by Ivo Tarfusser, MD (© 1996)
Every urologist who is closely following whatever has been written orpresented on the subject of prostatitis will soon discover that very littleprogress (if any) has been made during the past 20 years. This certainly is veryfrustrating for most doctors and patients, but can be a unique opportunity forthose 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 Ilearned that a whole deal of very interesting knowledge can be gained bydedicating some positive interest to this matter. I would like to share myexperience on this internet news group, which I consider a perfect platform fordiscussing this difficult field. In fact, I am convinced that scientificjournals like the Journal of Urology are not suited for this purpose and I'llexplain why: such periodicals accept articles only if they are based on methodswhich fulfill strict scientific criteria. However, I have found that in order tostudy something so diffuse like prostatitis one has to adopt more unconventionalmethods 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 apopulation of cancer patients treated with a certain drug). Furthermore, thereare too many variables involved in the genesis of "prostatitis",which, from a strict scientific point of view, renders any conclusion uncertainand questionable and, therefore, unsuitable for publishing on scientificmagazines. This is certainly one of the main reasons for the nearly completestall of prostatitis research. Sometimes, when we seem to be faced with aninpenetrable wall, like in the case of this condition, it may be necessary totake a step backward to gain some distance and create new working hypotheses.Nevertheless, I am convinced that systematic observations can deliver a lot ofplausible and practically useful understanding of this condition. In thefollowing, divided into several articles, I will survey shortly the current viewon "prostatitis" and, subsequently, based on the results of severalyears of studying patients with "prostatitis", I will try to expose myown considerations on the nature of this condition, and on what I think to be ameaningful approach for diagnosis and treatment. I want to point out thatseveral conclusions are not officially supported by the urologic community (i ethey have not yet been published by me or others), neither do I want to createthe impression of claming some sort of miraculous therapy. I am, however, surethat anybody (and not only me) really interested in prostatitis with a capacityto approach the problem with open eyes (avoiding to get stuck in the deadlock ofcurrent knowledge) can contribute with a lot of interesting observations.