Stanford’s Dr. Anderson discusses the Wise-Anderson Treatment for Prostatitis.
Prostatitis, which means an infection or inflammation of the prostate gland, is often diagnosed without the doctor doing any tests at all to establish the validity of such a diagnosis. As we have seen in a study of physicians in Wisconsin, a large majority of doctors view prostatitis as an inflammation or bacterial infection, and almost all prescribe antibiotics as a treatment. Most urologists know from their own experience that antibiotic treatment for prostatitis without evidence of infection routinely fails to help the patient’s symptoms and yet almost 100% of the cases of this kind of prostatitis receive antibiotics. We are always troubled to hear this routine diagnosis and antibiotic treatment in the patients who come to see us, when the patient’s doctor made no attempt to establish the presence of infection.
We always check for evidence of infection and inflammation in the prostatic fluid with men who complain of pelvic pain and urinary dysfunction. As we will discuss, antibiotics can have serious side-effects, especially when taken long-term. And we have had more than a few men suffer the consequences of inappropriate long-term antibiotic treatment.
We want to emphasize that the antibiotic treatment of bacterial prostatitis has been an achievement of modern medicine. If you have bacterial prostatitis, antibiotics are a very good treatment—certainly the only treatment. Viewing all conditions of pelvic pain and dysfunction in men, however, as acute or chronic bacterial prostatitis is an error in therapeutic judgment.
Despite the clear scientific evidence to the contrary and almost every urologist’s clinical experience of the ineffectiveness of antibiotics for nonbacterial prostatitis, it is amazing that giving antibiotics routinely for nonbacterial prostatitis is the common practice. This is very important to understand, particularly if you have been diagnosed with prostatitis and it has not been determined whether infection or inflammation is present. We would consider it quite appropriate for a patient diagnosed with prostatitis to ask his doctor if there is clear evidence of bacteria, should the doctor prescribe antibiotics.
The prostate gland is not the problem with most men diagnosed with prostatitis.
In the majority of men diagnosed with chronic prostatitis, the symptoms of pain arise from tender trigger points in the pelvic muscles. In recent years, there is clear evidence that a large majority of men typically complaining of the referenced symptoms have no prostate pathology and no infection demonstrated by culture. Even the evidence of inflammation (white cells found in the prostatic fluid) does not account for the referenced symptoms because typically when inflammation is removed, symptoms remain.
Chronic tension in the pelvic muscles is the source of pain in a majority of men diagnosed with prostatitis.
The great majority of men (95%) complaining of prostate and pelvic pain symptoms, have no evidence of prostate infection. This is why antibiotics fail to resolve symptoms. Additionally, even when there is some inflammation seen in the prostatic fluid it does not appear to be related to the degree of pain being suffered. The fact that is unfortunately resisted by many medical professionals is that most men with the referenced symptoms suffer from chronically tightened muscles inside the pelvic floor. When areas of this chronic tension are pressed on, as confirmed in our 2009 study published in the Journal of Urology, many symptoms above are recreated. When pelvic floor trigger points are resolved, the pelvic floor muscles are relaxed, the anxiety related to them calms down, and the symptoms tend to significantly reduce or disappear. Teaching our patients to release pelvic floor trigger points and lower the nervous system arousal related to them is the aim of our 6-day clinics.