Chronic Prostatitis and Its Impact on Sexual Function: Key Insights

Chronic prostatitis and sexual function?

Previously, I experienced difficulty urinating, sometimes feeling like I couldn't fully empty my bladder, and I had discomfort from the anus to the penis.
The doctor recommended a semen culture, which revealed some bacteria, and prescribed medication for me.
He mentioned that the treatment would last about 4 to 8 weeks, and I could stop taking the medication if I had no symptoms.
Now, it's been almost six months, and I have no significant symptoms, but I'm still unsure if I have completely cured the issue.
Should I do another semen culture?
Additionally, I wonder if the problem of not fully emptying my bladder is due to maintaining penile engorgement during urination.
I also have a question regarding sexual function.
I've had a habit of masturbation since childhood; could it be that because I used to do it too frequently, my penis now becomes erect with just a slight touch? I have not had any sexual experience, and my masturbation sessions last about 40 seconds to 1 minute, with what I believe is a normal amount of semen.
Will this affect my future sexual function?
Regarding endurance, I would like to ask if there is a specific indicator for the duration of intercourse.
Is there a threshold below which one might experience autonomic nervous system dysfunction? I also came across something online about retrograde nerve therapy and would like to know its purpose.
Thank you.

DD, 10~19 year old female. Ask Date: 2007/01/18

Dr. Xu Weikai reply Urology

Hello, regarding prostatitis, a general treatment duration of 4-6 weeks is usually sufficient.
If there are no clinical symptoms, continuous treatment is not necessary.
As for whether another semen culture is needed, I personally believe it is not required if there are no symptoms.
However, if you are concerned, you can certainly have it done.
It is important to note that semen can easily be contaminated by bacteria from the glans during collection, and sometimes the culture results may not indicate prostatitis but rather skin bacteria.
In such cases, an experienced physician will correlate the results with clinical symptoms for accurate assessment.

During an erection, due to nerve stimulation, it is generally difficult to achieve complete cleanliness, or one may indeed feel that it is not completely clean.
Frequent self-stimulation can lead to easier ejaculation during an erection, and after some time, a small number of men may experience premature ejaculation at the beginning of actual sexual intercourse, which tends to improve gradually with adaptation.

There is no definitive conclusion regarding the duration of an erection; literature often presents vague guidelines: as long as both partners are satisfied, it is considered a normal erection.
Therefore, I emphasize that sexual activity is a mutual endeavor that requires cooperation from both parties.
As long as both individuals are satisfied, it constitutes a perfect sexual experience.

Previously, some statistics (in the form of a questionnaire) indicated that most men believe a longer erection is necessary to satisfy their partner; however, women tend to be less concerned about size or duration.
What women care about is the process, including the atmosphere and attitude, which are more subjective aspects.

I hope this response is helpful to you.
If there are any unclear points, feel free to ask again, and we can explore further.

Director of Urology, Taitung Hospital, Department of Health, Executive Yuan, Dr.
Hsu Wei-Kai.

Reply Date: 2007/01/18

More Info

Chronic prostatitis, particularly the non-bacterial type, is a condition that can significantly affect a person's quality of life, including urinary function and sexual health. Understanding its symptoms and implications is crucial for effective management and treatment.

Symptoms of Chronic Non-Bacterial Prostatitis
Chronic non-bacterial prostatitis, also known as chronic pelvic pain syndrome (CPPS), can manifest through a variety of symptoms. Commonly reported symptoms include:
1. Urinary Issues: Patients often experience difficulty urinating, a sensation of incomplete bladder emptying, increased frequency of urination, and urgency. Some may also report pain during urination (dysuria) or a burning sensation.

2. Pelvic Pain: Many individuals report discomfort in the pelvic area, which can include pain in the perineum (the area between the scrotum and anus), lower abdomen, and even the lower back. This pain can be chronic and may fluctuate in intensity.

3. Sexual Dysfunction: While chronic non-bacterial prostatitis does not directly cause erectile dysfunction, it can lead to sexual difficulties. Patients may experience pain during ejaculation, reduced libido, or psychological impacts such as anxiety about sexual performance.

4. Testicular Pain: Some individuals report discomfort in the testicles or epididymis, which can be associated with the pelvic pain experienced.

Impact on Sexual Function
The relationship between chronic prostatitis and sexual function is complex. While many patients do not experience direct erectile dysfunction, the discomfort and anxiety associated with the condition can lead to sexual performance issues. For instance:
- Erectile Dysfunction: Some individuals may develop psychogenic erectile dysfunction due to anxiety about their condition or performance, especially if they associate sexual activity with pain or discomfort.

- Ejaculatory Pain: Pain during ejaculation can lead to avoidance of sexual activity, which can further exacerbate feelings of anxiety and stress related to sexual performance.

- Changes in Libido: Chronic pain and discomfort can lead to a decrease in sexual desire, impacting overall sexual health and relationships.

Treatment and Management
Management of chronic non-bacterial prostatitis often involves a multi-faceted approach:
1. Medications: While antibiotics are typically ineffective for non-bacterial prostatitis, other medications such as anti-inflammatory drugs, alpha-blockers, or muscle relaxants may help alleviate symptoms.

2. Physical Therapy: Pelvic floor physical therapy can be beneficial in relieving pelvic pain and improving urinary function.

3. Lifestyle Modifications: Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and stress management techniques, can help improve symptoms.

4. Psychological Support: Counseling or therapy can assist individuals in coping with the psychological impacts of chronic prostatitis, particularly regarding sexual function.

Concerns About Sexual Activity and Function
Regarding your specific concerns:
- Frequent Urination and Erection: It is possible that frequent erections, especially if they occur during urination, can contribute to a sensation of incomplete bladder emptying. This is due to the pressure that an erect penis can exert on the urethra.

- Masturbation and Sexual Function: Regular masturbation is generally considered a normal sexual activity and should not adversely affect sexual function. However, if it leads to anxiety or performance pressure, it may contribute to psychological issues related to sexual performance.

- Duration of Intercourse: There is no universally accepted standard for the "ideal" duration of intercourse. Concerns about duration often stem from societal pressures rather than medical necessity. If you experience anxiety about performance, it may be beneficial to discuss this with a healthcare professional.

- Retrograde Ejaculation Treatment: Retrograde ejaculation, where semen enters the bladder instead of exiting through the penis, can be treated with medications that help contract the bladder neck during ejaculation. This is typically discussed in the context of specific conditions affecting ejaculation.

In conclusion, chronic non-bacterial prostatitis can have a significant impact on both urinary and sexual function. It is essential to work closely with healthcare providers to develop a comprehensive treatment plan that addresses both physical symptoms and psychological well-being. If you have ongoing concerns about your symptoms or sexual function, consider seeking further evaluation and support from a urologist or a sexual health specialist.

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