Similar Conditions to Prostatitis
One of the complicated parts about prostatitis is diagnosing it correctly. Because there are other similar conditions to prostatitis and other diseases that share some of the same symptoms, it may take some time to narrow down the culprit for your pain or discomfort. The following conditions may be wrongly misdiagnosed, and, vice versa, they may be the actual cause of your symptoms when you think you have prostatitis. Plus it is always possible that you have more than one problem going on, and some of these conditions can cause prostatitis. If that is the case, resolving that other issue could help relieve your prostatitis symptoms.
Reactive arthritis, also called Reiter’s syndrome, is an autoimmune condition. It develops as a response to an infection that occurs somewhere else in the body. It can cause symptoms in the urinary system as well as the eyes, or it can cause arthritis symptoms in the joints that include swelling, pain, redness, and heat. As with chronic pelvic pain syndrome (CPPS), there are no specific criteria for diagnosing reactive arthritis.
Reactive arthritis sometimes occurs after a genital infection, such as Chlamydia. Many areas of the body can be affected, but this condition can also cause the bladder and prostate to become inflamed. There is some evidence that CPPS is an immunologically driven inflammatory disease that may occur with inflammation of other tissues in the body. Reactive arthritis patients tend to test positive for a certain antigen, and it has been suggested that CPPS patients may also test positive for this antigen. Further research may point to a connection between these two conditions.
A urethral stricture is a narrowing of the urethra that may cause painful urination and the inability to empty the bladder. It is common for a urinary tract infection to be present when diagnosed. Urethreal stricture can be a lifelong condition. There appears to be a slightly higher incidence of prostatitis in patients who have urethral stricture. Prostatitis is a possible cause of urethral stricture, and urethral strictures may cause prostatitis. Sounds like a case of which came first: the chicken or the egg?
When a urethral stricture causes prostatitis, it may have to do with travel of fluids. In a normal scenario, fluid should only travel from the prostate to the urethra when a man ejaculates. In patients who have a urethral stricture the high-pressure voiding can lead to urine flowing into the prostate ducts. This can cause inflammation or an infection. A doctor can diagnose urethral stricture by cytoscopy, which involves inserting a flexible scope into the urethra and bladder. There are several surgical treatments, and if urethral stricture is the cause of the prostatitis, treating the stricture may relieve the prostatitis symptoms.
There are some other causes of urethral stricture such as scarring, trauma, infection, procedures involving the urethra (cathetors, surgery, or cytoscopy), or even prostate enlargement. In about a third of the cases, they can find no specific cause for this condition.
Post-Vasectomy Pain Syndrome
For some unknown reason, some men experience chronic pain after having a vasectomy. It probably affects less than 6% of the 500,000 men who have vasectomies every year. It is defined as chronic testicular pain that lasts longer than three months after the procedure. The pain may also radiate to the groin or occur along the vas deferens. There can be pain upon physical exertion, when achieving an erection, when having intercourse, or when ejaculating. It is usually treated with medication, a nerve block, or even a reverse vasectomy.
Chronic fatigue syndrome is the name of a group conditions that are characterized by persistent fatigue and many other symptoms including muscle and joint pain. As with chronic pelvic pain syndrome (CPPS), chronic fatigue affects patients’ quality of life. Also like CPPS, nobody really knows what causes this frustrating condition and there are no specific laboratory tests for it besides ruling out other causes. Some researchers think that it may be related to fibromyalgia.
Men who suffer from chronic fatigue syndrome may also suffer chronic pelvic pain, and it is believed that CPPS and chronic fatigue syndrome may be connected. A study on twins in which one twin had chronic fatigue and the other did not found that the twin with chronic fatigue was also much more likely to have CPPS as well.
Stress-Related Pelvic Pain
Many men do not realize how much their emotional state can affect their health. Everyone deals with stress differently, and some people focus their tension in another part of the body. Some men might clench their jaw, causing TMJ problems, while others unknowingly squeeze their pelvic muscles when stressed, and this can lead to chronic tension in the pelvic area. Studies have shown that the myofascial trigger points found in muscles in the pelvic floor are affected by stress. Men who have CPPS that is stress related may benefit from myofascial release or trigger point release therapy for prostatitis. Looking into ways to manage stress and emotional health can help. Activities such as yoga, tai chi, and cognitive behavioral therapy for prostatitis may be helpful.
Pudendal Nerve Entrapment
The pudendal nerve is located in the pelvic region. This nerve can become compressed by or in between the ligaments, muscles or bone canals in the pelvis, resulting in pain. This can be caused by trauma, birth defects, pelvic tumors, scar tissue after surgery, or prolonged and regular cycling long-term. Patients may experience a variety of symptoms, including urinary and bowel trouble, sexual problems (painful intercourse, erectile dysfunction, and numbness of genitals), and neurological symptoms (Sharp stabbing, burning, aching, a prickling sensation, and sensitivity to pain in the genitals. The most characteristic symptom is that all the symptoms get worse when the person is sitting, but get better when the person is standing or lying down.
Pelvic Joint Dysfunction
Pelvic joint dysfunction is a condition in which the ligaments that normally keep your pelvis firm get stretched out and cause pain. It may be caused by abnormal motion and usually results in inflammation of the sacroiliac joint. Symptoms include pain in the lower back, butt, hips, and groins as well as sciatic leg pain. There may be urinary frequency and tingling or prickling that comes and goes. This condition can be debilitating and can be linked to chronic pelvic pain syndrome.
BPH (benign prostatic hyperplasia)
Benign prostatic hyperplasia, otherwise known as enlarged prostate, is another condition that commonly affects men, and prevalence goes up with age. About 70% of men experience BPH symptoms by age 70. Symptoms may vary, but the most common symptoms include having to wait for urine, having the flow start and stop like bad rush-hour traffic, a weak stream, frequent urination, having to wake up maybe three or four times a night to urinate, incontinence, urinary tract infections, and not emptying the bladder when urinating. There are tests for diagnosing BPH to rule it out.
Pelvic Trauma and Prostatitis
Pelvic or perineal trauma (blunt trauma to the perineum—the area between the scrotum and anus) can result from such traumas as a bicycle riding injury, a karate kick, getting hit with a hockey stick, or some other accidental injury to the area. Other activities that can irritate the prostate area include heavy lifting, horseback riding, or even workplace issues such as driving a truck or operating machinery that applies powerful vibrations to the prostate area. When the prostate area gets irritated or injured it can lead to chronic pelvic pain syndrome.
Prostate Cancer and Prostatitis
Researchers have been trying to determine whether having prostatitis is a risk factor for prostate cancer. It may be. Inflammation and rising of PSA levels are associated with both conditions. If you suffer from prostatitis, you should have your PSA looked at and get digital rectal exams to keep an eye on the health of your prostate. Since prostatitis can affect younger men, it may be an early sign that something is not right with the prostate, so you should take measures through diet and lifestyle to lower risks to prevent prostate cancer. Early prostate cancer usually has no symptoms.
Testicular pain occurs when either one of both testicles hurt and can include pain in the scrotum. Like prostatitis there are acute and chronic types. Chronic scrotal pain and testicular pain is pain that last for more than three months and can be caused by several different underlying conditions such as: prostatitis, inflammation, infection, hydrocele, surgery, trauma, or other conditions. Sometimes pain can linger after a vasectomy, and this is called post-vasectomy pain syndrome (PVPS).
Interstitial Cystitis (IC)
Interstitial cystitis (in-tur-STISH-ul sis-TIE-tis) is a painful bladder condition that is one of the similar conditions to prostatitis. Like chronic prostatitis, interstitial cystitis is a chronic condition. It causes patients to experience bladder pressure, and it can cause mild to severe bladder pain.
Interstitial cystitis can affect both women and men. Men may experience pain in the pelvis or in the perineum (the area between the scrotum and anus). Symptoms include chronic pelvic pain, a persistent need to urinate, and frequent urination. It can cause pain during sexual intercourse. While the symptoms resemble those of a urinary tract infection, the urine cultures usually do not contain bacteria.
Like prostatitis, there is not one single test to diagnose interstitial cystitis. First the doctor must rule out other conditions by going through the patient’s medical history and having him or her keep a journal to track symptoms, flare-ups, and severity. The doctor will perform a pelvic exam. There are a few diagnostic tests a doctor might use, use as urinalysis or urine culture. Other test may include a potassium sensitivity test, cystoscopy, and urodynamics. The doctor may perform a bladder biopsy under anesthesia.
There is no treatment that eliminates interstitial cystitis, but patients may find relief in medications and other therapies like bladder training. As with prostatitis, nondrug therapies such as physical therapy and home remedies such as dietary changes, getting exercise, reducing stress, and stopping smoking can help. Common bladder irritants include carbonated beverages, caffeine, alcohol, and acidic foods. Alternative therapies such guided imagery and acupuncture may help as well. Nerve stimulation and bladder distension have been found to help some patients.
Some patients take medications like nonsteroidal anti-inflammatory drugs (NSAIDS) for pain, tricyclic antidepressants to relax the bladder and block pain, and antihistamines to reduce urinary frequency and urgency. One medication, Elmiron (pentosan polysulfate sodium), is approved to treat bladder pain or discomfort for symptoms for interstitial cystitis. This medication must be taken continuously. Sometimes medications are distilled directly into the bladder.
Many men who have prostatitis also commonly have other conditions, called co-morbidities. One condition that occurs with prostatitis is irritable bowel syndrome (IBS). Irritable bowel symptoms include cramping, abdominal pain, bloating, gas, diarrhea, and constipation. It can be controlled through managing diet, lifestyle, and stress.
Many patients who have IBS also have a condition called leaky gut, which is caused by an intolerance to certain foods or ingredients. In leaky gut, some large proteins that are not meant to enter the blood stream from the intestinal tract leak into the circulating blood. These proteins travel to different areas of the body, becoming lodged in different places. If they get caught in the joints they may cause arthritis; sometimes they lodge in the prostate, possibly leading to prostatitis.
Different food allergies can cause prostatitis symptoms, so it is important to undergo allergy testing or do an elimination diet if you think that something in your diet could be a trigger for your prostatitis symptoms. Naturopathic urologists recommend trying a wheat-free or gluten-free diet to reduce chronic inflammation in the body as a what allergy or gluten sensitivity can cause CP/CPPS symptoms.
Sinusitis, also called rhinosinusitis, is inflammation of the paranasal sinuses. It is a common condition caused by infection, allergies, or autoimmune issues. Like prostatitis, there are acute cases (usually stemming from an upper respiratory tract infection) and chronic cases that last longer than three months. Chronic sinusitis is more of an inflammatory disorder than one caused by persistent bacterial infection, and there may be many different causes from structural abnormalities like a deviated septum, viruses, to bacteria, allergies, fungi, dental issues, food allergies, or problems with the Eustachian tubes.
While sinusitis affects a different part of the body than the prostate, it has some things in common with prostatitis in that figuring out its cause and proper treatment can be frustrating, it affects the patient’s quality of life, and it can be painful. Also, some men suffer from both sinusitis and prostatitis at the same time, and they may notice that when one condition is acting up the other one is also flaring up at that time, leading to these men to wonder if that what triggers one condition could be the trigger for the other.
In the United States there are between 7,500 and 8,000 newly diagnosed cases of testicular cancer each year. Symptoms may include a lump (which may or may not be painful) in one testis, a feeling of heaviness in the scrotum, a sharp pain or dull ache in the scrotum or lower abdomen, breast enlargement, and low back pain. Testicular cancer is most common in men between the ages of 25 and 40 years old. Because some of the pain and discomfort symptoms are similar to prostatitis, it is a good idea to rule out testicular cancer through a scrotal ultrasound and other tests.