Chronic Prostatitis and Its Connection to Bladder Inflammation

Can chronic prostatitis cause cystitis?

Dear Dr.
Hsu,
Thank you very much for your valuable advice, which has helped me clarify some doubts I have.
I am currently working overseas, and I am experiencing frequent urination along with painful urination.
Additionally, my recent health check revealed that my glomerular filtration rate (GFR) is only about 84%, which has alarmed me, as I wonder if this is a result of my previous chronic prostatitis.
This issue dates back to my third year of junior high school when I first experienced urethritis.
I took anti-inflammatory medication, which provided some improvement (at that time, there were no specialists in my rural area, and I obtained the medication from a pharmacy).
A few months later, I experienced urethritis again, but this time the painful urination did not improve.
I later underwent a circumcision and had a cystoscopy at Kaohsiung Medical University, but there were still no results.
Due to the lack of information and the absence of health insurance at that time, the costs were quite high, so I had to endure the symptoms.
After my military service, I visited a clinic where the doctor suggested it was prostatitis.
I received injections and medication, but there was still no relief.
Coincidentally, the technician who conducted my prostate tests became a good friend and helped me find a doctor who prescribed medication for me.
Unfortunately, I developed drug-induced hepatitis and had to stop the medication.
I then consulted a urologist at Kaohsiung Veterans General Hospital, who stated it was not prostatitis, but he did not specify what the condition was.
Since I thought it was just painful urination, I did not pursue it further.

Now, after undergoing examinations at a hospital overseas, including a cystoscopy, it was found that I have benign prostatic hyperplasia (BPH) compressing the urethra.
The doctor prescribed Harnalocars, and my symptoms have improved.
However, I am concerned that chronic prostatitis may still be unresolved, as I urinate about 200cc or less each time, and the frequency has exceeded the standard of 8 times.
Additionally, I sometimes experience dull pain below my navel, and I wonder if this could be cystitis.
I realize that my previous ignorance has led to greater problems, and now that I am overseas, I can only cooperate with local doctors to stabilize my condition.
I have a few questions I would like to ask:
1.
Should I ask the doctor to recheck my prostatic fluid?
2.
Is it necessary to have a blood test for PSA?
3.
Are there signs of cystitis in my bladder?
4.
Are there any other physical examinations I should undergo?

Xiao Feng, 40~49 year old female. Ask Date: 2015/08/04

Dr. Xu Weikai reply Urology

Hello! 1.
Yes.
2.
Yes.
3.
It depends on the urine tests and clinical symptoms.
4.
If you are concerned about kidney function, you can consult a nephrologist for relevant tests.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Online responses should only be used as a reference; if necessary, it is important to seek medical care at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/08/04

More Info

Chronic prostatitis is a complex condition that can significantly impact a patient's quality of life. It often presents with a variety of symptoms, including pelvic pain, urinary frequency, and discomfort during urination. Your concerns about the connection between chronic prostatitis and bladder inflammation are valid, as these conditions can indeed influence one another.

1. Rechecking Prostate Fluid: It is reasonable to discuss with your physician the possibility of rechecking your prostate fluid. While prostate fluid analysis can provide valuable information, it is not always definitive. In cases of chronic prostatitis, especially non-bacterial forms, symptoms may persist despite normal findings in prostate fluid. Therefore, a comprehensive evaluation that includes a physical examination and possibly imaging studies may be warranted.

2. PSA Blood Test: A PSA (Prostate-Specific Antigen) test can be beneficial in assessing prostate health. Elevated PSA levels can indicate inflammation or other prostate issues, including prostate cancer. Given your history of prostate enlargement and ongoing symptoms, it would be prudent to discuss the necessity of a PSA test with your doctor.

3. Bladder Inflammation: The symptoms you describe, such as frequent urination and pain during urination, could suggest bladder inflammation or cystitis. A urinalysis can help determine if there is an infection or other abnormalities in the bladder. If your urinalysis shows signs of infection (like white blood cells or bacteria), it may indicate cystitis, which could be related to your chronic prostatitis.

4. Additional Diagnostic Tests: Depending on your symptoms and initial test results, your physician may recommend further diagnostic tests. These could include imaging studies like an ultrasound or CT scan to assess the bladder and prostate, or a cystoscopy to visually inspect the bladder and urethra. Additionally, if kidney function is a concern, a referral to a nephrologist for further evaluation may be appropriate.

Chronic prostatitis can indeed lead to complications if left untreated. While it may not directly cause bladder inflammation, the two conditions can coexist and exacerbate each other. Chronic inflammation in the prostate can lead to pelvic pain syndromes, which may contribute to bladder symptoms. Furthermore, if there is a persistent infection or inflammation, it could potentially affect kidney function over time, as indicated by your reduced glomerular filtration rate (GFR) of 84%.
It is essential to maintain a dialogue with your healthcare provider about your symptoms and any changes you experience. Lifestyle modifications, such as staying hydrated, avoiding irritants (like caffeine and alcohol), and practicing stress management techniques, can also help alleviate symptoms.

In summary, your concerns about chronic prostatitis and its potential connection to bladder inflammation are valid. It is crucial to work closely with your healthcare provider to monitor your condition, conduct necessary tests, and adjust your treatment plan as needed. Chronic prostatitis can be a challenging condition, but with appropriate management, many patients find relief from their symptoms and improve their quality of life.

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