Chlamydia trachomatis has emerged as a very important pathogen causing both symptomatic and asymptomatic genitourinary infections and infertility. It is very common in our Clinic to find a majority of the prostatitis patients who come to us, and who were previously diagnosed as "abacterial" are infected with Chlamydia trachomatis. After some thousands of patients, we now know that Chlamydia trachomatis is the most significant cause of chronic prostatitis.
Chlamydia in Male Chronic Prostatitis Patients
Chlamydia enters the male genital tract through the urethra. The urethral pain that follows is usually moderate with a discharge that is clear, mucous or bloody for up to several days. Once infection reaches the prostate and bladder, typical symptoms of urgency, frequency, nocturia and dysuria develop. This development is very rapid, and inspection of semen and urine at this point will reveal numerous white and red blood cells.
The rapidly worsening infection causes scarring in the urethra which can even advance to strictures.
Damage of the prostate appears also as scar tissue and as more time goes by, enlargement of the prostate follows.
The ongoing infection will move to the seminal vesicles and ductus deferens and also cause calcification.
Infection of the seminal vesicles will damage the lining and the semen color will become yellowish and may include blood along with a decrease in semen volume. There will likely be pain during and after ejaculation and pain and discomfort in associated areas. By this time, a long-term course of antibiotic injections will be required to cure the chronic prostatitis patient.
Chlamydia in Female PID Cases
Chlamydia trachomatis in the female patient leads to cervicitis and urethritis, and on to Pelvic Inflammatory Disease (PID) and Tubal Factor Infertility (TFI). Common symptoms are painful intercourse, a vaginal discharge that is yellow and strong smelling, post-intercourse vaginal bleeding, and frequent urination with pain and burning.
Chlamydia infection may precede HIV-related AIDS and Papilloma virus in the cervix. Chlamydia trachomatis has also been implicated in an increased risk of cervical cancer. Chlamydia trachomatis may reside asymptomatically in the vaginal until sexual activity commences. Once Chlamydia reaches the uterus and upper reproductive system serious damage can take place, including endometritis, pelvic inflammatory disease (PID) and salpingitis. The most common symptoms are general abdominal pain, lower back pain, irregular periods often with interspersed with bleeding, spontaneous miscarriage, ectopic pregnancy (eccysis), obstructed fallopian tubes and resulting infertility.
Important Factors associated with Chlamydia
- Symptoms of Chlamydia can be mild or absent, especially in women, and serious complications, including infertility, can take place before the patient becomes aware of the problem
- There are believed to be over 50 million new cases annually worldwide
- Chlamydia is the most common sexually-transmitted disease in the USA
- An infected mother can infect her baby during vaginal childbirth
- Chlamydia can be transmitted during vaginal, oral and anal sex
- The often lack of symptoms by both sexes means many urologists miss identifying Chlamydia. This results in the "abacterial" verdict, or as a guess they frequently prescribe un-targeted antibiotics weakening the patient's immune system, along with creating antibiotic resistance and allowing the infection to create more serious damage
Infection Complications associated with a "Silent" Pathogen in Men and Women
- Male infertility
- Pelvic inflammatory disease (PID)
- Female Infertility
- Ectopic pregnancy
Chlamydia Laboratory Testing in Chronic Prostatitis and PID Cases
Chlamydia tends to hide in tissues deep in the genitourinary tract in the chronic infection stage, making it hard to obtain samples. For Chronic Prostatitis patients, the standard tests of urine and EPS are insufficient.
In first world countries where there are more highly developed medical services, there are more authoritative tests that can be done, however unless the patient has very good medical insurance, they may be difficult to access, especially if the all-too-easy verdict of "abacterial" is delivered by the patient's Doctor.
Should a patient be lucky enough to have all points in their favor (diligent Doctor, access to expensive tests), the following tests for Chlamydia infection should be sought:
- Chlamydia culture - test samples must be Lab. grown for 5 to 7 days (Labs will routinely refuse this unless pressed).
- DNA probe test (Nucleic acid hybridization test). This test is very accurate.
- DFA test (Direct fluorescent antibody test) This test can find Chlamydia antigens.
- NAAT (nucleic acid amplification test) A test looking for the DNA of chlamydia. This test is very accurate in identifying chlamydia. A PCR (polymerase chain reaction test) is an example of a NAAT test. A urine sample can be utilised for this test.
- ELISA (enzyme-linked immunosorbent assay testnzyme-linked immunosorbent assay test) This test isolates substances (antigens) causing the immune system to attack chlamydia.
Treatment of Chlamydia Infection In Chronic Prostatitis and PID Cases
Without proper testing, treatment is often a guess of a broad-spectrum antibiotics, usually followed by repeat courses, all for periods that even as a guess are likely to be too short. This may control symptoms only during the period of the medication course and shortly thereafter. The patient will likely relapse and the infection will progressively become resistant.
In the rare situation of a positive test for Chlamydia, the following drugs and recommendations apply:
- Azithromycin (Zithromax)
- Doxycycline (Vibramycin) - contraindicated during pregnancy
- Amoxicillin for the treatment of pregnant women
- Metronidazole (Flagyl) + Erythromycin for persistent urethritis
- No alcohol
- No sexual activity!
- Screen for HIV
However in chronic cases of prostatitis and PID where Chlamydia has been isolated in tests, it is very unlikely that oral antibiotics will kill the infection because the drugs listed above cannot penetrate the infected and blocked areas in the concentration required.
The Chlamydia-infected areas are by now usually found deep in the genitourinary tract where the oral concentration of the drug(s) along with possible resistance simply cannot do the job.
In these cases, our Clinic has successfully treated many Chlamydia patients. Have a read here to discover exactly why our unique treatment technique have cured so many cases of Chronic Prostatitis and PID due to Chlamydia.