Chronic Nonbacterial Prostatitis

Written by Julie Roddick
Medically Reviewed by George Krucik, MD

What Is Chronic Nonbacterial Prostatitis?

Chronic nonbacterial prostatitis is a condition that causes pain and inflammation in the prostate (gland located directly below the bladder) and the lower urinary tract in men. It is a common condition, especially in men between the ages of 35 and 50, but it can lead to serious sexual and urinary problems if left untreated. Inflammation of the prostate accounts for almost two million doctor’s office visits per year. (Cleveland Clinic)

What Causes Chronic Nonbacterial Prostatitis?

Chronic nonbacterial prostatitis accounts for the majority of prostatitis cases in the United States, but the exact cause is unknown. (CCJM, 2001)

Doctors have identified several potential causes, including:

  • past bacterial infection in the prostate
  • bacteria that are nontypical (resistant to antibiotics)
  • irritation caused by backup of urine into the prostate gland
  • chemical irritation
  • problem with the nerves in the lower urinary tract
  • parasites
  • problems with the pelvic muscles
  • sexual abuse
  • viruses

Signs and Symptoms

Symptoms can cause pain, discomfort, and urinary issues. They include:

  • blood in the urine or semen
  • pain or burning with urination
  • pain with bowel movement
  • pain with ejaculation
  • pain in the low back, above the pubic bone, between the genitals and anus, the tip of the penis, and the urethra
  • difficulty or straining to urinate
  • frequent or urgent need to urinate

Schedule an appointment with your doctor if you experience any of the above symptoms.

How Is This Condition Diagnosed?

Your doctor will review your medical history and conduct a prostate exam to provide a diagnosis. During a prostate exam, your doctor will insert a lubricated, gloved finger into the rectum to feel for signs of inflammation, such as a tender, soft, or swollen prostate. Additional tests may be performed, including:

  • urine test
  • semen culture
  • prostate culture (your doctor will massage the prostate to release fluid from the urethra, which is then sent to a lab for testing)
  • tests to rule out a sexually transmitted infection(STI)

What Treatment Options Are Available?

Treating this condition is difficult, and it is hard to cure. Some people respond well to treatment. In some cases, symptoms can return and may last for a long time. Treatment methods focus on managing symptoms to reduce pain and discomfort. Common treatments include:

  • antibiotics
  • medications to relax the prostate muscles called alpha-adrenergic blockers
  • nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen to reduce swelling
  • stool softeners to prevent constipation

Alternative and natural remedies may offer relief for certain symptoms. Therapies to reduce pain include:

  • warm baths
  • acupuncture (an ancient practice where thin needles are inserted into various pressure points)
  • relaxation exercises
  • cranberry juice or extracts

In rare cases, surgery to remove the prostate is recommended. However, this can cause serious side effects, including impotence, loss of urinary control, and sterility. As a result, this surgery is typically not performed on younger men.

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