"Chronic Prostatitis"

- a condition in need of new impulses -

1996, Ivo Tarfusser, MD

Every urologist who is closely following whatever has been written or presented on the subject of prostatitis will soon discover that very little progress (if any) has been made during the past 20 years. This certainly is very frustrating for most doctors and patients, but can be a unique opportunity for those who want to dig into some large, yet still unexplored field in medicine (there are not too many left). This has been a challenge also to me, and I learned that a whole deal of very interesting knowledge can be gained by dedicating some positive interest to this matter. I would like to share my experience on this internet news group, which I consider a perfect platform for discussing this difficult field. In fact, I am convinced that scientific journals like the Journal of Urology are not suited for this purpose and I'll explain why: such periodicals accept articles only if they are based on methods which fulfill strict scientific criteria. However, I have found that in order to study something so diffuse like prostatitis one has to adopt more unconventional methods which regrettably have the disadvantage of not always being quantifiable (like e g the size of a kidney stone to be crashed, or the mortality in a population of cancer patients treated with a certain drug). Furthermore, there are too many variables involved in the genesis of "prostatitis", which, from a strict scientific point of view, renders any conclusion uncertain and questionable and, therefore, unsuitable for publishing on scientific magazines. This is certainly one of the main reasons for the nearly complete stall of prostatitis research. Sometimes, when we seem to be faced with an inpenetrable wall, like in the case of this condition, it may be necessary to take a step backward to gain some distance and create new working hypotheses. Nevertheless, I am convinced that systematic observations can deliver a lot of plausible and practically useful understanding of this condition. In the following, divided into several articles, I will survey shortly the current view on "prostatitis" and, subsequently, based on the results of several years of studying patients with "prostatitis", I will try to expose my own considerations on the nature of this condition, and on what I think to be a meaningful approach for diagnosis and treatment. I want to point out that several conclusions are not officially supported by the urologic community (i e they have not yet been published by me or others), neither do I want to create the impression of claming some sort of miraculous therapy. I am, however, sure that anybody (and not only me) really interested in prostatitis with a capacity to approach the problem with open eyes (avoiding to get stuck in the deadlock of current knowledge) can contribute with a lot of interesting observations.