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Facts about Prostatitis

Most Prostatitis Symptoms not Caused by the Prostate

Approximately ninety five percent (95%) of what is called prostatitis is not prostatitis. Most men diagnosed with prostatitis have no pathology of the prostate gland that can account for symptoms of urinary frequency, sexual and sitting pain, and internal pelvic pain, among other symptoms. Read our published articles about the failure of prostate directed medication in treating prostatitis and other resources in our Published Research section.

Symptoms of Prostatitis

NOTE: Most men diagnosed with prostatitis have several of these symptoms:

  • Urinary frequency (need to urinate too often)
  • Urinary urgency (hard to hold urination once urge occurs)
  • Sitting triggers or exacerbates discomfort/pain/symptoms
  • Pain or discomfort during or after ejaculation
  • Discomfort in the rectum (feels like a “golf ball” in the rectum)
  • Discomfort/pain in the penis (commonly at the tip or shaft)
  • Ache/pain/sensitivity of testicles
  • Suprapubic pain (pain above the pubic bone)
  • Perineal pain (pain between the scrotum and anus)
  • Coccygeal pain (pain in and around the tailbone)
  • Low back pain (on one side or both)
  • Groin pain (on one side or both)
  • Dysuria (pain or burning during urination)
  • Nocturia (frequent urination at night)
  • Reduced urinary stream
  • Hesitancy before or during urination
  • Reduced libido (reduced interest in sex)
  • Anxiety about having sex
  • Pain after intercourse
  • Discomfort or relief after a bowel movement
  • Anxiety and catastrophic thinking
  • Depression
  • Social withdrawal and difficulty in intimate relations
  • Impairment of self-esteem

Most cases of prostatitis mistakenly treated with antibiotics.

Historically, the conventional medical viewpoint has explained most cases of what is typically diagnosed as prostatitis as an infection and/or inflammation of the prostate gland. Indeed, that’s what the name prostatitis indicates, namely, an “itis” of the prostate. The conventional advice of many urologists to men they diagnose as having prostatitis related to increasing sexual activity derives from the idea that there is inflammation or infection in the prostate gland and more frequent ejaculation will empty it of these noxious critters.

Unfortunately, many doctors make a diagnosis of prostatitis and prescribe antibiotics without verifying that there is any infection present in the prostate.

When a man comes into the physician’s office and complains about pelvic/urinary/rectal/genital pain and/or urinary symptoms like frequency, urgency, dysuria (pain during urination), sitting pain or ejaculatory discomfort, where there is no evidence of structural disease, the doctor typically treats the patient as if the cause of the problem is an infected or inflamed prostate gland and routinely gives antibiotics.

Stanford’s Dr. Anderson discusses the Wise-Anderson Treatment for Prostatitis.

Prostatitis, which means an infection or inflammation of the prostate gland, is often diagnosed without the doctor doing any tests at all to establish the validity of such a diagnosis. As we have seen in a study of physicians in Wisconsin, a large majority of doctors view prostatitis as an inflammation or bacterial infection, and almost all prescribe antibiotics as a treatment. Most urologists know from their own experience that antibiotic treatment for prostatitis without evidence of infection routinely fails to help the patient’s symptoms and yet almost 100% of the cases of this kind of prostatitis receive antibiotics. We are always troubled to hear this routine diagnosis and antibiotic treatment in the patients who come to see us, when the patient’s doctor made no attempt to establish the presence of infection.

We always check for evidence of infection and inflammation in the prostatic fluid with men who complain of pelvic pain and urinary dysfunction. As we will discuss, antibiotics can have serious side-effects, especially when taken long-term. And we have had more than a few men suffer the consequences of inappropriate long-term antibiotic treatment.

We want to emphasize that the antibiotic treatment of bacterial prostatitis has been an achievement of modern medicine. If you have bacterial prostatitis, antibiotics are a very good treatment—certainly the only treatment. Viewing all conditions of pelvic pain and dysfunction in men, however, as acute or chronic bacterial prostatitis is an error in therapeutic judgment.

Despite the clear scientific evidence to the contrary and almost every urologist’s clinical experience of the ineffectiveness of antibiotics for nonbacterial prostatitis, it is amazing that giving antibiotics routinely for nonbacterial prostatitis is the common practice. This is very important to understand, particularly if you have been diagnosed with prostatitis and it has not been determined whether infection or inflammation is present. We would consider it quite appropriate for a patient diagnosed with prostatitis to ask his doctor if there is clear evidence of bacteria, should the doctor prescribe antibiotics.

The prostate gland is not the problem with most men diagnosed with prostatitis.

In the majority of men diagnosed with chronic prostatitis, the symptoms of pain arise from tender trigger points in the pelvic muscles. In recent years, there is clear evidence that a large majority of men typically complaining of the referenced symptoms have no prostate pathology and no infection demonstrated by culture. Even the evidence of inflammation (white cells found in the prostatic fluid) does not account for the referenced symptoms because typically when inflammation is removed, symptoms remain.

Chronic tension in the pelvic muscles is the source of pain in a majority of men diagnosed with prostatitis.

The great majority of men (95%) complaining of prostate and pelvic pain symptoms,  have no evidence of prostate infection. This is why antibiotics fail to resolve symptoms. Additionally, even when there is some inflammation seen in the prostatic fluid it does not appear to be related to the degree of pain being suffered. The fact that is unfortunately resisted by many medical professionals is that most men with the referenced symptoms suffer from chronically tightened muscles inside the pelvic floor. When areas of this chronic tension are pressed on, as confirmed in our 2009 study published in the Journal of Urology, many symptoms above are recreated. When pelvic floor trigger points are resolved, the pelvic floor muscles are relaxed, the anxiety related to them calms down, and the symptoms tend to significantly reduce or disappear. Teaching our patients to release pelvic floor trigger points and lower the nervous system arousal related to them is the aim of our 6-day clinics.