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Testimony ofDr. Richard Alexander

Urologist and Associate Professor of Urology at the University of Maryland School of Medicine in Baltimore, Maryland.

(Appearing before the House Appropriations Subcommittee, February 29, 1996.)

I am Dr. Richard Alexander, a urologist and Associate Professor of Urology at the University of Maryland School of Medicine in Baltimore, Maryland.
Chronic prostatitis is truly the forgotten disease of men in this country. You have heard the frustration of patients with this disease. Urologists too are frustrated in trying to care for these men.
I am here to tell you that we do not know what to do for these patients. We do not understand why they have symptoms. We can offer little more than empirical or palliative therapies that, for the most part, do not work. These patients appear to have a disease caused by an infection of the prostate gland. And yet an infectious agent can be documented to be present and probably responsible for the symptoms in only 5% of cases. The vast majority of patients have a disease we are at a complete loss to explain.
And a significant disease it is. I coordinated a survey of prostatitis patients using the Internet last fall. One hundred, sixty three patients responded to the survey. With a mean age of 43 years these men are in the prime of their productive life. They describe a chronic, relapsing and episodic set of symptoms characterized by pelvic pain, irritative voiding symptoms and effects on their sexual life. They have been symptomatic for an average, an average, of 6 years. Half of the men have missed work because of the disease. Some are on permanent disability. Over two thirds report minor or major depression because of the disease and 5% report thoughts of suicide. They have received a bewildering array of antibiotic medications prescribed by a mean of 3.2 different doctors at great cost to our health care system and at almost no benefit to them. Often because of frustration with our inability to understand the disease patients will be prescribed almost anything that will get them out of the office. There is simply nothing else to offer them.
The state of research in this disease is woefully inadequate. At a workshop on chronic prostatitis held at the NIH last December a group of us from around the country could not agree how to define the disease, what to call it, or even that we know enough to conclude it is a disease of the prostate!
What needs to be done? To understand the disease will require research and hard work. This must consist of clinical investigation of patients as well as basic laboratory work. We must first create a definition, such as a set of symptoms or signs, which can reliably resolve the population of men with the disease form normal men or men with other benign diseases of the prostate gland. We must then search for differences between such populations for factors which may give insight into cause. Controlled trials of selected empiric therapies should be performed so we can tell patients if such treatments have a chance of helping them with acceptable side effects. Only through such research will we ever begin to understand this disease.
Ladies and gentlemen of the committee, my only desire is to find out the truth. The words of these men who are my patients and your constituents cry out to you for help. Please do not let their plight go unrecognized and their appeal for help go unanswered. Thank you.
Richard B. Alexander, M.D.
Senate Appropriations Subcommittee testimony
February 29, 1996.
This information is forwarded to you by the Prostatitis Foundation. We do not provide medical advice. We try to distribute literature and information relevant to prostatitis. While we encourage all research we do not endorse any doctor, medicine or treatment protocol. Consult with your own physician.
© 2002 The Prostatitis Foundation
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