r/Prostatitis Oct 19 '22

Starter Guide/Resource NEW? START HERE! Prostatitis 101/Checklist + Sub Rules

422 Upvotes

» QUICK START! «

  1. SUCCESS STORIES in this subreddit
  2. TOP TIPS AND INFO (All Posts)
  3. NEW 2025 AUA TREATMENT OUTLINE
  4. See below 'Subreddit Rules' for the full 101 prostatitis guide and newbie checklist

The information provided in this subreddit is not medical advice, including the information here. It is for educational and informational purposes only

SUBREDDIT RULES

  1. No harassment, abuse, or disrespect is tolerated here, especially to the volunteer mod team
  2. No promotion of pseudoscience, conspiracies, and/or fringe doctors
  3. No graphic photos allowed (NSFW)
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  5. One post per person, per day. Leave room for others
  6. No fear mongering

VIOLATIONS: Depends on the severity of the violation, but generally:

  1. First infraction is a warning
  2. Second is a temporary ban (~3 days)
  3. Last is a permanent ban

POSTING REQUIREMENTS

  1. To prevent abuse and spam we have an Automod in place. Accounts with very low comment karma and/or less than 36 hours old cannot post.

  2. Also, please tag any pessimistic/hopeless posts with the "vent/discouraged" flair, and any positive progress updates with "positive progress."

NEWBIE ORIENTATION: CPPS vs Prostatitis

The vast majority of prostatitis cases are non-bacterial, i.e. NIH Type III non-bacterial prostatitis. Expert consensus (of the research) estimates this number to be around ~95% of all cases. True chronic bacterial prostatitis (CPB) is rare. Read more about the prevalence of CBP here, complete with journal citations.

CBP also prevents with unique and specific symptoms. Here is how to identify bacterial prostatitis based on symptoms.

Q: If I don't have an infection, then why do antibiotics make me feel better? FIND OUT WHY

The rest of us have (or have had) NIH Type III non-bacterial prostatitis, now referred to as CPPS or UCPPS - (Urologic) Chronic Pelvic Pain Syndrome. Type III non-bacterial prostatitis can present either with or without actual inflammation of the prostate, but overt prostate inflammation is very uncommon. Most men with CPPS (non-bacterial prostatitis) have small, firm, 'normal' prostates upon examination. This means that the common 'prostatitis' diagnosis is very often a total 'misnomer,' as most cases have no prostate inflammation whatsoever.

While CPPS is officially a syndrome (The 'S' in CPPS), or a collection/pattern of symptoms with no singular cause agreed upon by the larger medical community, there are top theories with high quality evidence behind them. And importantly, most syndromes nowadays are being categorized as variations of central sensitization (ie nociplastic mechanisms) - including IBS, CFS, POIS, RSS, etc.

The top theory backed by research: CPPS is a psycho-neuromuscular chronic pain + dysfunction condition. It often affects the muscles of the pelvic floor, the peripheral nerves that innervate the pelvic region, and the central nervous system (which includes the brain and spinal cord) - among others. This means that treatment requires a multi-modal, integrated treatment approach, and that there is no single pathway or 'pill' to recovery.

I must emphasize that the central nervous system (ie centralized/nociplastic mechanisms) of CPPS affect at least 49% of all cases according to the MAPP study (Multidisciplinary Approach to Pelvic Pain). Do not neglect these. We recommend reading the centralization section below 👇

RECOMMENDED: 1. Centralized Pain Criteria and Citations

  1. Psycho neuromuscular CPPS - with journal citations and techniques to apply.

Things that are known to trigger CPPS (chronic pelvic pain and dysfunction)

These commonly happen via central (nervous system) or peripheral (pelvic floor or nociceptive/neuropathic) mechanisms

  1. Pelvic injuries (falls, hernia, accidents)
  2. Perceived injuries
  3. Infections (UTI/STD)
  4. Stressful experiences and trauma, including sexual abuse/assault
  5. Regretful/anxious sexual encounters
  6. Poor bowel/urinary habits (straining on the toilet often - constipation) or holding in pee/poo for extended periods (like avoiding using a public toilet)
  7. Poor sexual habits (edging/gooning excessively)
  8. Cycling or intense gym habits

SYMPTOM VARIABILITY:

CPPS also presents differently from person to person, and you may exhibit only a few symptoms from the total 'pool' of possibilities. For example, you may only have a 'golfball sensation' and some minor urinary urgency. Another person may have tip of penis pain, testicular pain, and trouble having bowel movements. A third may have ALL of those, and also have sexual dysfunction (ED/PE) and pain with ejaculation. But they are all considered to be CPPS. Here is the full list of symptoms of non-bacterial prostatitis (ie CPPS) - https://emedicine.medscape.com/article/456165-clinical?form=fpf

The chief symptom reported by patients with abacterial prostatitis/CPPS is pain. Genitourinary symptoms include perineal, penile tip, testicular, rectal, lower abdominal, or back pain.

Patients can also have irritative or obstructive urologic symptoms such as frequency, urgency, dysuria, decreased force of the urinary stream, nocturia, and incontinence. Other symptoms are a clear urethral discharge, ejaculatory pain, hematospermia, and sexual dysfunction.

Note: If your symptoms extend BEYOND the pelvis, this is a classic indication of centralized mechanisms (ie nociplastic mechanisms) - What some doctors have in the past called "central sensitization." According to the American Urological Association, these include symptoms like headaches and migraines, IBS, fatigue, fibromyalgia, and more.

So how do we treat it?

The most evidence based approach to treatment is called "UPOINT," a treatment/phenotyping system for Prostatitis/CPPS that was developed by the American Urological Association. UPOINT Stands for:

Urinary, Psychosocial, Organ Specific, Infection, Neurologic/Systemic, Tenderness (ie, Muscles)

it's been shown to be very effective (around 75%) in treating CPPS, as it takes each patient and groups them into phenotypes based on symptoms, then treats them in a customized, integrated, and multi-modal manner. Every case is treated uniquely by symptoms, and this leads to much better patient outcomes. UPOINT is what a good urologist uses to treat patients with CP/CPPS. If your urologist isn't aware of UPOINT, find a new one. You're probably not in good hands. Citation: https://pubmed.ncbi.nlm.nih.gov/34552790/

EXCELLENT MEDICAL/SCIENTIFIC VIDEO RESOURCE - 2015 AUA (American Urological Association) Meeting: https://www.youtube.com/watch?v=4dP_jtZvz9w

✓✓✓ NEW SUFFERER TREATMENT CHECKLIST

ENGAGE WITH A PHYSICIAN:

  • Do see a urologist to rule out any serious structural issues
  • Do get a LUTS and/or bladder ultrasound (check residual urine/voiding issues) along with a DRE for prostate size assessment
  • Do get a urinary culture and/or EPS localization culture, if infection is suspected (based on symptoms) - AUA guidelines DO NOT recommended semen cultures - full text, page 21
  • Do get any physician-specified blood tests
  • NOTE: Cystoscopy is typically reserved for suspicion of IC/BPS - but not typically recommend for CPPS
  • Do not use antibiotics without meeting specific diagnostic criteria. Only ~5% of all prostatitis cases are bacterial (even less if your case is > 90 days)

! ! WARNINGS ON INDISCRIMINATE USE OF FLOROQUINOLONE ANTIBIOTICS (Like Cipro or Levo) ! ! Click to Read FDA & EMA Warnings

Thinking about MicrogenDX testing? Please think again, the 2025 AUA Guidelines specifically advise against it's use: READ OUR MOD MEMO

ENGAGE WITH A PELVIC FLOOR PT - Muscles and Nerves

  • See a pelvic floor physical therapist, one who has experience TREATING MEN and can do INTERNAL AND EXTERNAL trigger point release. Studies suggest that 47% - 90% of CPPS cases have pelvic floor myalgia (pain, tenderness, trigger points), and multiple studies show 70-83% of people improve significantly with pelvic floor physical therapy
  • Practice diaphragmatic belly breathing daily
  • Practice pelvic stretching daily (and combine with the breathing)
  • NOTE: 2025 AUA Guidelines suggest that ESWT, acupuncture, dry needling, and TENS help some cases

CENTRALIZATION/BIOPSYCHOSOCIAL:

  • At least 49% of cases have centralized/neuroplastic mechanisms according to the MAPP research network study
  • EXTERNAL: Manage and reduce stress and anxiety in your external environment (work, relationships, finances, etc.)
  • INTERNAL: Address the fear towards your own symptoms. And, avoid obsessive preoccupation & problem solving with symptoms, redirecting your attention to things that are meaningful and enjoyable (distractions and hobbies)
  • Belief/perception of safety or danger (including assumptions about assumed injuries or assumed infections) is also shown in studies on chronic pain to affect our physical pain experience
  • Take time for yourself and do things to relax and engage in self care. Find SAFETY in your body again: mindfulness/meditation, yoga, baths, etc
  • See a chronic pain therapist, coach or psychologist who practices PRT, EAET, and/or CBT: Examples: Pain Psychology Center (LA), the app "Curable" for chronic pain/symptoms (Note on CBT - this is typically found less helpful for pain in controlled experiments, compared to newer PRT and EAET)
  • Recommended readings: Alan Gordon (LCSW) - 'The Way Out' or Dr. Howard Schubiner 'Unlearn Your Pain'

Urological (Pharmacological) Treatments to Discuss With A Doctor:

  • Discuss alpha blockers (Alfuzosin etc) for urinary/flow/frequency with physician, if you have urinary symptoms. Be aware of possible side effects in some users: PE, Retrograde ejaculation, etc
  • Alternate to above, if they don't work for you or you have side effects, discuss Cialis with your physician. Cialis (Generic: Tadalafil) also helps with ED and can be used at low doses of 2.5mg/day.
  • Discuss low dose amitriptyline (off label usage) with your doctor, which can help approx. 2/3 people to relieve the neuropathic pain associated with this condition
  • Discuss rectal suppositories for pain management, often containing meds like: diazepam (Valium), available via a compounding pharmacy - this is a controlled substance; always discuss with your doctor - not meant to be used daily.
  • You may try NSAIDs for pain during flair ups, but caution for daily, ongoing use. MOST find this class of meds unhelpful.
  • Oral Steroids are NOT RECOMMENDED, per 2025 AUA Guidelines

HERBS/SUPPLEMENTS:

  • Phytotherapy (Quercetin & Rye Pollen, ie Graminex) - highest level of evidence for CP/CPPS
  • Magnesium (glycinate or complex) - less evidence
  • Palmitoylethanolamide (PEA) - less evidence

BEHAVIORAL CHANGES (Lifestyle): Please note that these suggestions cast an extremely wide net, and many do not apply if symptoms are centralized/nociplastic.

  • Avoid edging or aggressive masturbation; limit masturbation to 2-3/week, and be gentle. No "Death grips"
  • Less sedentary lifestyle - walk for 1 hour daily or every other day (I would recommend you build up to this, start with 15 minutes daily, easier to start a habit with a gentle, but regular introduction)
  • Get your blood pressure, body weight, and blood sugar under control (if applicable)
  • Gym goers and body builders: lay off the heavy weights, squats, and excessive core workouts temporarily. Ask a physical therapist to 'OK' your gym and exercise routine. This is a possible physical trigger
  • Cyclists and bikers: Lay off cycling until your physical therapist OKs it - this is a known physical trigger
  • STAND MORE! Get either A) a knee chair, or B) an adjustable standing desk. You'll still need the regular chair, because you can't sit on a knee chair or stand all day, basically, although conceivably you could do both A and B, and skip the regular chair
  • Try a donut pillow if experiencing pain while sitting

BEHAVIORAL CHANGES (Diet) Note: Dietary triggers affect a small MINORITY of cases

  • Try reducing/eliminating alcohol (especially in the evening, if you have nocturia)
  • Try reducing/eliminating caffeine
  • Try eliminating spicy/high acid foods
  • Try eliminating gluten and/or dairy
  • Try the IC Diet (basically this is all of the above, and more)
  • If eliminating or reducing doesn't help, then it probably doesn't apply to your case, enjoy your food and drinks!

NEW 2025 AUA TREATMENT OUTLINE

Others suggestions? Beyond this abbreviated list, work with a specialist. This includes urologists who have specific training in CPPS (through continuing education), pelvic floor PTs, and chronic pain specialists, including PRT practitioners.

Welcome to r/Prostatitis, follow the rules, be respectful, and we'll be happy to have you in your recovery journey.

The content of this subreddit is not considered medical advice, including the information here. Even if a flared user (verified urologist or PT) makes a comment, this is not prescriptive advice, nor is it medical advice.

This guide was co-written by your moderators u/Linari5 and u/Ashmedai


r/Prostatitis Apr 07 '21

Starter Guide/Resource Confusion over ANTIBIOTICS

115 Upvotes

Tony's Advice for Beginners

Top Rated Thread of all time in this Reddit: The experience of an MD with CP/CPPS

Antibiotics

Every day numerous questions are posted here about the effects of antibiotics. How can my case be nonbacterial if antibiotics help me (for a while anyway)?

The simple fact is that antibiotics are ANTI-INFLAMMATORIES and also have other immunomodulatory effects. In fact they are used for these effects in many conditions (acne and other skin conditions, ulcerative colitis, Crohn's Disease, and more).

Sadly, even many doctors don't know this (it was only acknowledged this century and medical school curricula have mostly not been updated yet). But the research is all there. (Note that due to our genetic differences, some people react more to the anti-inflammatory effects and some people less, or not at all. This is known as pharmacogenetics).

Acute bacterial prostatitis does happen, and it's pretty obvious: very sudden abrupt onset, fever, chills, nausea, vomiting, and malaise (feels like having the flu). Nothing like what 99.9% of readers here have. It's often a medical emergency that requires a trip to the ER.

But you may still think your case is bacterial, perhaps a chronic and not acute case. Professor Weidner says:

"In studies of 656 men with pelvic pain suggestive of chronic prostatitis, we seldom found chronic bacterial prostatitis. It is truly a rare disease."Dr. Weidner (Professor of Medicine, Department of Urology, University of Giessen, Giessen, Germany)

Chronic bacterial prostatitis also has a distinct picture. It presents as intermittent UTIs where the bug is always the same (often E coli). Here's an example:

I have chronic bacterial prostatitis that responds well to antibiotics. ... The doctor will express some prostate fluid and run a culture to determine the bug and prescribe an appropriate antibiotic. My bug has consistently been shown to be E-coli.

That being said, my symptoms usually start with increased frequency of urination, burning and pain on urination, and pus discharge. But no pain other than that and it usually goes away after a few days on the antibiotics. I continue the antibiotics for 30 days which is well after the symptoms have disappeared. I can usually expect a relapse in 6 to 12 months. ... This has been going on for more than 30 years. .... My worst experience a number of years ago was when I thought I would tough it out and see what happened. The pain got excruciating, testicles inflamed, bloody discharge, high fever. But this responded well to antibiotics and I haven't tried to tough it out again after that experience. I know when it starts and go on antibiotics right away.

I know that guys who have chronic pelvic pain syndrome may scoff at what I say and I know that they are in the majority. I really don't know what they are going through but then, they don't know my experience either.

So here are the key points to look for in chronic infection:

  1. Relapsing UTI picture (dysuria [painful urination], discharge)
  2. Consistently identifiable bug (the bug does not change)
  3. Generally no pain unless accompanied by fever and discharge. So for most of the time, men with chronic bacterial prostatitis do not have any pain.

All the rest have, sigh, UCPPS (CPPS).


r/Prostatitis 3h ago

36M, taking 10–15 minutes to finish peeing. Anyone experienced this?

2 Upvotes

I’m 36M and over roughly the past 3–6 months, going to the toilet has gradually become a really long process. I can easily spend 10–15 minutes just trying to make sure I have actually finished peeing.

I have peed sitting down for at least the past five years. Previously, I would pee, wait briefly, use a tissue to wipe the tip, give it a final squeeze and that was basically it. If a tiny drop later ended up in my underwear occasionally, I could live with that.

What bothers me now is that I can think I have finished, but if I stand up, sometimes more urine will come out before I even get my underwear back on. It can be more than just a single residual drop.

Because of that, I have developed this whole routine where I pee, wait, pee a little more, wait again, and repeat until I feel like my bladder is genuinely empty. After that I still feel like there is urine left in the urethra, so I wipe and gently squeeze along my penis almost like emptying a tube, repeating that until I am confident there is nothing left. I have even started wrapping some tissue around the tip before standing up because I am worried more urine will come out.

The whole process can take around 15 minutes, which obviously does not seem normal.

I am curious whether any other guys, particularly around my age, have experienced something similar. If so, did you eventually find out what was causing it and what helped?

I have wondered about prostate problems, although at 36 I am not sure how likely that is. Searching online also brings up pelvic floor dysfunction. Apparently an overly tight/hypertonic pelvic floor can make it difficult to relax properly to urinate, but I have also read that a weak pelvic floor can cause post-urination dribbling, so I have no idea which direction to go in.

For anyone who has dealt with this, where did you start? Did you see a GP first and have your prostate/urinary system checked, see a urologist, or go directly to a male pelvic floor physiotherapist? Pelvic floor physios can be quite expensive, so I would rather work out whether that is actually the appropriate path before spending a lot of money on appointments.

I would especially like to hear from anyone who had the repeated “I’m finished… wait, there’s still more” problem rather than just the occasional normal drop after peeing.


r/Prostatitis 13h ago

How were you disgnosed with CP / CPPS.

4 Upvotes

Hi everyone

I just need to know as in what were your personal diagnostic criteria for confirming prostatitis, what procedures were invloved?

My symptoms are :

  1. Chronic balanitis type rashes , red patches tender on touch and somewhat itching , this keeps waxing waning since almost 2 years now. Prescribed steroids work the best but it comes back even 2-3 days from stopping.

  2. Pain the lower right back area

  3. Vague pain in lower from abdomen where the belt sits , comes and goes not constant

  4. Pain on ejaculation specially while mastrubating say 5 out of 10 times. Location of pain is directly on the exit of penis area.

Thanks!


r/Prostatitis 8h ago

Vent/Discouraged Can you give me your opinion on whether it’s bacterial?

1 Upvotes

Hi! First post here, I would really like to know your opinion on my situation.

My symptoms are:

- Higher temperature in my penis, like if I had a fever there. Other people can feel it too.
- Pain when urinating, it’s not a strong pain more like a 3 on a 1-10 scale.
- lingering burning sensation. It goes away most of the day but If I masturbate I feel it for a while.
- That’s pretty much it.

In a week, I usually have one or two days when my pain subsides. I’ve been like this for over a year. I’ve taken almost all common antibiotics including 2 months of levofloxacin.

I did a pcr std test and I was negative for all: chlamydia, gonorrhea, ureaplasma, etc…

I did a urethral swab and it was so painful I was literally peeing glass. It came positive with streptococcus spp. which was resistant to a lot of antibiotics. It showed sensitivity to levofloxacin which is why I took it.

I don’t have a lot of money which is why I can’t go to the doctor or tests often. The swab was kinda cheap but I’m scared of peeing glass again.

I just wanted your opinion on whether it is worth it to keep getting referred to antibiotics. I live in a third world country so I don’t have access to any advanced tests.

The most relief I’ve felt is while taking doxycycline. The other ones haven’t really changed how I feel.


r/Prostatitis 10h ago

Office chairs - flat seat pan

1 Upvotes

Hi everyone, I'm looking for an office chair to replace my Steelcase Leap V2, which is triggering my symptoms when I sit on it for a long time because there are probably a few things wrong with this chair:

  • The cushion is not thick enough, so I got it replaced with another cushion from Office Logic. The problem is that even with a thicker cushion, the chair seatpan is so contoured that it actually compresses the pudendal nerve.
  • The angle of the seat is lower in the back and higher in the front.
  • There is a bump at the perineum level. It's hard to see. You need to put your hand across the seat to feel it, because the fabric being taut between the two sides hides it. There is something there, and it really triggers me.

Given all this, I've noticed that when I'm on a flat chair that is not too hard and I'm just sitting on my seat bones, it actually is fine. I'm looking for an office chair that is not contoured, has a flat seat, and is not angled. The only chairs that seem to fit the bill are the worst ones, meaning the cheap ones, IKEA, things like that, but I'd like to have something that's comfortable enough to actually sit in it all day. I was looking at a few models:

  • The Knoll Generation model
  • The Hayworth Fern
  • The AMIA from Steel Case
  • The Gesture

When I look at the seat pans of the Hayworth/Steelcase Amia and Gesture, it looks fairly contoured, so I'm not sure that's going to work. I'd rather be on the safe side because those chairs are pretty expensive, and I don't want to have to return them.

I've tried the Aeron from the Hermann Miller showroom, and it seemed better, but I'm not sure that it would actually be good long term, given that there's some inclination. You really put your pelvic at a tilt, and you really need to sit back in it. There's an angle, meaning that your sit bones are actually lower than where the seat is supported, and I suspect it is still pulling some pressure on the pelvic floor, especially on the perineum.

It's complicated because, the more I look into it, I'd never find clear answers from people. They seem to disagree. I'm pretty sure I'm not the only one who's been researching this type of chair, so let me know if you found something good. Thanks!


r/Prostatitis 1d ago

Vent/Discouraged 3 years of constant pain. Gooning / edging related?

6 Upvotes

I’ve been dealing with chronic pelvic pain for about 3 years and am curious whether anyone here has had a similar progression.

Mine started with coccyx/tailbone pain, which lasted for 10 months. Had 3 months of of no pain then suddenly developed urinary urgency/frequency and urethral discomfort, which eventually evolved into chronic penile pain and testical pain. The urinary symptoms became less prominent, but the penile pain stayed. It can be sharp/stabbing or pressure-like and at times severe. It’s a constant pain but arousal and especially ejaculation can trigger major flares afterward.

After different opinions, the current thinking is CPPS involving a hypertonic pelvic floor/muscle spasm combined with nerve irritation and sensitization, rather than an infection or primarily a prostate problem. Pudendal nerve involvement has also been considered, and pelvic floor PT has consistently found significant tightness.

Here’s the part I keep wondering about: for years before and during the development of these symptoms, I regularly edged/gooned for 1–3 hours once a week or so. This is just how I’ve masterbated for as long as I can remember. Usually on cam laying in bed with laptop on my legs. It was something I enjoyed and I never thought it could have physical consequences.

Has anyone else had a history of prolonged edging/gooning before developing urinary urgency, penile/urethral pain, coccyx pain or CPPS? Did stopping for an extended period make a meaningful difference?

Most importantly, did anyone with a similar presentation significantly improve or recover and eventually return to normal, pain-free sexual activity? What helped you most?


r/Prostatitis 1d ago

Vent/Discouraged How to manage chronic prostatitis

6 Upvotes

I have been facing difficulties due to prostatitis for the last 4 years(29 M). The symptoms are painful ejaculation and difficulty during masturbation. In addition, during the initial phases I had the golf ball feeling underneath the right side of the scrotum while sitting. It becomes more prominent after I try masturbation. Now this feeling has become less prominent.

Medical checks done till now are ultrasound, mri pelvis, transrectal scan and lab tests(semen and urine)

Ultrasound - right grade 1 varicocele and epididymal head cyst

Mri - mildly enlarged prostate with disproportionate hypertrophy of peripheral zone. Multiple dark bands extending to the prostatic capsule.

Transrectal scan - mild prostatic enlargement. Subtle increase in vascularity in peri urethral and central zone

Lab tests - negative for bacteria. I have always observed very small amount of pus cells in urine.

Treatment - Initial urologist suggested alfuzosin. I was able to masturbate with full bladder. Otherwise no improvement but was having headache and fatigue while waking up. I took for few months then stopped.

Next doctor suggested pregabalin. There was good improvement initially but then it again went back to usual problems. Even in this case I was only able to masturbate with full bladder when I wake up early morning (1-3). But that time it felt completely normal and I didn't wake up with fatigue. I observed this same improvement when I went to gym but then the improvement stopped.

The doctor im seeing now asked me to take bacstol for some time. Now I'm taking nifutin for few months. He told it is prostatitis and not cpps. Still not much significant improvement. Sometimes I'm able to masturbate in early morning with full bladder only. Even then I wake up a bit tired. Otherwise it becomes very painful and I stop.

Can anyone who faced similar symptoms suggest how to deal with this. Although my normal activities are not affected, I'm not able to try any relationship thinking about this issue. This is slowly leading to some frustration.

Any help would be appreciated

Thanks


r/Prostatitis 1d ago

Cpps/groin discomfort

2 Upvotes

Hi - Has anyone else dealing with non bacterial prostatitis / CPPS suffer from the below symptoms?

  1. Pelvic/ Groin / area between thigh and groin discomfort especially when sitting. Kind of feels like it’s in my joints. Pretty much felt all day apart from if walking or running
  2. Waistband discomfort - I’m constantly pulling up or unbuttoning the top button of my jeans/shorts. I try to not wear belts anymore.
  3. Groin/pelvic area discomfort when lying on back. I only sleep on my sides now.

I also get discomfort after I masturbate in my perineum area towards my left testicle. This lasts for the rest of the day and only subsides the next day after sleep.

I’ve tried pelvic stretches to help but routine sort of fell away with life. Really need to get back into it though and breathing work to try to relax my pelvic floor.

Thanks


r/Prostatitis 1d ago

Are these prostatitis/cpps symptoms?

1 Upvotes

Hi so ive been dealing with a few symptoms that i think theyre prostatitis?
Pelvic floor pain/tightness and pressure, burning sensation when urinating, urinary urgency, discomfort and pain around the genital area, premature ejaculation, constipation, pain/pressure around the anus, discomfort around the pelvic area, a noticeable change in size of my penis.

I’m wondering whether this sounds similar to what people with chronic prostatitis/CPPS or pelvic floor dysfunction have experienced?

For anyone who has dealt with something similar What did your symptoms feel like? Did you eventually figure out what was causing them? Did you see a urologist or pelvic floor physiotherapist, and what tests or treatments actually helped?


r/Prostatitis 1d ago

Prostatitis or fissure/ hemmroid?

2 Upvotes

I’m 30 and since I was 21 have been dealing with prostatitis.

It’s always come and gone, depending on stress, diet etc.

The one thing I’m starting to wonder if this more recently is internal hemmroid or fissure based on the fact that it feels like 1) something is stuck and needs to be pushed out 2) there is a sore that seems to heal and then come back ever so often, and very minimal bright blood on toilet paper when wiping at the anus that gets aggravated when frequently going to the washroom.

I have no issues urinating, I get some bouts of more frequent urination.

Any advice would be appreciated


r/Prostatitis 1d ago

My penis got shrunk after getting prostatitis

2 Upvotes

My penis looks like a baby penis

What happened to me? Only tadalafil 5mg save me


r/Prostatitis 2d ago

Quercetin = yellow semen?

4 Upvotes

Hi all, just curious — anyone taking high-dose quercetin noticing yellow semen? I’m doing 2000 mg per day.

No other symptoms… just semen turned yellow! Thank you in advance.


r/Prostatitis 2d ago

[M20 Philippines] Has anyone found a cure for the persistent sensation of urine stuck in penis

1 Upvotes

Im a M20 college student, This condition found me 4 years ago When I was 16 years old, I felt like there was urine stuck in my urethra near frenulum at that time. I have never had a girlfriend or any sexual intercourse before. I'm hoping to get some advice or hear from others who might have experienced something similar.

Symptoms:

• I've noticed that the "stuck pee feeling in the tip of the penis" (weak urine stream) is often there. Just a minute or so after coming from the toilet, especially after pooping.

• I have had issues with the need to go to the toilet very often (Usually within the 40-60minute mark after taking a pee)

• I pee normally without any issues, but towards the end, I get this sensation that some urine is still stuck.

• After finishing, if I stand and apply a bit of pressure, a few drops and sometimes even a small stream of urine come out.

• The feeling is generally always there but varies in intensity. It takes up a lot of my focus, making it difficult to concentrate on anything or enjoy stuff and relax. It's ruining many aspects of my daily and social life

• The feeling has also developed a bit over this long time, but the "stuck pee feeling in the tip of the penis" has always been there.

I have no pain at all.


r/Prostatitis 2d ago

Please help me , very worried

2 Upvotes

On Tuesday the 18th I had a sexual encounter with a sex worker initially I had a condom on but throughout the time the condom manage to slip off , initially I didint think anything about it but fast forward to Saturday 22nd I came to the conclusion that I’m now potentially exposed to std and I instantly started to get so much anxiety and paranoia, this same day the tip of my penis started burning on and off throughout the day , and it was like this for the next day days , so I got tested for uti and chlaymida and gohnorrea , 7 days after exposure on Tuesday August 25th, everything came back negative but still having the mild burn at tip, not painful but just very uncomfortable, so I retested 9 days after exposure Thursday 27th , and still everything negative .. as I type this it is current 9:25pm August 30th Sunday , 12 days after exposure and I’m still feeling it . Do you think I need to do another test on day 14 to be completely conclusive ? I have a appointment with urology this upcoming Wednesday,

Also on a related or unrelated note , I’ve been a lot more shiveled up then normal throughout the day when flaccid , and not really having morning woods or in the mood for any sex.


r/Prostatitis 3d ago

Why has it come back?

2 Upvotes

I have had CPPS for getting on two years now. For about 14 months the pain was unrelenting, and then it went away (I was so so happy), only to appear again a month or so later..I have no idea why it went away but I guessed one of the reasons it came back was because I was under a lot of stress.

About a month or so ago the pain went away again. I attributed this to the use of Tadalafil as it went away almost as soon as I used it. A month in, I was starting to allow myself to believe it had gone and then yesterday, out of the blue, the pain started up again. I have absolutely no idea why. I am going through a very good patch mentally and physically. Haven't felt so relaxed in years (partly, admittedly because I was pain free) and this again. Why oh why?

I can't think of anything that could have triggered this. My life style hasn't changed and, as I say, mentally and physically things have been good. I just can't fathom it. It's like the condition is torturing me.

I have started taking the Tadalafil again but, so far, it's not had the impact it had before, though this is only the second day of it. The only differences in my life I can think of are that I started eating cheese for the first time in months (though I still consumed dairy products- kefir and yoghurt) and I wore some trousers that were a little tight. Could these things really be enough to bring this condition on again?

Is it the case there sometimes is no apparent rhyme nor reason why it comes on? I would have thought there must be a cause of some sort, be that physical, mental or both.

Very interested in what others have to say. Has the condition hit you out of the blue like this? Any advice would be very welcome.

Man, this condition is hard. :-(

.


r/Prostatitis 3d ago

Fluctuating frequent urination + functional bladder neck obstruction (PBNO) - Any experiences?

2 Upvotes

Hi everyone,

I (40M) am at my wit's end right now and am hoping for some of your experiences. I'm dealing with heavily fluctuating bladder issues that occur both during the day and at night.

**My Symptoms & History:**

* **Daytime & Work:** I have phases of high urinary frequency (pollakiuria). The situation is especially bad when I am at work: I usually have a coffee in the morning before leaving the house, and I mostly drink sparkling water at the office. While at my workplace, I have to go to the toilet every 30 to 60 minutes. I strongly suspect that a combination of work stress and coffee is triggering this extreme urge. I often get the feeling of incomplete emptying – right after peeing, the urge is already back. My urine stream strength varies a lot; it's usually weaker in the morning than the rest of the day.

* **Evenings/Nights:** In the evening, the constant urge to go in very short intervals is incredibly stressful. Currently, it's worse again – I sometimes wake up every hour (until about 1:00 AM). But regardless of these acute flare-ups: When I go to bed, I always have to pee at least twice before I can even fall asleep. The nighttime trips usually stop around 1:00 AM.

* **Childhood connection:** The frequent urination, especially needing to go multiple times right before falling asleep, has actually been an issue for me since my childhood.

* **Sports & Movement:** The interesting part is that during sports and physical activity, I have almost zero issues or urge. The symptoms usually only kick in once I sit down and come to rest. The overall course is extremely fluctuating; there are days and phases where I have almost no problems at all.

**Tests & Results:**

* **Voiding diary (3 days):** Confirmed the highly fluctuating pattern. Total frequency up to 12 trips/24h. Voided volumes vary drastically between 50 ml and 700 ml.

* **Urine & PVR (Post-Void Residual):** Urinalysis and urine culture are completely clear, so no bacterial infection. PVR fluctuates extremely (sometimes almost 0 ml, sometimes very clearly between 20 and 100 ml).

* **Ultrasound & Uroflow:** Prostate is slightly enlarged (approx. 30 ml) with an elevated bladder neck. Uroflowmetry recently showed a Qmax of 14.4 ml/s (at almost 400 ml voided volume).

* **Prostate evaluation:** The urologist largely ruled out the prostate as the root cause. She literally said that with this prostate I should "pee like a little boy." Age-related growth might be a slight factor, but it's not the root cause given how long I've had issues.

* **Urodynamics:** Could not be performed technically. The measuring catheter couldn't pass the elevated bladder neck (a standard catheter passes fine, though). This points to a specific functional barrier right at the bladder neck (Primary Bladder Neck Obstruction / PBNO).

* **Spine/Orthopedic:** I had an MRI of my thoracic and lumbar spine (T-spine/L-spine). Everything was completely clear, so there are no spinal or neurological issues causing this.

* My next follow-up appointment with the urologist is this September.

**Current Meds & Supplements:**

I am currently taking **Tamsulosin** combined with **Solifenacin**. Additionally, I take **125 mg of Magnesium Citrate** as a daily supplement, mostly in the morning.

**Next Therapy Idea:**

Based on the findings, my doctor recommended trying a Botox treatment before considering any surgical intervention (like a bladder neck incision/TUIP). Very important detail: The Botox would be injected directly into the bladder neck, NOT into the bladder detrusor muscle.

Has anyone here experienced a similar pattern (especially the work/desk triggers, the fluctuation, or the childhood connection)? Does anyone have experience with Botox injected specifically into the bladder neck?

**Furthermore, I would be very grateful for any other experiences, alternative treatment ideas, or general management strategies that have helped you!**


r/Prostatitis 3d ago

10 years of suffering, suspected Chronic Prostatitis, my story

5 Upvotes

Hello r/Prostatitis,

about two months ago, I was told I might have Chronic Prostatitis. I’m currently waiting for an appointment with a urologist to look into it. However, I have been suffering from severe symptoms for almost ten years now. In recent months, in addition to Chronic Prostatitis, I have also been diagnosed with autonomic somatoform disorder of the urogenital tract and myofascial pain syndrome.

In my case, the symptoms began with a traumatic incident during masturbation. Because of the trauma and the shame triggered by the event, I didn’t talk to anyone—not my family, not my friends—about my condition for eight years, except for doctors. And I also had trouble talking to the doctors, which is why I remained misunderstood and undiagnosed for a long time, while my symptoms worsened. Fortunately, I’ve been able to make some progress over the past four years and have achieved symptom relief through exercise, physical therapy, and stretching exercises. I’m also currently undergoing inpatient psychosomatic treatment.

Since my story is very long and complex—and I’m still coming to terms with it—I’ve written a medical history report in which I go into detail over seven pages about my history, doctor’s visits, diagnoses, symptoms, treatments, and more. I’d like to share this medical history report with you here. I’d be happy if some of you could read it and share your thoughts with me. As of today, I am still not sure about my diagnoses, which is why I am trying to reach out and find people that maybe have a similar story or exhibit similar symptoms. I uploaded my medical history report for you on my google drive, click here.

I am looking forward to hear from you guys, I will try to answer everything and be active on this subreddit. Since I am still undergoing inpatient treatment for a month and because there are rules here that limit my access to the internet, I might not be able to always answer quickly, but I will make sure to check in once in a while!


r/Prostatitis 3d ago

Positive Progress Amitripyline alternatives

2 Upvotes

Hello, I started this journey about five years ago. For the first couple years, I was kind of lost, but I found a solution that included gentle but stimulating stretch stretches for my pelvic floor. And the number one thing that basically gave me my life back amitriptyline. I recommended it to anyone who hasn’t tried it because it honestly was a lifesaver for me. However, when I started, it was only 10 mg and the side effects were minimal, but I felt like my pain can be reduced even more if I upped the dose. When I got to 25 mg I basically felt 90% like my normal self before this. Lately life has been extremely stressful and I feel like my constipation, which is one of the big side effects of it has gotten out of control and has taken over my life. I don’t have pain but being stuck in the restroom for an hour because the sensation is there, but nothing is coming out or very little is extremely demoralizing.

For anyone who’s been on amitriptyline and it helped them a lot, but hated some of the side effects like this. Is there any other medication you switched to that gave you the same benefits but with less side effects specifically less constipation ?


r/Prostatitis 4d ago

Positive Progress Update on prostatitis

6 Upvotes

I know I’m new here and thank you to everyone who’s responded!
Well, I went to a Urologist and thankfully my urine and prostate looked good. They did an ultrasound of my bladder right after my urine sample and it showed empty.
The Urologist seemed to think that I did have a bacterial infection somewhere that the Bactrum cleared it up and any lingering symptoms that I’m having should hopefully clear up over the next week or so.

Right now really my only symptoms are a “pressure” in the shaft of the penis area. Doesn’t hurt or anything but the feeling is just there sometimes.
He said that it’s a normal feeling as that whole area is healing from both the infection and the antibiotics.
I am also having slight urgency to pee at moments, but it’s honestly only after I’ve been drinking a lot of water. It’s nothing like it was when this whole thing started.
I actually went to the bathroom last night and slept a full 7.5 hours before waking up to my alarm.

He has prescribed me FloMax (I think) to supposedly help strengthen and heal the areas around my bladder and also recommend a citrate zinc supplement gummy for overall prostate/urinary tract health.

Does anyone have any recommendations on supplements that will help me not only heal but hopefully help keep the whole area healthy.

I had one super helpful guy message me about some Bee Polin tea that looks promising, but yikes I’m not sure I can afford that.

Anyways, thanks for letting me vent and now for any advice you might have.

This whole situation is new to me and honestly it was quite frightening and disruptive.


r/Prostatitis 5d ago

18yo male Any words of encouragement or help appreciated

6 Upvotes

Ughhhh this is embarrassing to post. It all started about 4 months back in late april I caught chlamydia from this chick I was messing with. Got it cleared up with doxy was completely fine after. But, like the idiot I am, I went back and had sex with the same girl who burned me (with protection though). She told me she had herpes but wasn’t having any outbreaks at the moment.

About a day after we had sex, I felt a burning sensation after I pissed, started pancaking because how? I used protection. I went to get urine tested three times (blood once) since and every test came back negative.

My symptoms consist of pain after urination, pain after ejaculation, pain when sitting, sometimes trouble when emptying bladder, pain that travels down to my foot, feels as foot pain is connected to pelvic pain ? ( possible nerve symptoms) its weird i also have to lay down a certain way at night so my legs wont feel numb, i sometimes have to limp when i walk because of the pain. It seems as symptoms are more mild when im in flow state like if im working, or just simply enjoying a certain part in life, but then i always remember

I go to the gym everyday, I havent trained legs in weeks because it may cause more pain or a flare up. I also hit carts and smoke weed almost everyday so please inform me if I have to get rid of these habits to get better, I try to stop weed but its one of the only things that help me cope. I recently started stretching a few days ago after mistakenly booking an appointment with a Pelvic floor therapist (They didnt accept my insurance)
After I left the therapist office without treatment I broke down crying in my car, I felt so lost. I thought that day would be the day I finally found a solution. Im only 18 I still want to have sex, I dont want this taken away from me this early especially when it seems like im actually hitting my prime with the women lol. But its hard to have sex, even though I tested negative for all STDs I still have fear of possibly burning someone else for some reason and thats the last thing I want on my name.
The stretching has helped slightly, my pain when sitting is better for sure. But the rest of the symptoms still linger, which its only been a couple days so Im not too worried about it.

I plan on booking with an actual urologist from my city tomorrow with a 5 star rating so Im hoping he can give me some lead on how to get this cured. Ive been to other doctors but they just recommend antibiotics or nodded my problems off and told me to wait on a urine test. Some days are good some days are bad I cant lie. The only person I can talk to about this really is my mom, she thinks its just a simple uti but at this point it has to be more than that, every-time I try to explain to her whats wrong I break down crying cause its so embarrassing and explaining to anyone other than a doctor is hella difficult. But I will update you guys after I see the doctor in the next coming days, any words of encouragement or advice for this would be greatly appreciated, thank you for taking the time to read❤️


r/Prostatitis 5d ago

Vent/Discouraged Dont feel one side of pelvic floor ?

1 Upvotes

So lately I noticed that I dont really feel right side of pelvic floor muscles.

when I try to relax I feel some movement or at least an effort to move in the left side of the pelvic floor muscles. But not on the right side. Its like I have no connection or controll over them ? I dont feel them move.

Note that my left side was always the one causing me issues and it still does. I feel tension and pain on left side while right side is "asleep" as mentioned above.

Anyone else dealt with something like that and fixed it ?


r/Prostatitis 5d ago

Do any body knows about Holep prosidure for large prostate?

2 Upvotes

Do any body knows about Holep prosidure for large prostate?


r/Prostatitis 5d ago

cymbalta ( duloxetine )

1 Upvotes

was anyone prescribed cymbalta for cpps? If so, did it work for you?


r/Prostatitis 6d ago

What do I do if my condition WAS caused by a bacterial infection?

5 Upvotes

Hey guys. I have been a member of this club for about 14 months now.

Last year I went to the ER for testical pain, after a few weeks I learned there was a bacterial infection in my prostate causing this. The infection took three rounds of antibiotics to get rid of. I was in absolute agony. It felt like I had acid in my balls. I could t walk. Apparently it was caused by excessive acidic drinks, not stretching my hips, not sleeping well (was drinking caffeine at night accidentally, Arnold palmers were betraying me), sitting in a chair all day, and clenching/stressing.

Since then I have had CPPS, and IC. Prostate still flairs up if triggered. If I drink citric acid I will be in pain for a week. I miss coffee and nicotine so bad. Haven’t slept well. Have been on disability for six months because I was getting suicidal.

A common point i see in this subreddit is that 19/20 cases of this are actually not due to bacteria but stress and muscular/structural reasons. But my bacterial infection was confirmed by multiple tests.

Does that mean the aim to “relax” my way out of this is not practical for me? Is this more of a biological problem than a lifestyle one? Like many I have been talking with AI trying to understand this, and today it explained that due to the severity of the infection my pelvis is “like a burned down house”.

I am on the full regimen- alpha blockers, amitryptalin, anti histamine, anti inflammatory. Plenty of supplements. Did physical therapy. Took a million hot baths. Haven’t really improved enough to get me back on my feet.

Just wanted to know if anyone had any insight on this. We are an unusual minority- and I am starting to realize I may be an outlier even in this community since infections aren’t normally the cause.