chronic pelvic pain syndrome CP/CPPS. This therapy could be helpful if the CP/CPPS is due to an autoimmune condition, and it is useful when the patient has no infection present. It is most likely to be used for select patients, such as those who need to undergo immunosuppression for another condition, such as kidney transplant.

A study published in Urology in 2011 shows that men who undergo immunosuppression therapy after having a kidney transplant have a lower risk of getting prostatitis. Researchers compared 33 immunosuppressed men who had kidney transplants with 183 men who had undergone surgical treatment for benign prostatic hyperplasia (BPH) and were not immunosuppressed. The men’s mean prostate-specific antigen (PSA), prostate volume, and International Prostate Symptom Score were not significantly different between both groups. However, 145 of the men (78%) who were not immunosuppressed had histological evidence of chronic prostatitis, whereas 3 immunosuppressed men (9%) had chronic prostatitis. The non-immunosuppressed patients had a 38.2 times greater risk of presenting with prostatitis. Researchers concluded that immunosuppression therapy in kidney transplantation has a protective factor in the prostatitis incidence.

There is an example of one patient’s symptoms resolving after undergoing immunosuppression. The patient had kidney disease plus several months of perineal and urethral sensitivity and pain due to CP/CPPS. After the patient received a kidney transplant and immunosuppression with steroids, cyclosporine, and mycophenolate mofetil, the patient’s CP/CPPS symptoms completely resolved. He remained symptom-free at his 13-month checkup. This is not going to be the right course for many patients, but it does suggest that the etiology of CP/CPPS is not an active infection, which would have gotten worse under immunosuppression. Also, full immunosuppression is necessary for the treatment to work. Just taking steroids is not enough for success.

What Does Immunosuppression Involve?

Imunosuppression involves suppressing your immune system with medications. It is usually used to keep your body from rejecting an organ transplant or to treat autoimmune diseases. It can be used to treat other non-autoimmune inflammatory diseases as well.

Immunosupprssants are available only by prescription. They can be administered as capsules, tablets, liquids, or injections. You doctor will determine the best course of treatment for you. You must follow your doctor’s instructions exactly as prescribed every day. You may receive regular blood tests to monitor the effectiveness of the drugs.

If you undergo immunosuppression for prostatitis, it is important to avoid catching an infection. Wash hands frequently, avoid sports that could lead to injury, use care around sharp objects, and avoid contact with people who are sick.

What Are the Side Effects?

Immunosuppression has side effects such as making you more susceptible to infections and diseases, including cancer. The corticosteroids used in immunosuppression can lead to osteoporosis, putting you at risk for bone fractures. Several immunosuppressant medications can decrease muscle function and cause high blood sugar. They can cause hypertension, moon face, peptic ulcers, or injury to the liver or kidneys. The drugs increase likelihood of uncontrolled bleeding. There are several other side effects as well. Less serious side effects may include nausea, vomiting, hand trembling, or changes in hair growth.

Make sure to research any medications your doctor prescribes and to ask questions about the side effects and risks of taking immunosuppressive drugs. Notify your doctor immediately if you get a fever or chills, have back or side pain, have difficulty urinating, blood in the urine, have any unusual bleeding or bruising, or have bloody or black stools.

Due to the side effects associated with immunosuppression for prostatitis, this treatment should be considered a last resort for chronic nonbacterial prostatitis that has not responded for several months to conventional, alternative, and natural therapies. If you need to undergo immunotherapy for another condition, it may conveniently help your prostatitis.

Reference for Immunosuppression for Prostatitis:

Piovesan AC, et al. Histologic inflammatory changes on the prostatic gland due to immunosuppression for kidney transplantation. Urology. 2012 Mar;79(3):662-4.