Chronic Prostatitis: Symptoms, Concerns, and Diagnosis

Five years of chronic prostatitis with hematuria?

Hello Doctor, I am 26 years old and have been suffering from chronic non-bacterial prostatitis for about five years.
In the first year, I experienced discomfort in the perineal area, but as that improved, I stopped taking medication.
However, over the past few years, I still have to wait a while to urinate, and sometimes during winter, I experience sharp pain in the prostate while urinating.
Recently, I have started to feel swelling and a burning sensation in the perineal area, which sometimes extends to the testicles, causing discomfort that is alleviated when I spread my legs.
Additionally, after ejaculation, it takes longer for the swelling of the penis to subside compared to before.
Therefore, I returned to see my doctor.
The digital rectal examination was very painful, but the fluid obtained was still non-bacterial.
Later, a urinalysis revealed hematuria (not visible to the naked eye).
The doctor immediately recommended a CT scan, but I am hesitant due to the high radiation exposure.
I would like to ask if it is possible for someone my age to develop prostate cancer, or if my prostatitis has worsened.
I used to masturbate once a day, occasionally two to three times.
Could this be related? Thank you, Doctor.

Kai, 20~29 year old female. Ask Date: 2018/07/20

Dr. Xu Wencang reply Urology

At such a young age, one is unlikely to develop prostate cancer.
Chronic inflammation requires treatment for a period of time, and it is essential to maintain a regular lifestyle, avoid irritant foods, and undergo physical therapy.

Reply Date: 2018/07/20

More Info

Chronic prostatitis, particularly the non-bacterial type, can be a challenging condition to manage, especially for younger individuals like yourself. At 26 years old, experiencing symptoms for five years can understandably lead to concerns about your health and the potential for more serious conditions, such as prostate cancer. However, it's essential to clarify a few points regarding your symptoms, diagnosis, and treatment options.

Understanding Your Symptoms
The symptoms you've described, including discomfort in the perineum, pain during urination, and issues related to ejaculation, are common in chronic prostatitis. The fact that your prostate fluid was found to be sterile during examination suggests that you may be dealing with a non-bacterial form of prostatitis, which is often more difficult to treat than bacterial prostatitis.
The presence of blood in your urine, even if not visible to the naked eye, can be concerning and warrants further investigation. While it is not uncommon for chronic prostatitis to cause some degree of urinary discomfort and even hematuria (blood in urine), it is crucial to rule out other potential causes, including urinary tract infections, kidney stones, or other underlying conditions.

Concerns About Prostate Cancer
Regarding your concerns about prostate cancer, it is relatively rare in individuals under 40, especially in the absence of significant risk factors such as a family history of prostate cancer or specific genetic predispositions. Your age and the nature of your symptoms suggest that it is more likely that you are experiencing complications related to chronic prostatitis rather than prostate cancer. However, it is always wise to discuss these concerns with your healthcare provider, who may recommend further testing or imaging to ensure everything is in order.

The Role of Sexual Activity
You mentioned engaging in frequent masturbation, which is generally considered a normal sexual activity and is not directly linked to the development of prostatitis or prostate cancer. However, excessive sexual activity can sometimes lead to temporary discomfort or exacerbate existing symptoms. Moderation and listening to your body are key. If you notice that certain activities worsen your symptoms, it may be beneficial to adjust your frequency.

Diagnostic and Treatment Options
Given your symptoms and the findings from your recent evaluations, it may be worthwhile to consider the following steps:
1. Imaging Studies: While you expressed concern about the radiation from a CT scan, it can provide valuable information about your urinary tract and prostate. Discuss with your doctor the risks and benefits, and consider alternatives like an MRI if appropriate.

2. Further Urological Evaluation: If your symptoms persist or worsen, a referral to a urologist specializing in chronic prostatitis may be beneficial. They can provide a more comprehensive evaluation and possibly recommend treatments such as pelvic floor physical therapy, dietary changes, or medications aimed at managing pain and inflammation.

3. Lifestyle Modifications: Implementing lifestyle changes can significantly impact your symptoms. This includes staying hydrated, avoiding irritants like caffeine and alcohol, and practicing stress management techniques. Regular, moderate exercise can also help improve overall pelvic health.

4. Pain Management: If pain continues to be a significant issue, discussing pain management strategies with your healthcare provider is essential. This may include medications, physical therapy, or alternative therapies such as acupuncture.

Conclusion
In summary, while your symptoms are concerning, they are more indicative of chronic prostatitis rather than prostate cancer, especially given your age. It is crucial to maintain open communication with your healthcare provider, pursue necessary diagnostic tests, and explore treatment options that can help alleviate your symptoms. Remember, managing chronic prostatitis often requires a multi-faceted approach, including medical treatment, lifestyle changes, and possibly physical therapy. Your proactive approach to your health is commendable, and with the right support, you can find relief from your symptoms.

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