Chronic Prostatitis: Impact on Sexual Function and Health Concerns

I'm sorry, but I need more context or content to provide

I'm sorry to bother you again, doctor.
I have a phimosis issue, so I went to the New Taipei City Keelung Hospital yesterday to see if I need a circumcision.
The doctor said it was too long.
I also mentioned to the doctor that I've been experiencing itching and pain lately, and the doctor directly told me it was chronic prostatitis.
I had a urinalysis and an ultrasound, both of which were normal, but the doctor said chronic prostatitis cannot be completely cured and can only be managed with medication.

I would like to ask if chronic prostatitis affects sexual function, as I have read online.
For the past six months, I have been experiencing difficulties with erections, insufficient blood flow, lack of hardness, and premature ejaculation.
Sometimes it’s normal, and sometimes it’s not.
Could this be related to chronic prostatitis? I also read that stress can contribute to chronic prostatitis.
Could my constant worry about potential sexual dysfunction lead to anxiety and stress, which then causes chronic prostatitis? Additionally, I have been cycling a lot these past few days, which might explain the pain.
Also, if I frequently have erections without ejaculation, could that trigger chronic prostatitis and cause pain? Sometimes, when my erection is not firm enough or when I try to masturbate, I keep attempting to achieve an erection.
Could this lead to penile fatigue or sexual dysfunction?
Is the erectile issue I've been experiencing for the past six months due to chronic prostatitis, or is it caused by psychological factors that trigger chronic prostatitis? Several doctors have told me that young people typically do not experience sexual dysfunction and that it is usually psychological.
I tend to get very anxious over small matters, which might be why my problems persist.
If I want to have sex in the future and the issue is still psychological, will I need medication?
Now that I understand that my chronic prostatitis situation is similar to what I have, I feel more at ease and less anxious.
Will taking medication to manage it help restore my sexual function to normal, especially if I also address the psychological factors?
Another question I have is that if I frequently have erections, I do not experience morning erections, only slight ones.
Is this normal? Lastly, if I undergo circumcision, will my penis appear larger? Currently, it measures 5 cm when flaccid and 10 cm when erect.
Is this a normal length? I feel that when erect, my glans is tightly trapped inside the foreskin.
Will circumcision help with sexual function? Also, will it significantly reduce the risk of penile cancer?
Thank you, doctor, for your detailed explanation.
I will also communicate with my attending physician during my next visit.

Yundongyuan, 10~19 year old female. Ask Date: 2019/07/05

Dr. Du Shixi reply Urology

Hello, I also mentioned to my doctor that I've been experiencing itching and pain recently.
The doctor directly told me it was chronic prostatitis.
After a urinalysis and ultrasound, everything was fine, but the doctor said chronic prostatitis cannot be completely cured and that I can only manage the condition with medication [the general idea is that if there are symptoms, medication is necessary].
I would like to ask if I saw online that chronic prostatitis can affect sexual function.
Is it possible that my difficulties with erections, insufficient rigidity, and premature ejaculation over the past six months are related to chronic prostatitis? [The connection is likely minimal.] I also read that stress can contribute to chronic prostatitis.
Could my constant worry about potential sexual dysfunction be causing anxiety and stress, which in turn leads to chronic prostatitis? [There are many causes of chronic prostatitis, and it's difficult to pinpoint the exact one.] Additionally, I've been cycling a lot these past few days, which might be why the pain has appeared.
By the way, if someone frequently has erections without ejaculation, could that lead to chronic prostatitis and pain? [No, it wouldn't.] Sometimes, when I have insufficient rigidity or my masturbation isn't satisfying, I keep trying to achieve an erection.
Could this lead to penile fatigue or sexual dysfunction? [The connection is minimal.] Are the erection issues I've experienced over the past six months due to chronic prostatitis, or are they caused by psychological factors that trigger chronic prostatitis? Several doctors have told me that young people typically do not experience sexual dysfunction, and it is often psychological.
I tend to get very anxious over small matters, which might be why the problem persists.
If I want to engage in sexual activity and psychological factors are still an issue, would I need medication? [If sexual function is not ideal, medication may be necessary for improvement.] Now that I realize my chronic prostatitis situation is similar to my condition, I feel more at ease and less likely to overthink [there are many causes, and it's not easy to identify them].
If I manage my condition with medication, will my sexual function return to normal, especially if I also address the psychological factors? [It should improve.] One more question: if I frequently have erections, but I don't experience morning erections, only slight ones, is that normal? (Young people typically have morning erections with normal sleep.) Lastly, if I undergo circumcision, will my penis become larger? Currently, it measures 5 cm when flaccid and 10 cm when erect; is this a normal length? (It will not increase in size.) I feel that when erect, my glans is tightly constricted inside the foreskin.
Would circumcision help with sexual function? (The connection is minimal.) Also, does circumcision significantly reduce the risk of penile cancer? (Penile cancer and phimosis may be related to inadequate hygiene; if proper hygiene is maintained, there should be no risk of cancer.)

Reply Date: 2019/07/05

More Info

Chronic prostatitis, particularly chronic pelvic pain syndrome (CPPS), can indeed have a significant impact on sexual function and overall health. Your concerns about the relationship between chronic prostatitis and erectile dysfunction (ED) are valid and warrant a comprehensive understanding.

Firstly, chronic prostatitis can lead to various symptoms, including pelvic pain, urinary difficulties, and sexual dysfunction. While some studies suggest that chronic prostatitis may not directly cause erectile dysfunction, it can contribute to sexual performance issues through a combination of physical and psychological factors. The inflammation and discomfort associated with chronic prostatitis can lead to anxiety and stress, which are known to negatively affect sexual function. This means that while the physical condition may not directly impair erectile function, the psychological burden it creates can certainly play a role.

Regarding your specific symptoms, such as difficulty achieving or maintaining an erection, premature ejaculation, and changes in ejaculation, these can be linked to both the physical effects of chronic prostatitis and the psychological stress it induces. The discomfort and pain you experience may lead to a decreased libido or anxiety about sexual performance, which can further exacerbate erectile issues. It’s also important to note that the cycle of anxiety and erectile dysfunction can become self-perpetuating, where fear of failure leads to further dysfunction.

You mentioned that you have been experiencing erectile difficulties and that these issues have fluctuated over time. This inconsistency can be frustrating and may lead you to question whether the root cause is physical or psychological. In many cases, it is a combination of both. Chronic prostatitis can cause physical discomfort that leads to anxiety, which in turn can affect sexual performance.
As for the concern about frequent erections without ejaculation potentially causing prostatitis, it is generally not the case that this would lead to prostatitis. However, prolonged arousal without ejaculation can lead to discomfort and may contribute to a cycle of anxiety regarding sexual performance.
Regarding your question about whether treatment for chronic prostatitis can restore sexual function, the answer is that it can help manage symptoms and reduce discomfort, which may improve sexual function over time. It is crucial to address both the physical and psychological aspects of your condition. This may involve medication to manage inflammation and pain, as well as counseling or therapy to address anxiety and stress related to sexual performance.

Concerning your concerns about circumcision and its effects on sexual health, circumcision can have various benefits, including reducing the risk of certain infections and potentially improving sexual function for some individuals. However, it is essential to discuss this with your healthcare provider, who can provide personalized advice based on your specific situation.

Lastly, regarding your measurements, the size of the penis can vary widely among individuals, and what you describe falls within the normal range. If you feel that the tightness from your foreskin is causing discomfort or affecting your sexual experience, discussing circumcision with your doctor may be beneficial.

In summary, chronic prostatitis can impact sexual function through both physical symptoms and psychological stress. Addressing both aspects through appropriate medical treatment and psychological support can lead to improvements in sexual health. It is crucial to maintain open communication with your healthcare provider to explore all treatment options and ensure a comprehensive approach to your health concerns.

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