Chronic Prostatitis and Urethral Pain: Causes and Treatments

Q: Chronic Prostatitis and Urethral Pain: Causes and Treatments

Hello： You may be experiencing a condition similar to non-bacterial prostatitis. <br>In this case, symptoms can only be alleviated with medication, and it is often difficult to achieve complete recovery. <br>Some patients may take medication for several months and only experience

Prostatitis and urethral pain?

Hello Dr.
Du,
I would like to share my situation with you.
Around the end of February this year, after I finished masturbating one afternoon, I suddenly felt a sharp pain in my urethra (which I had not experienced before).
I typically engage in this activity once a day, sometimes two or three times.
That evening, when I went to the bathroom, I felt a stinging pain throughout my urethra, accompanied by a burning sensation and significant discomfort.
I went to the hospital for a urinalysis, and after visiting a second hospital for another test, both results indicated no bacterial infection, which has been quite frustrating.

Additionally, I have been experiencing swelling and pain in the perineal area near the anus, particularly in the urethra (entirely) up to the urethral opening.
At a third hospital, the doctor suggested that I might have chronic prostatitis.
I underwent a digital rectal exam, which indicated slight inflammation on the left side, and an ultrasound was performed, showing no issues with stones.
I have also taken antibiotics, but there has been no improvement.
I am wondering whether this is a urethral infection, prostatitis, or possibly some form of fibrosis (although the ultrasound did not show any enlargement; my prostate is 17 grams).
The pain in my urethra is more pronounced than the discomfort in my prostate, yet the tests have not revealed any bacteria.
Could it be an infection from something like Chlamydia? However, antibiotics should have been effective, and I have seen no improvement after two weeks of treatment.
Should I consider undergoing a cystoscopy to examine the condition of my urethra? A clinic later suggested a type of extracorporeal shock wave therapy or another low-frequency high-temperature electrotherapy to eliminate the inflamed tissue, but I need to confirm whether I have urethritis or prostatitis first, as I am unsure which condition to treat.
It has been nearly two months, and I also experience pain during ejaculation, which has led me to reduce the frequency to once a week, as each time results in pain, making me hesitant to engage in sexual activity.
This situation has been very distressing for me.

I would greatly appreciate your assistance.
Thank you very much.

Xiao Yu, 20~29 year old female. Ask Date: 2017/04/07

Dr. Du Shixi reply Urology

Hello: You may be experiencing a condition similar to non-bacterial prostatitis.
In this case, symptoms can only be alleviated with medication, and it is often difficult to achieve complete recovery.
Some patients may take medication for several months and only experience improvement, without full resolution (symptoms may fluctuate).
During this time, it is essential to pay attention to your lifestyle; avoid alcohol and spicy foods, walk for half an hour each day, and maintain a regular sleep schedule.
You might also consider warm sitz baths.
As for the two methods you mentioned, they are worth trying but may not necessarily be effective.

Reply Date: 2017/04/07

More Info

Chronic prostatitis, particularly nonbacterial prostatitis or chronic pelvic pain syndrome (CPPS), can be a challenging condition to manage. The symptoms often include pelvic pain, discomfort during urination, and pain during ejaculation, which can significantly affect a person's quality of life. Your experience with persistent urethral pain and discomfort in the pelvic region is not uncommon among those suffering from this condition.

Understanding Chronic Prostatitis and Urethral Pain
Chronic prostatitis is classified into several categories, with nonbacterial prostatitis being the most prevalent. This condition can be particularly frustrating because, unlike bacterial prostatitis, it does not respond to antibiotics. The exact cause of nonbacterial prostatitis is often unclear, and it may involve a combination of factors including pelvic floor muscle tension, inflammation, and possibly autoimmune responses.

Your symptoms of burning pain in the urethra, discomfort in the perineum, and pain during ejaculation suggest that you may be experiencing a flare-up of chronic prostatitis. The absence of bacteria in your urine tests indicates that a bacterial infection is unlikely, which aligns with the diagnosis of nonbacterial prostatitis.

Treatment Options
1. Pain Management: Since antibiotics have not been effective, focusing on pain relief is crucial. Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage discomfort. However, it's essential to use these medications judiciously and not to mix them without consulting a healthcare provider, as this can lead to complications.

2. Physical Therapy: Pelvic floor physical therapy can be beneficial for many patients. A physical therapist specializing in pelvic pain can help you learn exercises to relax and strengthen pelvic floor muscles, which may alleviate some of your symptoms.

3. Heat Therapy: Warm baths or heating pads applied to the pelvic area can provide temporary relief from pain and discomfort.

4. Lifestyle Modifications: Avoiding irritants such as caffeine, alcohol, and spicy foods may help reduce symptoms. Staying hydrated and practicing regular, gentle exercise can also be beneficial.

5. Alternative Therapies: Some patients find relief through acupuncture, biofeedback, or other complementary therapies. While these treatments may not work for everyone, they can be worth exploring.

6. Medications: In some cases, medications such as alpha-blockers (which relax the muscles around the bladder and prostate) or muscle relaxants may be prescribed to help alleviate symptoms.

7. Interventional Procedures: If conservative treatments fail, some patients may consider procedures like transurethral microwave thermotherapy (TUMT) or other minimally invasive techniques that target prostate tissue.

Monitoring and Follow-Up
It's crucial to maintain regular follow-ups with your healthcare provider to monitor your symptoms and adjust treatment as necessary. If your symptoms persist or worsen, further diagnostic procedures, such as cystoscopy, may be warranted to rule out other conditions affecting the urinary tract.

Conclusion
While chronic prostatitis can be a frustrating and painful condition, understanding your symptoms and exploring various treatment options can help you manage your pain and improve your quality of life. It's essential to work closely with your healthcare provider to find the most effective treatment plan tailored to your specific needs. Remember, you are not alone in this journey, and many resources and support systems are available to help you cope with this condition.

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