This is a very neglected disease, priority rightly being given to prostate cancer. However, sufferers of prostatitis are often told by the medical profession that "nothing can be done", which is not true, and there seems to be an under-estimation of the prevalence of chronic bacterial prostatitis. This is because traditional urine sampling will generally fail to show up a prostate infection, unless it breaks out into cystitis. In fact, cystitis in men is rarely an isolated condition and should be investigated fully to uncover any possible prostate infection.
There is also a mistaken belief (see Wikipedia) that chronic bacterial prostatitis is symptom-free. Those who have suffered from it will testify that the pain (not discomfort as it is often referred to by doctors and urologists in an attempt to minimise the symptoms) can be a burning sensation in the groin, needle-like pain in the penis and a vice-like grip on the testes. The pain can stretch from the navel to the knee. Also, the sufferer can feel ill, because this is a bacterial infection which the body is trying to control. Antibiotics can help, but there is a risk (as I have experienced) of resistance, particularly after long duration use. Men may not be properly diagnosed with the condition because of the lack of positive urine culture, and could feel ill for years.
Such is the medical scepticism surrounding chronic bacterial prostatitis, that medical professionals may try to convince sufferers that they do not have an infection, and that antibiotics are only helping because they have an analgesic effect. If this were true, then the pain would return quickly after a course of antibiotics whereas, after the correct course and dosage, the pain may well disappear for months or years because the infection has been controlled, albeit temporarily.
But that rarely means that the infection has gone completely. It is known that the type of bacteria commonly associated with prostate infections (eg, E-coli) can produce biofilms which protect the bacteria from the immune system and antibiotics. This biofilm production may explain the relatively pain-free periods, until the bacteria break out into the prostate again. These pain-free periods are often used as an excuse by doctors and urologists to do nothing, in the hope that the problem will go away; it often doesn't!
It is difficult to break out of the cycle of repeated infections followed by a lull in symptoms and a failure to properly diagnose the underlying cause. This year, I became significantly resistant to the antibiotics commonly used for prostatitis. Even though that resistance was apparent over 5 years ago, not a single doctor or urologist considered an alternative approach (such as surgery). Consequently, I have been unable to properly control the infection for almost 8 months, finally resorting to private treatment. As a result, I was able to have 2 consultations and 6 tests done in 3 weeks (2 weeks if it had not been for a prostate flare-up and the weather), which concluded that I had florid granulomatous prostatitis, a rare condition caused by the immune system destroying part of the prostate in a vain attempt to control a severe inflammation caused by repeated infection; only surgery has some chance of correcting the condition. But I suspect that this condition is not as rare as it appears, because most prostatitis sufferers have not had the appropriate tests.
This is an area which I believe needs some serious attention from the NHS. Not everyone has the option of going private - and why should they! After all, my condition was diagnosed from a simple biopsy, suggested because the right prostate lobe was firmer than the left. This imbalance had been known for at least 4 years, and could easily have been diagnosed earlier.
If any readers have a view on this subject, I would welcome their input. I aim to take the issue further in the Health Service and would appreciate any ideas and support.
I look forward to hearing from you.