Chronic Nonbacterial Prostatitis

What is chronic nonbacterial prostatitis?

Chronic nonbacterial prostatitis is a common condition that causes pain and inflammation in the prostate and the lower urinary tract in men. The prostate gland is located right below the bladder in men. It produces fluid that helps transport sperm.



What are the symptoms of nonbacterial prostatitis?

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

  • difficulty urinating or straining to urinate
  • frequent or urgent need to urinate
  • 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, on the tip of the penis, or in the urethra
  • sexual dysfunction

Make an appointment with your doctor if you have any of the above symptoms.

Don’t ignore symptoms of chronic nonbacterial prostatitis; the condition may be treatable.


What causes chronic nonbacterial prostatitis?

There are two types of prostatitis: acute and chronic. Acute cases are often caused when bacteria in the urinary tract cause inflammation. Symptoms typically develop suddenly. Chronic nonbacterial prostatitis is an ongoing problem. You might have symptoms that last for a long period of time.

Symptoms may also appear and disappear over the course of several months.

Chronic nonbacterial prostatitis is the most common type of prostatitis, but the exact cause is unknown. Doctors suspect that it may be due to a prior infection or a small injury that causes inflammation over time.


Risk factors

What are the risk factors for chronic nonbacterial prostatitis?

The cause of chronic nonbacterial prostatitis is unknown. This makes it difficult to predict who is at high risk for this condition. However, research is ongoing. Once a cause is discovered it will be easier to identify risk factors.


How is this condition diagnosed?

Your doctor will review your medical history and give you a prostate exam to determine a diagnosis.

A prostate exam involves your doctor inserting a lubricated, gloved finger into your rectum. They will feel for signs of inflammation, such as a tender, soft, or swollen prostate. Your doctor may perform additional tests, such as:

  • urine test
  • semen studies
  • tests to rule out a sexually transmitted infection
  • prostate fluid studies

To examine prostate fluid, your doctor will massage the prostate to release fluid from the urethra. The fluid is then sent to a lab for testing.



What treatment options are available?

The goal of treatment is to help improve symptoms. Using antibiotics to treat this condition is controversial.

Some doctors don’t give antibiotics because the condition is believed to be chronic and not due to an active infection. Some doctors will prescribe antibiotics, thinking it could help treat an infection that’s difficult to see in the urine.

Other common treatments include:

  • medications to relax the prostate muscles called alpha-adrenergic blockers, which are the same medications used to treat other prostate conditions, like BPH (benign prostate hypertrophy)
  • prescription pain medication or nonsteroidal anti-inflammatory drugs to reduce pain and swelling
  • stool softeners to prevent constipation

Alternative and natural remedies may relieve certain symptoms. Therapies to reduce pain include:

  • warm baths
  • acupuncture
  • relaxation exercises
  • drinking cranberry juice or extracts
  • taking herbal supplements (e.g., antioxidant bioflavonoid quercetin to reduce inflammation)
  • using a cushion or pillow when sitting for long periods
  • massage therapy
  • avoiding spicy foods, caffeine, and alcohol
  • biofeedback, a relaxation technique

Talk to your doctor before taking any herbal supplements. Some combinations of herbs may reduce the effectiveness of certain medications.


Coping and support

Coping with a chronic condition

Chronic nonbacterial prostatitis can be an ongoing, painful condition. Flare-ups can cause distress and frustration. There have been a few small studies that suggest prostatitis increases the risk of prostate cancer, however much more research needs to be done before the link can be established. Make sure you follow up with a urologist to discuss your risk of developing cancer if you have this condition.

To cope with anxiety or depression triggered by chronic pain and inflammation, discuss treatments to improve your mental health with your doctor. These might include prescription or natural antidepressants. Joining a support group or seeking private counseling can also help you cope with the condition until your symptoms improve.

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