Prostate Pain

Prostate pain is caused by inflammation of the prostate gland, which is an exocrine gland of the male reproductive system. Its main function is to secrete and store a fluid that makes up one third of the volume of semen. This inflammation of the prostate is also known as prostatitis. If the prostate grows too large, may constrict the urethra and impede the flow of urine, making urination difficult and extremely painful and in extreme cases completely impossible. Prostatitis is usually treated with antibiotics, prostate massage or in extreme cases, surgery.

In older men, the prostate gland often enlarges to the point where urination becomes difficult. This is known as benign prostatic hyperplasia and can be treated with medications or surgery to remove a portion of the prostate gland. The surgical technique used in these cases is called transurethral resection of the prostate. In this case, an instrument is inserted through the urethra to remove excess prostate tissue that is pressing against the top of the urethra and restricting urine flow.

Prostate cancer is one of the most common cancers affecting elderly men in developed countries and the leading cause of death among them. Rectal exams are recommended for older men to detect prostate cancer in its early stages. There is also a blood test that measures the concentration of a protein, Prostate Specific Antigen (PSA), which is usually very low.

Results of higher and more sophisticated tests can be an indicator of disorder within the prostate or prostatitis or benign hyperplasia or prostate cancer. The PSA test can not distinguish between them, but certainly can lead a doctor to investigate further. Prostate cancer is treated with hormone manipulation, which is preventing the production of testosterone, with radiation and surgery. It was recently discovered that a drug called docetaxel may be effective in treating prostate cancer.

Pain Medicine

Pain medications usually with analgesics, medically known as analgesics. It is a member of the diverse group of drugs used to relieve pain. The word analgesic is derived from the Greek word "a" meaning "without", and "algia" meaning "pain".

Analgesic drugs act differently in the peripheral and central nervous system of the body. These include paracetamol (acetaminophen), nonsteroidal antiinflammatory drugs (NSAIDs) such as salicylates, narcotics such as morphine, synthetic drugs with narcotic properties such as , and various others. Some other classes of drugs, not otherwise considered analgesics are also used to treat neuropathic pain syndromes, including tricyclic antidepressants and anticonvulsants.

Analgesics can be broadly classified into three groups. The first consists of acetaminophen and NSAIDs. The exact mechanism of action of paracetamol is uncertain, but appears to act centrally. Aspirin and NSAIDs inhibit cyclo-oxygenase, resulting in a decrease in the production of prostaglandins. This improves the pain and inflammation, in contrast to paracetamol and opioids. Paracetamol has few side effects, but the administration is limited by possible hepatotoxicity (potential for liver damage). NSAIDs may predispose to peptic ulcers, kidney failure, allergic reactions, and hearing loss, and may also increase the risk of bleeding.

The second group of opiates and morphinomimetics. and buprenorphine are considered partial agonists of opiate receptors. Morphine, common opioids, and several other drugs such as pethidine, oxycodone, hydrocodone and diamorphine, all exert a similar influence on the brain opioid system. The dosage may be limited by the toxicity caused by opioid drugs leads to confusion, myoclonic jerks and the pupils, but no dose ceiling in patients who can tolerate this. Opioid analgesics, although very effective, can have some unpleasant side effects. Up to 1 in 3 patients starting morphine may experience nausea and vomiting, which usually is relieved with a short course of antiemetics. The itching may require a change to a different opioid. Constipation occurs in almost all patients on opioids, and laxatives such as lactulose, macrogol-containing or co-danthramer often co-prescribed. When used appropriately, opioids and similar narcotic analgesics are safe and effective, carrying relatively little risk of addiction. Occasionally, gradual dose reduction is necessary to avoid withdrawal symptoms.

The third category is that of the specific agents consumed by patients suffering from chronic or neuropathic pain. Tricyclic antidepressants, especially amitriptyline, have shown improvement in pain so apparently a station. The exact mechanism of carbamazepine, gabapentin and pregabalin is unclear, too, but these anticonvulsants are used to treat neuropathic pain with modest success.