Prostadynia

“Prostadynia” is a confusing diagnosis because there is disagreement within the medical community about what the term actually means. The problem is that different people use the term differently. What is prostadynia? It depends upon whom you ask.

The health insurance company Aetna defines prostadynia as a condition “when symptoms of prostatitis are present, but there is no evidence of prostate infection or inflammation. Doctors understand very little about why some people — often young, otherwise healthy men — develop this problem.”

According to Drs. David Wise, Ph.D and Rodney Anderson, M.D., the authors of A Headache in the Pelvis and founders of The National Center for Pelvic Pain Research, “Prostadynia (Prostatodynia) is an outmoded term although sometimes still used as a term to diagnose men with symptoms identical to what is more commonly called prostatitis, chronic pelvic pain syndrome, or pelvic floor dysfunction.”

At Choices in Health, we look at prostadynia as part of a spectrum of male urinary tract inflammation and pain. As you can see in the figure below, this spectrum runs from the more acute urinary tract infections all the way to chronic prostatitis, with prostadynia somewhere in between. Instead of a differential diagnosis, we see prostadynia as occupying the middle of an overlapping Venn diagram between UTIs and chronic prostatitis — with all three conditions sharing certain symptoms and underlying pathology.

Spectrum of Urinary Tract Symptoms in Men

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UTI                            Prostadynia                         Chronic Prostatitis

 

Prostadynia symptoms range from occasional twinges of pain to constant itching, burning, and pressure. This type of pain and discomfort most often occurs along the urethra, in and around the prostate, at the tip of the penis, in the perineum, in the anus, and sometimes the testicles. (As these symptoms increase in intensity and frequency, the condition moves closer to being considered chronic prostatitis.)

In addition, prostadynia may also be accompanied by a host of urinary symptoms (urinary urgency, urinary frequency, painful urination, and others) as well as post-ejaculatory pain, and pain while sitting down (feels like you’re sitting on a small tennis ball).

By definition, bacterial infection of the urinary tract or prostate is NOT part of prostadynia, so it’s not surprising that treatment with antibiotics and alpha blockers (FloMax, Hytrin, and others) doesn’t do much to resolve the symptoms — although in some cases there may be a temporary placebo effect.

Inflammation of the urinary tract and prostate may accompany prostadynia, however, treating prostadynia as an inflammatory condition fails to address the most common underlying cause: chronically contracted pelvic floor muscles. In fact, the prostate is more often the scapegoat for these symptoms than the source.

All this is to say that prostadynia is an uncomfortable condition that frequently leaves men feeling frustrated, unmanly, and depressed. And up until the invention of the Stanford Protocol, there was no easy way to cure prostadynia.

Common Symptoms of Prostadynia

Pain & Discomfort
  • Prostate
  • Urethra
  • Perineum
  • Anus
  • While sitting
  • After bowel movements
  • Above the pubic bone
  • Bladder
  • Tail bone
  • Low back
  • Testicles
Urinary Issues
Sexual Issues
Emotional component
  • Anxiety about what’s happening to your body
  • Feelings of helplessness
  • Depression because the symptoms just won’t go away
Prevention
  • Avoid urinary tract irritants (Don’t eat anything you wouldn’t put on an open wound)
    • Spicy foods
    • Alcohol
    • Carbonated beverages
    • Acidic foods
    • Caffeine
    • Smoking
  • Herbs
    •  Pay d’arco
    •  Pygeum
    •  Saw palmetto
Supplements
  • Quercetin
  • Bromelain
  • Flower pollen
  • Nettle root
  • Zinc
Diagnostic Tools
  • Medical history
  • Physical exam
  • AUA symptom score (AUASS)
  • Urinalysis
  • Urine culture
  • Urine cytology
  • Post void residual (PVR) testing
  • Semen analysis
  • Allergy testing

Treatment

The treatment of prostadynia is rapidly moving away from the antibiotics, alpha blockers, anti-inflammatory medication, and surgery that were once considered the gold standard of treatment. At Choices in Health, our individualized and integrated approach to treating prostadynia looks first to pelvic floor dysfunction and its many causes.

This type of prostadynia treatment was first developed at Stanford University (hence the name “Stanford Protocol”). It is designed to treat the pain and discomfort caused by a chronic contraction of the pelvic floor muscles. Once these muscles lock down into what feels like an evolutionary adaptation gone wrong, they often remain clinched in a spasm of pain that can radiate all over the pelvis and generally wreaks havoc on the urinary tract.

According to PelvicPainHelp.com, what the medical community used to consider an “alternative therapy” for prostadynia has now shown itself to be far more effective than the “conventional treatment” of drugs and surgery— and with a lot fewer side effects.

At Choices in Health, our treatment of prostadynia includes the following areas:

Physical Therapy
  • Stanford Protocol
  • Myofacial release
  • Biofeedback/Electrical stimulation
  • Frequency specific microcurrent
  • Cranio-sacral work
In-office Care
  • Acupuncture
  • Joint and ligament injections
  • Nerve blocks
  • Trigger point injections
Conventional
Home Care
  • Have regular ejaculations
  • Drink 8-10 glasses of pure water every day