Nonbacterial prostatitis cure

Prostatitis – nonbacterial

Chronic nonbacterial prostatitis causes long-term pain and urinary symptoms. It involves the prostate gland or other parts of a man’s lower urinary tract or genital area. This condition is not caused by an infection with bacteria.

Possible causes of nonbacterial prostatitis include:

• A past bacterial prostatitis infection
• Bicycle riding
• Less common types of bacteria
• Irritation caused by a backup of urine flowing into the prostate
• Irritation from chemicals
• Nerve problem involving the lower urinary tract
• Parasites
• Pelvic floor muscle problem
• Sexual abuse
• Viruses

Life stresses and emotional factors may play a part in the problem.

Most men with chronic prostatitis have the nonbacterial form.

Symptoms may include:

• Blood in the semen
• Blood in the urine
• Pain in the genital area and lower back
• Pain with bowel movements
• Pain with ejaculation
• Problems with urinating

Exams and Tests

Most of the time, a physical exam is normal. However, the prostate may be swollen or tender.

Urine tests may show white or red blood cells in the urine. A semen culture may show a higher number of white blood cells and low sperm count with poor movement.

Urine culture or culture from the prostate does not show bacteria.

Treatment for nonbacterial prostatitis is difficult. The problem is hard to cure, so the goal is to control symptoms.

Several types of medicines may be used to treat the condition. These include:

• Long-term antibiotics to make sure that the prostatitis is not caused by bacteria. However, people who are not helped by antibiotics should stop taking these medicines.
• Drugs called alpha-adrenergic blockers help relax the muscles of the prostate gland. It often takes about 6 weeks before these medicines start working. Many people do not get relief from these medicines.
• Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs), which may relieve symptoms for some men.
• Muscle relaxers like diazepam or cyclobenzaprine can help to reduce spasms in the pelvic floor.

Some people have found some relief from pollen extract (Cernitin) and allopurinol. But research does not confirm their benefit. Stool softeners may help reduce discomfort with bowel movements.

Surgery, called transurethral resection of the prostate, may be done in rare cases if medicine does not help. In most cases, this surgery is not done on younger men. It may cause retrograde ejaculation. This can lead to sterility, impotence, and incontinence.

Other treatments that may be tried include:

• Warm baths to ease some of the pain
• Prostate massage, acupuncture, and relaxation exercises
• Dietary changes to avoid bladder and urinary tract irritants
• Pelvic floor physical therapy

Outlook (Prognosis)

Many people respond to treatment. However, others do not get relief, even after trying many things. Symptoms often come back and may not be treatable.

Possible Complications

Untreated symptoms of nonbacterial prostatitis may lead to sexual and urinary problems. These problems can affect your lifestyle and emotional well-being.

When to Contact a Medical Professional

Call your health care provider if you have symptoms of prostatitis.

Alternative Names

NBP; Prostatodynia; Pelvic pain syndrome; CPPS; Chronic nonbacterial prostatitis; Chronic genitourinary pain

• Male reproductive anatomy

References

Carter C. Urinary tract disorders. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 40.

Kaplan SA. Benign prostatic hyperplasia and prostatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 129.

McGowan CC, Krieger J. Prostatitis, epididymitis, and orchitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 112.

Nickel JC. Inflammatory and pain conditions of the male genitourinary tract: prostatitis and related pain conditions, orchitis, and epididymitis. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 13.

Chronic Nonbacterial Prostatitis

Chronic nonbacterial prostatitis, also known as chronic pelvic pain syndrome, is a common condition that affects men. It causes pain and inflammation in the prostate, pelvis, and the lower urinary tract. The prostate gland is located right below the bladder in men. It produces fluid that helps transport sperm. In the United States, chronic nonbacterial prostatitis affects around 10 to 15 percent of men.

Symptoms can cause ongoing pain, discomfort, and urinary issues, such as:

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

Don’t ignore any of the symptoms of chronic nonbacterial prostatitis. Instead, make an appointment with your doctor. There are a variety of treatments that may help.

The National Institutes of Health (NIH) describes four categories of prostatitis:

• Acute bacterial prostatitis happens when bacteria, like sexually transmitted organisms, cause an infection in the prostate. Symptoms typically develop suddenly, and usually respond well to antibiotics.
• Chronic bacterial prostatitis is an ongoing problem. It’s also more difficult to treat. It’s often associated with ongoing urinary tract infections.
• Asymptomatic inflammatory prostatitis has no symptoms. It’s usually discovered while undergoing other tests. It appears to be more common in men who smoke and drink regularly.
• Chronic (nonbacterial) prostatitis/chronic pelvic pain syndrome is the most common type of prostatitis. But the exact cause is unknown. It causes a variety of symptoms that can be difficult to treat. Doctors suspect it may be due to a prior infection or a small injury that causes inflammation.

The cause of chronic nonbacterial prostatitis is unknown. This makes it difficult to predict who is at risk for this condition. However, research into the cause is ongoing. Once a cause is discovered, doctors will be able to identify risk factors and target treatment.

Your doctor will review your medical history and likely ask you to fill out a questionnaire about your symptoms. They will also perform a prostate exam. And they will likely request a urine sample to look for infection.

During a prostate exam, your doctor will insert a lubricated, gloved finger into your rectum. They do this so they can feel for a tender, soft, or swollen prostate, which indicates inflammation or infection. Depending on the results of your exam, your doctor may perform the following:

• prostate ultrasound
• tests to rule out a sexually transmitted infection
• studies to evaluate urine flow
• further evaluation of the urinary tract

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

Some doctors don’t give antibiotics because the condition may be chronic and not caused by an active infection. Some doctors will prescribe antibiotics, thinking it could help treat an infection that may not be easily identified.

Other common treatments include:

• medications to relax the prostate muscles called alpha-adrenergic blockers — the same medications used to treat other prostate conditions, like BPH (benign prostate hypertrophy)
• other medications like muscle relaxants or tricyclic antidepressants to help with pain
• prescription pain medication or nonsteroidal anti-inflammatory drugs to reduce pain and swelling
• plant extracts, like some herbal supplements (pollen extract cernilton and bioflavonoid quercetin) that have evidence of effectiveness

Alternative and natural remedies that may reduce ongoing pain include:

• warm baths
• acupuncture
• relaxation exercises
• using a cushion or pillow when sitting for long periods
• massage therapy
• avoiding spicy foods, caffeine, and alcohol that can irritate the bladder
• biofeedback, a relaxation technique

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

Chronic nonbacterial prostatitis/chronic pelvic pain syndrome can be an ongoing, painful condition. Exercise and pelvic floor physical therapy may improve your symptoms. According to the American Urological Association, having prostatitis does not increase your risk of prostate cancer.

To cope with anxiety or depression triggered by chronic pain and inflammation, talk with your doctor about treatments to improve your mental health. Other treatments may include anxiety medication and antidepressants. Joining a support group, getting private counseling, or participating in behavioral therapy can also help you cope with the condition.

What is Prostatitis?

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The prostate is a walnut-sized gland that all men have. It’s found below your bladder and in front of your rectum. The job of the prostate is to make fluid that contains sperm (semen). This fluid protects the sperm when they travel toward a female’s egg.

If your prostate becomes swollen, tender, and inflamed, you have a condition called “prostatitis.” This isn’t cancer, and it’s different from having an “enlarged prostate.”

Symptoms of Prostatitis

There are four types of prostatitis. Each has its own set of symptoms and causes. These include:

Acute bacterial prostatitis. Your urinary tract is made up of your kidneys, bladder, and the tubes that pass between them. If bacteria from here finds its way into your prostate, you can get an infection.

This type of prostatitis comes on quickly. You might suddenly have:

• High fever
• Chills
• Muscle aches
• Joint pain
• Pain around the base of your penis or behind your scrotum
• Lower back pain
• Feeling like you need to have a bowel movement
• Trouble peeing
• Weak urine stream

Acute bacterial prostatitis is a severe condition. If you notice these symptoms, seek medical care right away.

Chronic bacterial prostatitis. This is more common in older men. It’s a milder bacterial infection that can linger for several months. Some men get it after they’ve had a urinary tract infection (UTI) or acute bacterial prostatitis.

The symptoms of chronic bacterial prostatitis often come and go. This makes them easy to miss. With this condition, you might sometimes have:

• An urgent need to pee, often in the middle of the night
• Painful urination
• Pain after you ejaculate (release semen at orgasm)
• Lower back pain
• Rectum pain
• A “heavy” feeling behind your scrotum
• Blood in your semen
• A UTI
• Urinary blockage (no urine comes out)

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This is the most common type of prostatitis. It shares many of the same signs as bacterial prostatitis. The difference is that when tests are run, no bacteria are present with this type.

Doctors aren’t sure what causes CP/CPPS. Triggers include stress, nearby nerve damage, and physical injury. Chemicals in your urine or a UTI you had in the past may play a role. CP/CPPS has also been linked to immune disorders like chronic fatigue syndrome and irritable bowel syndrome (IBS).

The main sign of CP/CPPS is pain that lasts more than 3 months in at least one of these body parts:

• Penis (often at the tip)
• Scrotum
• Between your scrotum and rectum
• Lower abdomen
• Lower back

You may also have pain when you pee or ejaculate. You might not be able to hold your urine, or you may have to pee more than 8 times a day. A weak urine stream is another common symptom of CP/CPPS.

Asymptomatic prostatitis. Men who have this type of prostatitis have an inflamed prostate but no symptoms. You may only learn you have it if your doctor does a blood test that checks your prostate health. Asymptomatic prostatitis doesn’t need any treatment, but it can lead to infertility.

Prostatitis Risk Factors

You’re more likely to have problems with your prostate if:

• You’re between the ages of 36 and 50
• You’ve had a UTI
• You’ve had a groin injury
• You use a urinary catheter
• You’ve had a prostate biopsy
• You have HIV/AIDS
• You’ve had prostatitis before

An inflamed or infected prostate gland is common in men of all ages.

If you have prostatitis, your doctor can help you find ways to manage your symptoms and control your pain. Researchers are also trying to better understand what causes it. This will allow them to find more treatments that work.

Mayo Clinic: “Prostatitis.”

Urology Care Foundation: “What are Prostatitis and Related Chronic Pelvic Pain Conditions?”

National Institute of Diabetes and Digestive Kidney Diseases: “Prostatitis: Inflammation of the Prostate.”

Harvard Medical School + Harvard Health Publications: “Prostatitis: inflamed prostate can be a vexing health problem.”

NHS Choices: “Prostatitis.”

Cleveland Clinic: “Prostatitis.”

Prostate Cancer UK: “Prostatitis: A guide to infection and inflammation of the prostate.”