Nonbacterial Prostatitis

What is nonbacterial prostatitis?

Nonbacterial prostatitis is a condition in which there is persistent pain in the area around the prostate gland. This condition is also sometimes called chronic (long-lasting) prostatitis or chronic pelvic pain syndrome. Although the condition is called prostatitis, it is uncertain if the prostate is the cause of the pain. The prostate gland is a walnut shaped gland that sits snugly beneath the bladder in men. The exact cause of this condition is unknown, but it is not caused by a bacterial infection. It is most common in older men who have an enlarged prostate. Common symptoms include pain in the area between the scrotum and anus, pain when ejaculating and, sometimes, blood in the urine or semen. Treatment includes medications to reduce pain, to relax the muscles of the prostate gland and, often, a course of antibiotics. Nonbacterial prostatitis can be difficult to treat, and many people find that they, at best, only gain partial control of their symptoms, even after trying several therapies.

Risks

The prostate is a walnut-shaped gland that sits under the bladder, and forms the first part of the urethra (the tube that carries urine away from the bladder). Although this ongoing pain in the area is called prostatitis, it is uncertain if the prostate is the cause of the pain. The exact cause of the pain is unknown. In some cases, there may be inflammation in the area without a specific cause, in others, the pain may be coming from the muscle or nerves in the area. This condition is most common in older men who have an enlarged prostate and in men with other medical conditions, such as fibromyalgia or irritable bowel syndrome.

Symptoms

The most common symptom is a pain felt in the perineal area, the area between the scrotum (the muscular bag which contains the testicles) and anus. There may also be lower back pain. Other symptoms include pain when ejaculating, defecating or urinating. There may be blood in the urine or semen. Some men find that they have to urinate more frequently, or that they have a weak urinary flow. Erectile dysfunction is sometimes a symptom of this condition. These symptoms may be associated with a low mood.

Diagnosis

The diagnosis is usually made by an experienced doctor or urologist (urinary tract specialist) based on the symptoms and a prostate exam. To make the diagnosis of nonbacterial prostatitis, other possible causes for the symptoms should be excluded. This may involve urine tests, semen tests and blood tests. In some cases, an ultrasound of the prostate or a CT scan of the abdomen may be required.

Treatment

Treatment includes medications to reduce pain, to relax the muscles of the prostate gland and, often, a course of antibiotics. Many people find reducing the time spent sitting helps their symptoms. Gentle exercise which doesn't place stress on the pelvic floor may also help. Some people find acupuncture helpful. Emotional and psychological support is also very important in helping people cope with their symptoms. Counseling may be useful. Surgery for the removal of prostate might be an option for older men, but it can lead to erection difficulties.

Other names for nonbacterial prostatitis

  • Nonbacterial prostatitis
  • Chronic abacterial prostatitis
  • Chronic pelvic pain syndrome