How to resolve the symptoms of prostatitis?

Hi doctor,

I am concerned about my enlarged prostate. I have had prostatitis symptoms since I was 30 years old. I used to take a one-week round of Cipro. But, since last year, signs have been returning twice a year, and they persist for around three or four weeks and do not react well to Cipro. Is this a dangerous or normal part of the aging process, given that the DRE and PSA levels are normal? What should I do to resolve the symptoms as soon as possible? Should I be worried? Also, I would like to know how prostatitis can be avoided. Is it the source of all my symptoms? Does excessive masturbation cause these? Please help.

Thank you.

Hi doctor,

Thank you for your reply.

I realize that minor prostate enlargement may be age-related. Based on my present symptoms (four weeks) and medical history, do you think I have prostatitis? If so, is it non-bacterial, considering that repeated urine tests and cultures have returned normal or negative results? Do I still need a prostate massage from a urologist and a fluid examination to rule out bacterial infection? Is it possible that it is CPPS? Lastly, I would like to know what course of action you recommend for me to get complete relief. Also, my symptoms gradually improved, but I am still not out of the woods. I still have an urge to urinate frequently and pressure in the perineum.

Thank you.

Hi doctor,

Thank you for the reply.

Could you kindly confirm the following steps and treatment plan for a future occurrence, as well as any preventative strategies you may recommend? Also, please let me know if anything is lacking here that should include in current therapy for future episodes and preventions. For the Present Situation, in the following two weeks, add an Alpha-blocker to your treatment. Inflammatory medications should be taken as needed. Perform simple pelvic floor exercises. Stress should be avoided as much as possible. Quercetin should be taken. Get enough sleep and reduce caffeine. Cranberry extract should be added as a daily supplement. Future Episode of Prostatitis, immediately start antibiotics for 7 to10 days upon onset of urinary symptoms and start alpha-blockers for two to three weeks. For prevention, perform mild pelvic floor stretches twice daily, avoid stress as much as possible, avoid long bike rides and sitting too much, and take daily Omega 3 oil with high EPA (Eicosapentaenoic acid) and consume Quercetin (Flavonoid) and cranberry extract supplements daily. In addition, add more fruits and green vegetables to the diet. Now, I have a few questions about the above: Do I need to start alpha-blocker with antibiotics or wait for prostatitis symptoms to appear like perineum discomfort.

Thank you.

Hi doctor,

Thank you for your reply.

So what you suggest is that I should not start taking alpha-blockers until I have had symptoms of prostatitis for at least 16 weeks? In my situation, my symptoms barely last for four to five weeks in total, but they are severe. So, should I not take alpha-blockers as soon as I notice signs of prostatitis, say after ten days? Also, I never had difficulties urinating, and it is simply that I frequently urinate after every hour.

Thank you.

Hi doctor,

Thank you for your reply.

I have a few more questions to understand the situation better. Firstly, my symptoms do not appear when I wake up or during the day. However, as the day progresses and I consume more fluid (maximum of two to three liters), I urinate more often, and the perineum ache begins. Sometimes there is also a burning sensation in the rectum. Could you please explain why this happens? Second, should I restrict my fluid intake such that I only drink when I am thirsty until the symptoms appear? Thirdly, alpha-blockers help with urinary issues, which is when one has difficulty urinating. I am wondering if it can assist me in reversing my frequent urinating problem. Finally, I cannot overcome frequent urination and mild pressure in the perineum area, but the rest of my symptoms have improved. It has already been five weeks. As per our discussion, I will begin with the alpha-blocker shortly.

Thank you.

Hi doctor,

Thank you for your reply.

I would like to know if, from a medical perspective, prolonged masturbation sessions have led to this condition? For many years, I have had longer masturbation time, but no flare-ups were noticed, and I wonder whether I have done some internal damage due to masturbation leading to this issue. Unfortunately, my symptoms worsen when I have sex but not always, which is not ideal given that I am sexually active. So what can I do in these circumstances? I understood that it is a disorder with recurring increases and decreases in symptoms; however, earlier, it would only last 3 to 4 weeks and disappear completely. But why is it not getting any better this time? Do you see a pattern in your patients where the severity and duration grow with time or remain constant?

Thank you.

Hi doctor,

Thank you for your reply.

I have attached the report from my recent pelvic TA ultrasound (from Canada) for your review. It mentions that the urinary bladder wall is minimally thickened with uncertain significance. I would like your opinion on whether this finding is concerning, especially in relation to prostatitis, or if it is just a normal age-related change. The ultrasound was performed while I still had prostatitis symptoms.

Thank you.

Hi doctor,

Thank you for your reply.

I appear to have fully recovered from prostatitis symptoms and am feeling completely normal. Should I continue taking the alpha-blocker despite having no symptoms, or should I stop taking it? What would you recommend in this case?

Thank you.

Hi doctor,

Thank you for your reply.

What else can I do to prevent recurrence? Should I completely avoid biking? Would saw palmetto, cranberry vitamins, or probiotics be beneficial?

Thank you.

Hi doctor,

Thank you for your reply.

I had a week without symptoms while off alpha-blockers, and I thought I had fully recovered. However, some minor symptoms have returned, including:

1. Uncomfortable feeling in the perineum area
2. Dull pain in the rectum area

Urination is normal so far. I have resumed taking Alfuzosin 10 mg and Ibuprofen.

My questions are:

1. Is there anything else I should take now?
2. Why did the symptoms relapse suddenly? I did have a few small bike rides last week—could that have triggered the relapse?
3. Based on your clinical experience, how long does it typically take for Alfuzosin to work, and when should I consider stopping it if there is no improvement?

I am hopeful that Alfuzosin will help. Please help.

Thank you.

Hi doctor,

Thank you for your reply.

The symptoms are worsening. It is surprising as I was almost completely normal last week, and the relapse occurred so quickly—previous episodes were months apart. How long should it take to notice relief from Alfuzosin?

Thank you.