Chronic Prostatitis: Symptoms, Diagnosis, and Treatment Options

Q: Chronic Prostatitis: Symptoms, Diagnosis, and Treatment Options

Hello： 1. During my visit to the doctor, there was no examination or testing of prostate fluid and semen. Should I discuss the need for these tests with my doctor? -- This test is not easy to culture and is primarily for reference; it can be considered. 2. It h

Prostatitis

Hello Doctor, I have recently been diagnosed with chronic prostatitis.
Urinalysis and bacterial cultures did not reveal any bacteria.
When symptoms flare up, I experience a tingling and burning sensation in my penis and perineum.
Additionally, since the onset of prostatitis, I have lost my morning erections for about a month.
Although I can still achieve full erections, they feel very strained and uncomfortable.
I would like to ask you a few questions:
1.
During my visit, there was no digital rectal examination or testing of prostate fluid and semen.
Should I discuss the need for these tests with my doctor?
2.
It has been about three years since my last sexual encounter.
Is there still a need to test for trichomoniasis?
3.
The doctor suggested low-energy shockwave therapy to soften the prostate, making it easier for medications to penetrate.
Since the cost is not cheap, I would like to know if this treatment is necessary.
4.
I work in a physically demanding job (often sweating and moving around) and only take two days off a month.
I also have a habit of exercising in the evenings.
My diet consists mainly of water, alcohol, and I smoke (I do not drink soft drinks).
I am unsure what might be causing the inflammation.
What habits should I improve?
5.
Regarding erections, can aerobic exercise (like running) help improve this issue? Thank you (I am quite anxious about this and fear future complications).
Thank you for your response, Doctor.

Jiao lü, 20~29 year old female. Ask Date: 2022/02/13

Dr. Du Shixi reply Urology

Hello:
1.
During my visit to the doctor, there was no examination or testing of prostate fluid and semen.
Should I discuss the need for these tests with my doctor? -- This test is not easy to culture and is primarily for reference; it can be considered.
2.
It has been about 3 years since my last sexual activity.
Is there still a need to test for Trichomonas? -- No need.
3.
The doctor suggested low-energy shockwave therapy to soften the prostate, making it easier for medication to penetrate.
Since the cost is not cheap, I would like to ask if this treatment is necessary? -- It is advisable to try treatment for a few months; if there is no improvement, then consider it.
4.
I work in a labor-intensive job (often sweating and moving around) and only take two days off a month.
I also have a habit of exercising at night.
My diet consists mainly of water, with alcohol and smoking (I do not drink soft drinks).
I am not quite sure what might be causing the inflammation.
What habits should I improve? -- It is recommended to engage in moderate exercise and avoid excessive intensity.
5.
I would like to ask the doctor if aerobic exercise (running) can help improve my erectile function.
Thank you (I am very anxious about this and fear future difficulties).
-- Walking can be considered.
Wishing you good health.

Reply Date: 2022/02/13

More Info

Chronic prostatitis, particularly non-bacterial prostatitis, can be a challenging condition to manage due to its complex nature and the often elusive causes. Your symptoms, including the discomfort in the penis and perineum, as well as the changes in erectile function, are common among those diagnosed with this condition. Let's address your questions one by one.

1. Need for Prostate Examination and Semen Analysis: While your doctor may not have performed a digital rectal exam (DRE) or analyzed prostate secretions, these tests can provide valuable information. A DRE can help assess the prostate's size and tenderness, which may indicate inflammation. Prostate secretions can also be analyzed for inflammatory markers. Discussing these tests with your physician could be beneficial, especially if your symptoms persist or worsen.

2. Testing for Trichomonas: Given that you have not engaged in sexual activity for three years, the likelihood of a trichomonas infection is low. However, if you have any concerns about sexually transmitted infections (STIs), it may be prudent to discuss testing with your doctor, especially if you have had any potential exposure in the past.

3. Low-Energy Shockwave Therapy: This treatment has been proposed for chronic prostatitis as it may help improve blood flow and reduce inflammation in the prostate. While some patients report relief from symptoms, the evidence is mixed, and the cost can be a significant factor. It would be wise to weigh the potential benefits against the financial investment and discuss this thoroughly with your healthcare provider.

4. Lifestyle Modifications: Your lifestyle choices can significantly impact your prostate health. Alcohol and tobacco use are known to exacerbate symptoms of prostatitis. Reducing or eliminating alcohol consumption and quitting smoking could lead to improvements in your symptoms. Additionally, maintaining a balanced diet rich in fruits, vegetables, and whole grains while staying hydrated is essential. Regular exercise is beneficial, but ensure that you are not overexerting yourself, as excessive physical strain can lead to increased pelvic discomfort.

5. Impact of Aerobic Exercise on Erectile Function: Aerobic exercise, such as running, can improve cardiovascular health, which is crucial for erectile function. Improved blood circulation can enhance erectile quality and overall sexual health. Regular physical activity can also help reduce anxiety and stress, which are often contributing factors to erectile dysfunction. Therefore, incorporating aerobic exercises into your routine could be beneficial.

In summary, chronic prostatitis can be a multifaceted condition requiring a comprehensive approach to management. Open communication with your healthcare provider about your symptoms and concerns is vital. Consider discussing the potential benefits of prostate examinations, lifestyle modifications, and treatment options like shockwave therapy. Remember that while chronic prostatitis can be frustrating, many patients find relief through a combination of medical treatment and lifestyle changes. Don't hesitate to seek a second opinion if you feel your concerns are not being adequately addressed. Your health and well-being are paramount.

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