Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.
The question every chronic prostatitis sufferer asks. Why doesn't his urologist want to treat him?
There are many reasons. The cruel fate of c.p. sufferers is that their illness falls between 2 stools: Urology and sexual transmitted disease. And this is central in understanding why urologists don't want to treat you. Why his shoulders sag as soon as you enter the room.
1) Status. A urologist doesn't want to be associated with STDs. In every profession, there is a "pecking order", and medicine is no different. Heart surgeons, brain surgeons, are at the top. Urologists are not. But within urology, and amongst urologists, there is also a pecking order; and any urologist worth his salt doesn't want to be associated with treating STDs. It's not status enhancing.
2) Ego. Which is closely related to the first reason, but with a subtle twist. There is no glory in treating chronic prostatitis. Nobody cares about the illness. There is no "pyschological payback" for the urologist, or from his patient for that matter. Conversely, if the urologist manages to cure somebody with bladder cancer, or prostate cancer, then he is going to be glorified by the patient and his family. This feeds the doctor's sense of self. His ego. After all, cancer is perceived as far more important than prostatitis.
3) Diagnostic Testing. Almost all the tests to identify prostatitis and to successfully treat it, are either unpleasant, tedious, or need to be repeated over long periods of time. In some cases--years. If not to cure the illness (and many are cured), then to keep the illess under control. This requires stamina on the part of the physician; but when progress is slow, or non-existent, and yet more tedious and unpleasant tests are required, the urologist gives up, or loses heart. or passes the patient on to somebody else, or accuses the patient "it's all in his head".
4) These Unpleasant Tests. If infection is suspected, bacteria has to be removed from the prostate gland via massage. The key to an early cure. If bacteria is found, it can be taken to the lab, tested, and an effective antibiotic prescribed. But most urologists refuse to do this basic test. Why? It's a simple test, which if done correctly, lasts no longer than 60 seconds--yet very few urologists can obtain fluid by massage. So what do they do? They tell you that these tests don't work, or your urine is clear, or it's the wrong day of the week, etc, etc. But the truth is, they don't want to do the massage. Why? Because the test is disgusting--that's why, to both doctor and patient. It's unnatural. It's against Judeo/Christian teachings. It's not what the doctor came into medicine for. It's not what he wants to discuss with his wife over dinner when she ask him, "Has he had a nice day?". The test has homosexual overtones. Sticking your finger up another man's rectum is what homosexuals do. It's not something any "normal" person would do, or want to have done. So the doctor shakes his head, says no massage for you, then hands the patient a sackful of antibiotics which won't work. By now, the patient has moved from the acute stage of prostatitis, to the chronic stage. His chances of a cure have diminished substantially.
5) Money. There's more money in treating prostate cancer.
I can think of more reasons. But it's getting late. Feel free to add more reasons if you wish.