Prostatic congestion

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Prostatic congestion is a medical condition of the prostate gland that happens when the prostate becomes swollen by excess fluid and can be caused by prostatosis. The condition often results in a person with prostatic congestion feeling the urge to urinate frequently. Prostatic congestion has been associated with prostate disease, which can progress due to age. Oftentimes, the prostate will grow in size which can lead to further problems, such as prostatitis, enlarged prostate, or prostate cancer. [1]

Contents

Prostatic congestion is commonly observed in individuals between the ages of 20–40 years. It can however appear during any age. [2] Chronic prostatitis is one of the main causes of this condition and this occurs when there is accumulation of fluid that can lead to swelling of the prostate that can therefore lead to congestion. [3] Other possible causes of prostatic congestion include benign prostatic hyperplasia, [4] prostate cancer, [5] urinary tract cysts, [6] and infrequent ejaculations. [7] [8]

Symptoms are often patient-specific, and diagnosis includes a workup and a digital rectal examination. Individuals are often referred to a urologist for further examination.

Treatments identified for prostatic congestion include mechanical treatments such as varicocele sclerotherapy, [4] minimally invasive treatments, [9] and alternative treatments such as massaging the prostate regularly, [10] [11] acupuncture combined with Traditional Chinese Medicine, dietary supplementation, exercise, and other therapies such as warm baths, local therapy with heating pads, and physical therapy. An alternative form of medicine called Ayurveda is also used for treatment. Medical consultation is recommended before attempting these treatments.

Possible causes of prostatic congestion

There is limited information available on prostatic congestion, as it has been commonly associated as a side effect or complication of other conditions, such as chronic prostatitis. Due to this, there are lifestyle factors that are able to influence the symptoms of such conditions due to their relation to prostatic congestions. In a nationwide epidemiological survey in China, it was found that an increase in alcohol consumption was related to an increase in symptoms of discomfort or pain from their chronic prostatitis. This was due to the understanding that alcohol in circulation can exacerbate prostatic congestion, contributing to such symptoms. [16] The prostate is sensitive to alcohol therefore alcohol consumption can also increase how severe the congestion may be. [17] This is because acetaldehyde, a breakdown product of ethanol, can lead to vasodilation and therefore prostate congestion and cause inflammation. [15]

Signs and symptoms

Common Symptoms

Symptoms vary depending on the cause of the prostatic congestion. [8] [18]

In addition to these symptoms, prostatitis can be a complication of recurrent prostatic congestion. In cases where an individual engages in minimal sexual activities resulting in reduced ejaculation frequency, there can be an accumulation of secretion leading to prostatic congestion. This can block the prostatic ducts, ultimately increasing the person's risk of developing prostatitis. [19]

Serious Symptoms

If an individual experiences the following symptoms, it is highly encouraged to seek medical attention for a proper diagnosis. [18]

Diagnosis

A workup is an important factor for diagnosis since symptoms can vary and are patient specific. One exam that is performed is a digital rectal examination to examine the prostate. The doctor may refer the individual to another doctor that specializes in urinary tract disease, also known as a urologist. A urologist may perform additional tests such as a prostate-specific antigen (PSA) blood test or a bladder pressure testing. Imaging tests such as transrectal ultrasound and magnetic resonance imaging (MRI) might also be performed. Although prostatitis does not increase the risk of prostate cancer, a prostate biopsy may be performed. [20]

Treatment

Mechanical Treatments

Varicocele Sclerotherapy

Since the testicular and prostatic veins are connected, back flow of fluid from the testicular veins can cause fluid to be backed up into the prostate. Varicocele sclerotherapy is a procedure that seals off veins that contain a lot of fluid and redirect blood flow through other veins, thereby relieving fluid backed up to the prostate. A study with 36 participants from ages 40-80 was conducted , and the results were statistically significant in that varicocele sclerotherapy helps relieve pressure on the prostate, thereby relieving prostatic congestion. [4]

Minimally invasive Treatments

Although there are not many studies on this, due to expense and lack of support from healthcare systems, minimally invasive therapies include form of heating the prostate. A needle is inserted directly into the prostate, or, a catheter, endoscope or probe is inserted into the urethra. There are two types of heating: low energy and high energy. Low energy heating include using laser, microwave or electrical methods, and high energy includes vaporization of the prostatic tissue. Vaporization usually requires anesthesia. [9]

Alternative Treatments

Massaging Prostate Regularly

Physicians have recommended massaging the prostate regularly to reduce congestion in the prostate. In 1980, a study was conducted in which participants were given 10 sessions of prostate massages in 3–4 weeks and hypertrophy (enlargement of an organ) was reduced in almost all participants. [11] By massaging the prostate, it causes a release of the inflammatory cells and fluids that have accumulated in the prostate gland, leading to congestion or enlargement. This method has been historically used as a treatment for prostatitis, as prostatic congestion has been commonly associated with prostatitis. [10]

There is still limited information available on prostatic congestion treatment, however, there have been studies that combined therapies to address prostatic congestion in the presence of prostatitis. For example, the combination of antibiotic and prostatic massage was found to help relieve chronic pelvic pain syndromes in people with chronic prostatitis. This was based on the understanding that massage treatment has been previously shown to help relieve prostatic congestion. [21]

Acupuncture combined with traditional Chinese medicine

Acupuncture combined with Chinese medicine can alleviate symptoms caused by prostate congestion and can be used as an effective treatment method for chronic prostatitis. A systematic review and meta-analysis published in 2021 used 19 randomized controlled trial studies with a total of 1831 cases to come to this conclusion. The results highlighted that acupuncture combined with traditional Chinese medicine could improve patients’ urination symptoms, alleviate pain symptoms, and overall improve quality of life. In addition, results showed that with these alternative treatments there was no increase in adverse reactions. [22]

Dietary supplement

Saw palmetto, a phytotherapeutic agent, has been shown to reduce prostatic congestion and urinary symptoms related to benign prostate hyperplasia. The exact mechanism is unknown however it is commonly believed to work by inhibiting the enzyme 5-alpha reductase that converts testosterone into dihydrotestosterone, its active metabolite. [23] An individual with benign prostate hyperplasia may produce an excessive amount of dihydrotestosterone. Increase in dihydrotestosterone levels can lead to enlargement of the prostate since it plays a role in the hyperplasia of the prostate stomal and epithelial cells. [24]

Exercise

Walking or performing regular exercise for 30 minutes a day, 5 times a week can help alleviate symptoms of an enlarged prostate or acute prostatitis that can lead to congestion. It can also help prevent the development of congestion in the prostate in the future and help reduce any pain experienced due to congestion. [25]

Other

Other treatments can include warm baths, local heat therapy with heating pads, and physical therapy. Some examples of physical therapy would be pelvic muscle exercises which strengthen and relax muscles that hold the bladder in place. Myofasical release is a trigger point release which can also help in relieving pain symptoms. This includes pressing and stretching with a warming or cooling device the muscles in the lower back and pelvic area. [26]

Clinical studies

Medication

Bangshil and Fortege are commonly used as an alternative form of medication called Ayurveda. When taken together, they have said to help with prostatic congestion and other symptoms experienced during urination. Bangshil tablets contain the following ingredients: Shilajit (Asphaltum), Guggul (Balsamodendron Mukul), Svarnamakshika Bhasma (Ferri sulphuratum), Kasis (Ferr: sulphas),Vanslochan (Bambusa arundinaecia), Bang Bhasma (Tin Bhasma), Sandalwood oil, Chandraprabha Co. Some of the ingredients found in Bangshil are thought to have antibacterial properties to help keep the prostate free of infection. Fortege tablets contain the following ingredients: Kamboji (Breynia patens), Kuuncha beej (Mucuna pruriens), Suddha Kachura (Stryclmos yuxvQmica), Samudra Sesh Beej (Argyria speciosa), Vardhara beej (Rourea santaloides seeds), Asan (Withania Somnifera), Vardhara mool (Rourea santaloids root). Some of the ingredients found in Fortege are thought to help strengthen the genitourinary system. [2]

Between January 1978 and June 1979, a study of 104 individuals between the ages 17–60 years old were given Bangshil and Fortege for 6 weeks where prostatic congestion resolved for 40.2% of cases, “much improved” for 42.3% of cases, “slight improvement” seen in 5.8% of cases and no improvement for 11.5% of cases. There was also improvement of symptoms such as burning urination and low back pain in most participants. The study observed these improvements for most patients in two weeks and reported absence of side effects from the treatments. [2]

Related Research Articles

<span class="mw-page-title-main">Prostate</span> Gland of the male reproductive system in most mammals

The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemically, and physiologically. Anatomically, the prostate is found below the bladder, with the urethra passing through it. It is described in gross anatomy as consisting of lobes and in microanatomy by zone. It is surrounded by an elastic, fibromuscular capsule and contains glandular tissue, as well as connective tissue.

<span class="mw-page-title-main">Benign prostatic hyperplasia</span> Noncancerous increase in size of the prostate gland

Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control. Complications can include urinary tract infections, bladder stones, and chronic kidney problems.

<span class="mw-page-title-main">Retrograde ejaculation</span> Redirection of ejaculated semen into the urinary bladder

Retrograde ejaculation occurs when semen which would be ejaculated via the urethra is redirected to the urinary bladder. Normally, the sphincter of the bladder contracts before ejaculation, sealing the bladder which besides inhibiting the release of urine also prevents a reflux of seminal fluids into the male bladder during ejaculation. The semen is forced to exit via the urethra, the path of least resistance. When the bladder sphincter does not function properly, retrograde ejaculation may occur. It can also be induced deliberately by a male as a primitive form of male birth control or as part of certain alternative medicine practices. The retrograde-ejaculated semen, which goes into the bladder, is excreted with the next urination.

Dysuria refers to painful or uncomfortable urination.

<span class="mw-page-title-main">Urinary retention</span> Inability to completely empty the bladder

Urinary retention is an inability to completely empty the bladder. Onset can be sudden or gradual. When of sudden onset, symptoms include an inability to urinate and lower abdominal pain. When of gradual onset, symptoms may include loss of bladder control, mild lower abdominal pain, and a weak urine stream. Those with long-term problems are at risk of urinary tract infections.

<span class="mw-page-title-main">Spermatocele</span> Medical condition

Spermatocele is a fluid-filled cyst that develops in the epididymis. The fluid is usually a clear or milky white color and may contain sperm. Spermatoceles are typically filled with spermatozoa and they can vary in size from several millimeters to many centimeters. Small spermatoceles are relatively common, occurring in an estimated 30 percent of males. They are generally not painful. However, some people may experience discomfort such as a dull pain in the scrotum from larger spermatoceles. They are not cancerous, nor do they cause an increased risk of testicular cancer. Additionally, unlike varicoceles, they do not reduce fertility.

<span class="mw-page-title-main">Tamsulosin</span> Uroselective alpha 1 blocker

Tamsulosin, sold under the brand name Flomax among others, is a medication used to treat symptomatic benign prostatic hyperplasia (BPH) and chronic prostatitis and to help with the passage of kidney stones. The evidence for benefit with a kidney stone is better when the stone is larger. It is taken by mouth.

<span class="mw-page-title-main">Acute prostatitis</span> Serious bacterial infection of the prostate gland

Acute prostatitis is a serious bacterial infection of the prostate gland. This infection is a medical emergency. It should be distinguished from other forms of prostatitis such as chronic bacterial prostatitis and chronic pelvic pain syndrome (CPPS).

Saw palmetto extract is an extract of the fruit of the saw palmetto. It is marketed as a dietary supplement that may help with benign prostatic hyperplasia, but there is no clinical evidence that it is effective for this purpose.

<span class="mw-page-title-main">Mepartricin</span> Chemical compound

Mepartricin is a macrolide polyene compound that is useful for urethra, prostate, and bladder function. It has been studied for use in treating chronic pelvic pain syndrome and benign prostatic hyperplasia.

Lower urinary tract symptoms (LUTS) refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra and, in men, the prostate. The term is more commonly applied to men—over 40% of older men are affected—but lower urinary tract symptoms also affect women. The condition is also termed prostatism in men, but LUTS is preferred.

<span class="mw-page-title-main">Transurethral microwave thermotherapy</span> Medical procedure

Transurethral microwave thermotherapy (TUMT) is one of a number of effective and safe procedures used in the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia. It is an alternative treatment to pharmacotherapy such as alpha blockers, transurethral resection of the prostate (TURP), transurethral needle ablation of the prostate, photoselective vaporization of the prostate and prostatic removal or prostatectomy.

<span class="mw-page-title-main">Chronic bacterial prostatitis</span> Bacterial infection of the prostate gland

Chronic bacterial prostatitis is a bacterial infection of the prostate gland. It should be distinguished from other forms of prostatitis such as acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS).

<span class="mw-page-title-main">Chronic prostatitis/chronic pelvic pain syndrome</span> Medical condition

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), previously known as chronic nonbacterial prostatitis, is long-term pelvic pain and lower urinary tract symptoms (LUTS) without evidence of a bacterial infection. It affects about 2–6% of men. Together with IC/BPS, it makes up urologic chronic pelvic pain syndrome (UCPPS).

<span class="mw-page-title-main">Asymptomatic inflammatory prostatitis</span> Medical condition

Asymptomatic inflammatory prostatitis is a painless inflammation of the prostate gland where there is no evidence of infection. It should be distinguished from the other categories of prostatitis characterised by either pelvic pain or evidence of infection, such as chronic bacterial prostatitis, acute bacterial prostatitis and chronic pelvic pain syndrome (CPPS). It is a common finding in men with benign prostatic hyperplasia.

Urologic diseases or conditions include urinary tract infections, kidney stones, bladder control problems, and prostate problems, among others. Some urologic conditions do not affect a person for that long and some are lifetime conditions. Kidney diseases are normally investigated and treated by nephrologists, while the specialty of urology deals with problems in the other organs. Gynecologists may deal with problems of incontinence in women.

<span class="mw-page-title-main">IgG4-related prostatitis</span> Medical condition

IgG4-related prostatitis is prostate involvement in men with IgG4-related disease (IgG4-RD), which is an emerging fibroinflammatory disease entity which is characterised (i) by a tendency to mass forming lesions in multiple sites of the body and (ii) by usually a prompt response to steroid therapy.

<span class="mw-page-title-main">Prostatic artery embolization</span> Non-surgical technique for treatment of benign prostatic hypertrophy

Prostatic artery embolization is a non-surgical technique for treatment of benign prostatic hypertrophy (BPH).

<span class="mw-page-title-main">Surgery for benign prostatic hyperplasia</span> Type of surgery

If medical treatment is not effective, surgery may need to be performed for benign prostatic hyperplasia.

References

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  3. ↑ Mo MQ, Long LL, Xie WL, Chen S, Zhang WH, Luo CQ, Deng LW (December 2014). "Sexual dysfunctions and psychological disorders associated with type IIIa chronic prostatitis: a clinical survey in China". International Urology and Nephrology. 46 (12): 2255–2261. doi:10.1007/s11255-014-0810-2. PMID   25158893. S2CID   22642788.
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