Introduction
Prostatitis is the swelling and inflammation of prostate gland, a small gland situated directly below the bladder in men. The prostate gland produces fluid (semen) that nourishes and transports sperm. Prostatitis often causes painful or difficult urination. Other symptoms include pain in the groin, pelvic area or genitals and sometimes flu-like symptoms.
Prostatitis affects men of all ages but tends to be more common in men 50 or younger. The condition has a number of causes. Sometimes the cause isn’t identified. If prostatitis is caused by a bacterial infection, it can usually be treated with antibiotics.
Depending on the cause, prostatitis can develop gradually or suddenly. It might improve quickly, either on its own or with treatment. Some types of prostatitis last for months or keep recurring (chronic prostatitis).
Signs & symptoms
Signs and symptoms of prostatitis include:
- Pain or burning sensation during urination (dysuria)
- Difficulty urinating, such as dribbling or hesitant urination
- Frequent urination, particularly at night (nocturia)
- Urgent need to urinate
- Cloudy urine
- Blood in the urine
- Pain in the abdomen, groin or lower back
- Pain in the area between the scrotum and rectum (perineum)
- Pain or discomfort of the penis or testicles
- Painful ejaculation
- Flu-like signs and symptoms (with bacterial prostatitis)
Causes
In many cases of prostatitis, the cause isn’t identified. Common strains of bacteria in most cases. It can be acute or chronic bacterial prostatitis.
Risk factors for prostatitis include:
- Being young or middle-aged
- Having had prostatitis previously
- Having an infection in the bladder or the tube that transports semen and urine to the penis (urethra)
- Having pelvic trauma, such as an injury from bicycling or horseback riding
- Using a tube inserted into the urethra to drain the bladder (urinary catheter)
- Having HIV/AIDS
- Having had a prostate biopsy
Pathophysiology
In bacterial prostatitis, sexual transmission of bacteria is common, but hematogenous, lymphatic, and contiguous spread of infection from surrounding organs must also be considered. Prostatitis is characterized by the presence of acute inflammatory cells in the glandular epithelium and lumens of the prostate, with chronic inflammatory cells in the peri glandular tissue. However, the presence and quantity of inflammatory cells in urine or prostatic secretions does not correlate with the severity of the clinical symptoms. A nonspecific mixed inflammatory infiltrate that consists of lymphocytes, plasma cells, and histiocytes is typical in chronic bacterial prostatitis.
Viral and granulomatous prostatitis may be associated with HIV infection and is another cause of culture-negative disease. A common viral pathogen of prostatitis in HIV-infected patients is cytomegalovirus (CMV). Mycobacteria, such as Mycobacterium tuberculosis, and fungi, such as Candida albicans, have also been associated with culture-negative disease in this population.
Diagnosis
Urine tests to check for signs of infection in urine
Blood tests for signs of infection and other prostate problems.
Post-prostatic massage
Imaging tests like an ultrasound or CT scan
Treatments
Prostatitis treatments depend on the underlying cause. They can include:
- Antibiotics
- Alpha blockers
- Anti-inflammatory agents like Nonsteroidal anti-inflammatory drugs (NSAIDs)
Prognosis
In acute bacterial infections, when it is happening for the first time, the prognosis is usually good with proper medicines and therapy. In recurrent & chronic cases, the prognosis depends upon the underlying cause.
Complications
Bacterial infection of the blood (bacteraemia)
Inflammation of the coiled tube attached to the back of the testicle (epididymitis)
Pus-filled cavity in the prostate (prostatic abscess)
Semen abnormalities and infertility, which can occur with chronic prostatitis
Disease & Ayurveda
There is no direct correlation or description in Ayurveda for prostatitis. But while explaining disorders of the urinary system where urine output is less than normal, Mootrakrucchra can be compared with prostatitis to an extent by their clinical features.
Nidana
Causative factors for the vitiation of Kapha, Pitta and Vaata
Purvaaroopa
Not mentioned separately
Samprapti
Normally, mootravahasrotas works through continuous filtration and filling of vasti by minute and numerous tubules. This process includes Vrkka (Kidney)gavini(ureter), mootravaha dhamanis and siras & nadi (Renal vessels and nerves associated) Vasti(badder) and mootrapraseka (urethral opening). In men, the male reproductive organs including prostate and seminal vesicles are also a part of this area. When the vitiated Kapha & Pitta cause any obstruction in this system, the Vaata gets aggravated and the disease manifests.
Lakshana
Vaatika
Vasti-vamkshana-medhra arti – Severe pain in the bladder and penis/area of urethral opening
Alpalpam muhu mootrayet – frequent urination as drops
Or
Paittika
Peeta/Rakta/sadaaha – Yellow/red discolouration with burning sensation
Or
Kaphaja
Vasti-medhara gourava & sopha- Heaviness & oedema of Bladder and penis/area of urethral opening
Sapiccham mootram- Turbidity of urine
Savibandham mootram- Obstructed urination
In tridoshaja mootrakruchra, sgns & symptoms of all three doshas will be present.
Divisions
Vaatika
Paittika
Kaphaja
Tridoshaja
Prognosis
Sadhyam in new and single dosha vitiated
Kashtasadhyam in chronic & three doshas involved
Chikithsa
Ayurvedic treatment for prostatitis depends upon the predominance of vitiated dosha. Considering the swelling and inflammation, the Kapha & Pitta are managed first with caution not to vitiate Vaata.
Samana
Teekshna-ushna-katu bhojanam(pungent,hot and spicy diet)
Diet with Yava (Barley)
Ksharam (Alkaline diet and drinks)
Kaalaseyam-buttermilk
Dhatreephalarasa+ela
Madya+ela
Kantakariswarasa+honey
Sodhana
Vamanam
Virechanam
Sneha-Swedanam
Asthapanavasti
Anuvasanavasti
Uttaravasti
Commonly used medicines
Bruhatyadi kashayam
Veerataradi kashayam
Chandanasava
Punarnavasavam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
The following might ease some symptoms of prostatitis:
- Soak in a warm bath (sitz bath) or use a heating pad.
- Limit or avoid alcohol, caffeine, and spicy or acidic foods.
- Avoid prolonged sitting or bicycling.
- Drink plenty of caffeine-free beverages.
- Low sodium intake.
- Omega 3 fatty acid intake.
- Gluten free diet.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups.
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from hot climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active.
Yoga
No hectic exercises or physical activities are recommended in severe cases of prostatitis.
Regular stretching and cardio exercises are advised in mild cases. Also, specific yogacharya including naadisuddhi pranayama, & pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556531/
https://pubmed.ncbi.nlm.nih.gov/26926407/
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
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