What are the symptoms of chronic prostatitis? The main symptom of chronic prostatitis is pain in the pelvis or genital area. For some men, the pain feels like stabbing, intense, or sharp. The pain may come and go or be constant. Other symptoms of chronic prostatitis include: A need to urinate frequently, including getting up several times during the night to use the bathroom; Pain during urination; Difficulty urinating; A sense of urgency when needing to urinate; Pain in the perineum, the space between the scrotum and rectum; Pain in the lower back, rectum, penis or testicles; Pain during ejaculation; Difficult ejaculation; Signs of infection, such as chills, nausea or vomiting How is chronic prostatitis diagnosed? Men with symptoms of prostatitis should see a doctor. Bacterial infections of the prostate can spread, so anyone with symptoms of an infection should seek medical attention as soon as possible. To diagnose prostatitis, the doctor usually begins by taking the patient’s history (medical history). The specialist may also perform a rectal examination. During a rectal exam, the doctor inserts a finger into the patient’s rectum to check the prostate for swelling and inflammation. The specialist may also check for signs of infection, such as discharge from the penis or swollen lymph nodes. If the problem is suspected to be due to a bacterial infection, the doctor may prescribe antibiotics. If symptoms do not improve after antibiotic treatment or there are no signs of infection, other tests may be needed, such as: A test of urine, semen, or blood to look for signs of infection or other prostate problems; Prostate biopsy, in which the doctor uses a needle to take a small sample of tissue from the prostate for analysis; Ultrasound of the prostate or urethra; Cystoscopy, an endoscopic examination that allows the doctor to directly view parts of the lower urinary tract What is the treatment of chronic prostatitis? Treatment for prostatitis depends on the cause of the condition. For bacterial prostatitis, the urologist usually prescribes oral antibiotics. Men with chronic prostatitis or recurrent infections may need a long-term course of antibiotic treatment lasting up to 6 months. If symptoms do not improve after oral antibiotics, other treatment options include: Intravenous antibiotics for severe infections; Muscle relaxants to relieve spasm of the pelvic muscles; Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief; Alpha-blockers for the treatment of difficulty urinating; Surgery to remove fibrosis in the urethra, which can help with difficulty urinating; Therapy to help with psychological stress and anxiety Kegel exercises, also known as pelvic floor exercises,may help improve difficulty urinating in men with chronic prostatitis. The exercises work by strengthening the muscles around the bladder. To perform these exercises, it is necessary to sit in a comfortable position, after which the pelvic muscles should be tightened and relaxed 10 to 15 times in a row. The patient can locate his pelvic muscles by pretending to stop urination mid-stream. Kegel exercises should be repeated several times a day. When a man feels more comfortable performing the exercises, he can increase their duration as well as the number of repetitions he does. It may take several months before the patient notices results. Other home and alternative remedies that may provide symptom relief in people with chronic prostatitis include: Biofeedback; Daily baths with warm or hot water; Relaxation exercises; Using a hot water bottle or heating pad to heat the perineum or rectum References: 1. Krieger, JN, Lee, SW, Jeon, J., Cheah, PY, Liong, ML, & Riley, DE (2008, February). Epidemiology of prostatitis. International Journal of Antimicrobial Agents 2. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Prostate Problems 3. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Prostatitis: Inflammation of the prostate 4. Sharp, VJ, Takacs, EB, & Powell, CR (2010, August 15). Prostatitis: Diagnosis and treatment. American Family PhysicianSharp, VJ, Takacs, EB, & Powell, CR (2010, August 15). Prostatitis: Diagnosis and treatment. American Family PhysicianSharp, VJ, Takacs, EB, & Powell, CR (2010, August 15). Prostatitis: Diagnosis and treatment. American Family Physician