Chronic Prostatitis: Causes, Treatments, and Self-Care Options

Recurrent prostatitis?

At the end of August 2017, after receiving oral sex from a girl I had just met, I immediately felt pain in my right urethra that same day.
Later, I was diagnosed with acute bacterial prostatitis.
At that time, I noticed an unusually strong odor from her mouth, which led me to reasonably suspect that the infection was transmitted through oral sex.
We did not end up dating.
After 10 months of treatment, I was completely cured by June 2018.
However, at the end of June 2019, after several days of drinking alcohol, my girlfriend, for some unknown reason, suddenly became enthusiastic and aggressively licked my urethral opening during oral sex, causing pain.
I tried to stop her, but the stimulation continued, and afterward, I experienced urethral pain again.
Upon examination, I was diagnosed with prostatitis once more, this time chronic prostatitis without bacteria.
After nearly five months of treatment, by the end of October this year, I was almost pain-free.
My urologist confirmed my recovery through urinalysis and prescribed the last two months of medication.
However, just a few days after being declared recovered, I started experiencing pain again.
I thought I still had medication on hand, so I continued taking it.
As a result, for the past week, I have been experiencing persistent urethral pain, which has plunged me back into despair after believing I had fully recovered.
I would like to ask the doctor:
1.
Could excessive stimulation of the glans and urethra be the cause of my chronic prostatitis without bacteria flare-up?
2.
Is this episode of prostatitis related to the previous bacterial prostatitis?
3.
Can prostatitis truly be completely cured? This recent flare-up has made me feel as though I might never escape it, which is very distressing.
4.
Extracorporeal shockwave therapy is quite expensive, and some patients have shared with me that its effectiveness is limited.
However, my current symptoms have left me desperate enough to consider trying it.
Could you recommend any more affordable facilities that offer this treatment?
5.
There is a device on the market called a "muscle fascia gun," which claims to massage deep muscles.
Could it have similar effects to extracorporeal shockwave therapy?
6.
Is it possible to perform prostate massage on myself? I initially asked my girlfriend to help, but her fingers seemed too short and lacked the necessary pressure to massage the prostate like my urologist does.
In desperation, I attempted self-massage in a squatting position, but I am unsure if I am reaching the correct area, as there seems to be no sign of prostate fluid being expelled.
7.
There are sexual wellness products that claim to provide prostate massage benefits.
While they are indeed sexual products, I, suffering from prostatitis, am even considering trying them.
Do you think these products can effectively self-massage the prostate?
8.
Besides Western medical treatments, can acupuncture, massage, and herbal medicine from Traditional Chinese Medicine also help in treating prostatitis?
Thank you very much, doctor, for taking the time to answer my numerous questions.
A desperate patient.

Niming, 40~49 year old female. Ask Date: 2020/01/03

Dr. Li Xinyi reply Urology

Chronic prostatitis and chronic pelvic pain syndrome are conditions with relatively unclear causes and often poor treatment outcomes, which can be quite frustrating for both doctors and patients.
There may be several underlying reasons, such as an unresolved bacterial infection that you still harbor, or a sexually transmitted infection that could be transmitted between you and your girlfriend.
Even if you have been treated, if your girlfriend remains untreated due to a lack of symptoms, she could reinfect you, which is known as "ping-pong infection." Additionally, the infectious agent could be a virus that manifests when your body is weakened, or it could be neuropathic pain.
My recommendation is to return to the original physician who treated you, as they are more familiar with your medical history.
Have a thorough discussion with them and consider further tests and alternative treatments.
As for other alternative therapies, it might be best to hold off for now and save your money.
Extracorporeal shock wave therapy is likely to be expensive, so you might want to inquire about prices at larger medical centers.

Reply Date: 2020/01/03

More Info

Chronic prostatitis, particularly nonbacterial prostatitis, can be a challenging condition to manage due to its multifaceted nature. It is essential to understand the potential causes, treatment options, and self-care strategies that can help alleviate symptoms and improve quality of life.

1. Causes of Chronic Prostatitis: Chronic prostatitis can arise from various factors, including previous infections, pelvic floor muscle tension, and psychological stress. In your case, the repeated episodes following sexual activity may suggest that mechanical irritation or trauma to the urethra and prostate could be contributing to your symptoms. Overstimulation of the urethra and prostate, especially during sexual activities, can lead to inflammation and pain, which may explain the recurrence of your symptoms.

2. Relation Between Bacterial and Nonbacterial Prostatitis: While bacterial prostatitis is caused by bacterial infections, nonbacterial prostatitis can occur even after a bacterial infection has been resolved. The inflammation may persist due to residual effects from the initial infection or due to other factors such as pelvic floor dysfunction. Therefore, it is possible that your current nonbacterial prostatitis is related to your previous bacterial infection, particularly if the initial infection led to changes in the pelvic region.

3. Complete Recovery from Prostatitis: Many patients with chronic prostatitis can achieve significant symptom relief and even complete recovery, but this may take time and require a multifaceted approach. It is not uncommon for symptoms to fluctuate, and some patients may experience periods of exacerbation even after feeling better. Continuous communication with your healthcare provider is crucial to adjust treatment plans as needed.

4. Extracorporeal Shock Wave Therapy (ESWT): This treatment modality has shown promise in some studies for chronic prostatitis, but results can vary. While some patients report relief, others may not experience significant benefits. If cost is a concern, it may be worth discussing with your healthcare provider about local clinics or hospitals that offer this treatment at a lower price or inquire about clinical trials that might provide access to such therapies.

5. Muscle Fascia Gun: While muscle fascia guns can help relieve muscle tension and improve blood flow, they are not a substitute for medical treatments for prostatitis. They may provide temporary relief for muscle tightness in the pelvic area but are unlikely to address the underlying inflammation of the prostate itself.

6. Self-Massage of the Prostate: Prostate massage can be beneficial for some individuals with prostatitis, but it should be approached with caution. If you choose to self-massage, ensure that you are using proper technique and hygiene to avoid introducing bacteria. If you are unsure about the technique, it may be best to consult a healthcare professional for guidance.

7. Use of Prostate Massagers: Some commercial prostate massagers can be effective for self-massage, but it is essential to choose a product that is safe and designed for this purpose. These devices can help stimulate the prostate and may provide relief from symptoms, but they should be used carefully to avoid injury.

8. Alternative Therapies: Acupuncture, herbal medicine, and other traditional Chinese medicine approaches may offer additional support for managing chronic prostatitis symptoms. While scientific evidence varies, some patients report improvement with these therapies. It is advisable to consult with a qualified practitioner who understands your condition and can provide a tailored approach.

In summary, managing chronic prostatitis requires a comprehensive approach that includes medical treatment, lifestyle modifications, and potentially alternative therapies. Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary. Additionally, maintaining a healthy lifestyle, managing stress, and avoiding irritants can contribute to symptom relief. If you have further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice.

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