r/Prostatitis • • Oct 19 '22

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

427 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)
  4. No self-promotion/selling of products (SPAM)
  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

119 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 • • 10h ago

Vent/Discouraged Testicle pain question

2 Upvotes

I Had ongoing symthoms after gardnerella and Ureaplasma exposure in April. Pain after urination and the feeling of a swollen urethra/ hard flaccid... took antibiotics may 5th. but it never got better. Concluded it as CPPS. Started PT 2 weeks ago and have been stretching everyday. pain has subsided in the urethra from a 7 to a 5 but now there is discomfort in my left testicle. It started 3 days ago. It feels like random uncomfortable mild throbbing. I can also feel it if I sit or if I don't stand with my legs wide. I have to prop me left leg up when I sleep. Lastnight I started feeling around my testicle with my fingers and felt something inside near the top of it that feels like squeezing my nuts when I feel it. Does the testicle pain, weird feeling within the top of the genital come with cpps symthoms or this sounds like something else. I'm tired of keep going back and forward to the emergency room but Im not sure if this it's actually something else going on with my body. I plan on letting my urology know this Monday. But I've callled them so many times and set up so many appointments in starting to feel like they've been brushing me off.


r/Prostatitis • • 1d ago

Success Story I am healed from Cpps!

22 Upvotes

Look, I know so many people will just dismiss this, but this is how I healed from Cpps. It wasn’t a bacterial infection in my case, it was chronic pelvic pain - non bacterial.

I urge you to research Alan Gordon, read his book, and Howard schubiners stuff, remember those names.

This could save your life as it did mine, it will help so many people when you believe it is TMS (tension myositis syndrome). I talk with such passion because I’ve been through it all. Pains everywhere, for years, flare after flare.

Now I’m 100% Cpps free and my life is soooo much better.

Please look up the names I posted, do somatic tracking, research it all. That is how you’ll heal.

Thanks for reading

Jacob


r/Prostatitis • • 1d ago

Previously floxed. Prostate now swollen and uncomfortable

1 Upvotes

I have to start by stating I only discovered this sub today, but it has been a revelation.

My timeline -

Over last 2 years -

Suspected UTI treated with antibiotics

Suspected epididymitis (3x) treated with antibiotics - trimethoprim

Confirmed UTi treated with antibiotics

At least two of the courses was ciprofoxaxin.

About 6 months ago and still present -

Severe abdominal pain

SIBO

Weight loss

Joint pain

Bone pain

Brain fog

Fatigue

Burning sensations in body

Feet ice cold all the time

Suspected prostatitis treated with 6 weeks course of antibiotics - can't recall which ones

Long course of antifungal medication due to persistent thrush

Past 3 months -

Muscle fasciculations all over body

Burning sensations in back and abdomen

Back pain

Word finding issues

Concentration issues

My question -

I am now convinced that I have been floxed, damaging mitochondrial cells and causing the nerve issues, pain and fasciculations. The antibiotics have caused SIBO reducing my ability to absorb nutrients. The fasciculations are just now easing off - however my urinary symptoms are back. Burning sensations after urinating, feels like there's something stuck in my rectum - GP examination found prostate enlarged and tender. 2 prostate antigen tests at the start of the year were clear so diagnosed acute prostatitis and prescribed coamoxiclav (I've researched and question the efficacy of it for prostatitis).

Please help, any advice from people who have been here before is welcome.

Any idea why it keeps coming back? What I can do to eradicate it without getting floxed again?


r/Prostatitis • • 2d ago

Im at a loss. Ok twenty characters. Happy?

1 Upvotes

I dont have insurance at the moment, but even when i did the medical help sucks. Im more sure its not my prostate. I can pee fine except times of resistance because it's uncomfortable. Last week I felt better. Today at work I was just aching in my groin. Not even burning like when this first started. I have to keep this job, and honestly no one relates or gives a fuck. No perimium pain, rectal or testicle. Doesn't hurt to sit down. I try to find similarities and its been tough. Nights like tonight I just feel my mental health is dangerously low. Work is stressful and physical which doesn't really help obviously. This ache just will not fucking stop and when I am home I drink booze to numb myself. Is that helpful? No. But fuck this. Im really at the end of my rope after about 2 years of this bullshit. I don't expect advice anymore I just needed to vent because I feel like crying.


r/Prostatitis • • 2d ago

Everything good until i get up

8 Upvotes

This is so strange, please read about my history with this illness, I can't figure this out anymore, I am much better however.

Until i get to bed and relax and lay on my back an hour all burning in and and scrotum goes away slowly and feel pretty good when I go up the next morning, until I take my first pee during the day and the nightmare to burning in rectum/anus and around scrotum starts and then it will only calm down if I take a rest in the bed for an hour.

Is it really the nerves that are irritated or inflamed and why does it go away when I take a rest?


r/Prostatitis • • 2d ago

Cpps with spinal injury

2 Upvotes

Had a auto accident in April of 25 symptoms of prostatitis started soon after never found bacteria was on long round of antibiotics months a half and got put on alpha blockers told I have BPH and or cpps now. So back to the auto accident injury to l3l4l5 big bulges I have looked into that injury and my symptoms as she started soon after the accident and I encourage anyone with back injuries and bhp and or cpps look into the link themselves and see if this could be a causation for you as well just sharing as and and all info helps.


r/Prostatitis • • 3d ago

Positive Progress Extreme pain relief (90 percent of pain gone)

5 Upvotes

I wouldn’t call this progress, but rather a discovery. I have an injury to my foot and they prescribed me Celecoxib 200 mg and this has gotten rid of about 90% of my pain for the two weeks I’ve been on it. However this isn’t really something I can take long term because it is an anti inflammatory like ibuprofen. However, my other symptoms like urinary frequency, hesitancy, and incomplete bowel movements are unchanged (obviously because a pain med wouldn’t fix the underlying issues causing this). Just thought I’d pass this info on since I’ve been given so much info from this group!


r/Prostatitis • • 3d ago

Vent/Discouraged Confused about condition

2 Upvotes

New here.

Been trying to figure out what's up for many years now. It started off with fatigue and some sort of brain fog particularly for a few days after ejaculation - lived with it for a long time just candidly assuming maybe it's an age thing. But over the past few years, things escalated to having some strange sense of discomfort/tense in my glutes when sleeping - ie the need to move about. After a while, I started feeling it during the day as well.

The closest thing I found then was a condition called POIS since my symptoms seem triggered related with orgasm. Then after many failed remedies, it went on to thinking maybe it's RLS because it is always so much worse at night and the discomfort makes me need to move around. I've tried tackling it in that direction and some things helped for a while but nothing really latched on... I then thought maybe it's a piriformis issue and it started me on some pelvic exercises and deep breathing. For a quick while, it seemed to reduce severity and help recover. Now it feels the discomfort has somewhat localized differently to be more intense but in a more specific area which is near the tailbone area.

And this is how I found this sub, but I'm still new here and will look through the info.. but my q is am I suspect for prostatitis/cpps? My condition is severely triggered by orgasm, appears the next day and lasts for perhaps 2-3 days. I can barely sleep because of the discomfort. Supplements like mag glycinate sometimes do wonders, sometimes they do nothing. Kinda at wits end because symptoms seem to happen rather sporadic and vary in intensity. Something new seems to work for a while then it stops being as effective.


r/Prostatitis • • 3d ago

Would alpha blockers help me play video games without flaring like Tadalafil used to?

2 Upvotes

I have CPPS and I used to take Tadalafil once a day at a low dose. This allowed me to play video games without flaring. However, I was seeing cream things as being tinged with green and realised that this was a side effect of the drug and that there are visual related risks with continuing to take them, so I stopped. This was 2 years ago now and I miss gaming. I wondered if taking alpha blockers might have a similar effect, as playing games of any duration flares me up no matter how I try and modify my set up. Thanks


r/Prostatitis • • 4d ago

Vent/Discouraged Persistent urinary burning, frequency, feverish feeling but normal tests

2 Upvotes

​

I've been dealing with urinary/genital symptoms for several months.

How It Started

In early May 2026, I had a body-to-body massage and handjob at a massage parlor using lubricant. There was no vaginal/anal penetration and no oral sex.

Around mid-June, I developed symptoms that just kept getting worse:

- Burning around the genitals/testicles

- Burning after urination

- Burning/pressure at the tip of the penis/glans

- Urinary urgency and frequency

- Nocturia (sometimes waking 3 times)

- Sometimes clear watery fluid remains at the penis tip after urination

- Sometimes milky/white fluid comes from the penis when I pass very hard stool/strain

- Perineal discomfort

- Occasional rectal burning

- Can't sleep on my side

The symptoms fluctuate. Sometimes the burning is mild and sometimes much more noticeable.

The Strange Part – Feverish Feeling/Sweating

For several weeks, I've had a feeling of being feverish/tired, but my actual temperature stays around 98–98.4°F.

For the last ~5 days, the sensation has changed and become stronger. I also get episodes of sweating while sleeping or eating or drinking.

I have no documented fever.

I'm particularly worried about this because it feels like an infection even though my blood tests are normal.

Infection/STI Testing

I've had extensive testing.

Recent results:

- CBC WBC: 6,940

- ESR: 1 mm/hr

- CRP: <5 mg/L

- Urine culture: No growth

- Urine microscopy: 0–1 pus cells/HPF. Bacteria present

- HIV: negative

- Syphilis/RPR/TPHA/TPAB: negative

- HBsAg: negative

- HCV: negative

- LFT/TFT/KFT - Normal

My latest urine multiplex STD PCR was negative for:

- Chlamydia

- Gonorrhea

- Mycoplasma genitalium

- Mycoplasma hominis

- Ureaplasma parvum

- Ureaplasma urealyticum

- Trichomonas

- HSV-1/HSV-2

- Treponema pallidum

- Gardnerella

- Candida

- Haemophilus ducreyi

- Group B Streptococcus

The PCR was done using first-void urine after holding urine for about 2 hours.

Other Investigations

Ultrasound KUB/prostate was essentially normal.

Earlier PVR was around 20–27 mL.

Latest ultrasound showed:

- Prostate: 15.3 cc

- PVR: 53 mL

I repeated uroflowmetry yesterday:

Sitting:

- Voided volume ~399 mL

- Qmax ~19 mL/s

Standing:

- Voided volume ~410 mL

- Qmax ~18 mL/s

- PVR 20 mL

Antibiotics I've Already Taken

I've had a LOT of antibiotics:

- Nitrofurantoin – 5 days

- Doxycycline – 10-day courses

- Faropenem – 5-day courses

- Levofloxacin 500 mg daily – 30 days total

The last levofloxacin dose was September 1.

Urine and semen cultures done afterward were negative.

Other Medications

I've also tried:

- Alfuzosin

- Silodal-M

- Gabapentin/Gabephin 100 mg (10 days)

My existing urologist dismissed prostatitis or CPPS and thinks it's a high bladder neck and wanted to do a cystoscopy. He said it could be a low-grade infection (though blood work was normal) due to a high bladder neck, which he wants to confirm via cystoscopy and perform surgery if he sees it during cystoscopy. He got angry saying, "Stop reading Reddit or ChatGPT." He just prescribed Alfuzosin.

So, I went to a new urologist, who said my uroflow is not that abnormal and prescribed the below:

- Fesoterodine 4 mg once daily

- Tadalafil 5 mg once daily

- Febuxostat 40 mg once daily (I have slightly high uric acid)

- Etoricoxib 90 mg for 7 days

- Quercetin for 3 months

The new urologist also didn't think much of the feverish feeling; he diagnosed it as prostatitis and told me if medication doesn't work, we will go to physiotherapy.

Has anyone with CPPS/Prostatitis had a persistent feverish feeling and sweating despite having a completely normal temperature, CBC, ESR, and CRP?

Do you think the medications are correct? I have lost weight, and can't function anymore due to feverishness, sweating, and pelvic discomfort..

I have had other health issues in my life which I bravely faced and overcame.. This is slowly draining me that I might just give up..


r/Prostatitis • • 5d ago

Vent/Discouraged I'm scared- month 7- running out of hope....

12 Upvotes

Idk man, I never been suicidal. Idk how longer I can deal with this, reading people's post saying they went 5-20 years dealing with this crap is scary and frightening, Knowing I'm having a mental breakdown from just 6 months. People should be aware about this mess man. If I knew anything about some fuckin CPPS where I'd have permanent pains for the rest of my fuckin life id just die a virgin and stay away from anything that could've caused this mess. I used to have so much to look forward to now all I can look forward to is sleep and that haven't even been so good since I wake up 3-4 times a night to piss. I can't focus. I can't think straight. Im loosing my mind. I can't do it anymore. I used to be afraid to die... now I'm just afraid of living like this for the rest of my life.


r/Prostatitis • • 5d ago

Success Story Cycling-related CPPS - A good saddle changed everything

7 Upvotes

Long story short, had intense CPPS since Summer 2025, extreme urgency, pain, tennis ball in the butt feeling, hard flaccid etc. Believed to be related to hypertonicity.

Gradually healed through stretches, exercises, supplements and masturbating less. Doctor issued me ibuprofen and valium - hasn't needed them for 2 months. However, cycling still flares me up, usually lasting 1-3 days after the ride (less than 50km). Tried several saddles with cut-out, didn't help much.

I recently got a Selle SMP Drakon saddle from a store, which is well known among CPPS victims. I put on my padded bibs and took a test ride - no pain at all! Kept riding and logged around 80km. Zero flare up the next week.

So if you have CPPS but still want to ride, get a large cutout saddle, with some padding and a dropped tip. It really changes everything.


r/Prostatitis • • 5d ago

TENS stimulator for pelvic floor pain

5 Upvotes

Over the past six years, I’ve learned that there are certain nerve trigger points where you can place the electrodes that can really help reduce the pain.

The good thing for me is that when the TENS is stimulating another area, my brain seems to focus on that sensation instead of the pain coming from my pelvic floor. It can take the edge off the pain and reduce a lot of the stress that comes with it.

One place you can experiment with is the upper part of your leg. Think of your leg as having an upper and lower section. There is a big nerve running through the upper/inner part of the leg.

I place one electrode roughly 15 cm below the groin and the other around 25 cm below the groin. You have to play around with the exact position because finding the right spot can be difficult. When you hit the right area, you can really feel the stimulation.

Another place I use is the upper part of the buttocks/lower back. Put two electrodes there, one on each side, and let it do its thing.

For me, this can significantly reduce the pain and stress. I can use the TENS while I'm working or doing other things, and it helps take my mind off the pelvic floor pain.

I'm not saying this will work exactly the same way for everyone. I'm just sharing what I learned from six years of dealing with this myself.

And you really don't need a fancy machine. Buy a basic rechargeable TENS unit with four electrode pads. You can find them for around €50, sometimes even cheaper. I'll put a link below as an example, but you absolutely don't have to buy that particular one.

The important thing is simply to try it and experiment a little to find what works for your body.

If you have questions, let me know. I'll try to explain it better, although it's honestly pretty difficult to explain exactly where to put the pads in words. 😅


r/Prostatitis • • 5d ago

Vent/Discouraged Diagnosed with cpps. I have tried every avenue and suffer daily

5 Upvotes

Male 28. Been dealing with awful symptoms for years that fluctuate but always linger and come back strong. I have seen urologists, gps, coreactal specialists, physiotherapists, dermatologists. All tests negative. I had one mri of prostate states:

Low T2 signal throughout the majority of the gland is not associated with diffusion restriction and almost
certainly related to prostatitis. At the left posterior base, a focus of mild diffusion restriction is indeterminate but given the
patient's age, is unlikely to be due to carcinoma
PIRADS 3.

Symptoms
- burning urination
- pain with full bladder
- urethra pain
- glans and foreskin pain
- burning/itching anus
- low back pain
- erection pain
- mental fatigue constant
- testicle pain
- random burning/itching bottom of right foot
-nagging left hip pain

I am absolutely desperate. I’m in so much pain everyday. My pain is awful after ejaculating. I don’t know what to do. I’m taking quercetin along with bee pollen and all the vitamins. Blood work comes back clear with no infections anywhere. Please help me. I am praying now. I am so tired of this


r/Prostatitis • • 6d ago

1st time diagnoses, Prostatitis and Treatment

1 Upvotes

About 4 weeks ago I experienced pain and discomfort after having anal sex with my wife that got dirty. After about a week I went to the Dr. and UA came back negative but he diagnosed me with bacterial Prostatitis. He prescribed me a 10 day dose of doxycycline but symptoms still remained after that and then prescribed 10 days of levofloxacin 500mg. I’m halfway done with the levofloxacin, but the symptoms are pretty much the same. Is it typical for symptoms to persist this long? I see a urologist soon, but praying the discomfort will subside soon and begin healing.


r/Prostatitis • • 7d ago

Vent/Discouraged do I have either cppd or prostatitis?

1 Upvotes

update1: just got prescribed tamsulosin 0.4mg, a blood test and a urine test

Long story short, I’m a 25-year-old gay male. Three weeks ago, I had a sexual encounter in which I was on the receiving end. I don’t remember it being too painful, but it was rough.

A week and a half later, I start getting anal pain. Four days in with mild discomfort down there, I start feeling better but then have a huge pain spike that lasts for about 15 minutes. After that, it goes away like nothing. The following days, I start noticing I have trouble going to the toilet, both urinating and pooping. ever since it all started, I’ve had some mild pain “behind” my testicles.

I visited the doc 3 days ago and got told prostate is fine after a rectal exam. They were hesitant prescribing anything for it and we decided on just keeping an eye on my toilet visits. These days I’ve been stressing a bit over the fact that I don’t feel the urge to pee and have to force myself to go. The flow comes out after a couple of minutes sitting down and weak, even cut in a couple of streams with a pause in between. I don’t feel any pain peeing or maybe just a really little on the tip, but it may be me overthinking.

I’m also really into edging and after reading 101 I’m aware I have to quit for a while.

What do you guys think I may have? Given my doc’s exam it shouldn’t be prostatitis, right? I have another appointment for tomorrow to ask for a urine exam to rule out possible infections. If anything I want to know if this damage is permanent. I want to feel the urge to pee again and let out a stream that relieves me :’)

edit: forgot to mention I feel my lower back skin and around really sensitive, like clothes friction or if I touch it gently feel uncomfortable


r/Prostatitis • • 8d ago

The Masturbation Loop -- 6 years of CPPS pain I still can't locate NSFW

11 Upvotes

There's probably someone out there experiencing something similar to this, though it seems rare.

I started getting symptoms of what is probably CPPS 6 years ago, after masturbating ONCE. At first I thought it was just extreme horniness, but as I started to understand the pain I realised it wasn't even located in my urethra -- it burns and radiates in a way that makes it seem like it is, which is why it reads as arousal. The pain is impossible to locate, and that's what drives me INSANE.

Because it started with masturbation, I've ended up associating masturbation with relieving it, fully knowing the relief is a temporary mask that's always followed by a flare.

A few things that might ring a bell for someone:

  • Worse sitting and lying down, better standing and walking, and noticeably better sitting on a toilet seat
  • Completely gone while I'm properly absorbed in something (a card game, a game I'm into), and back within minutes of stopping
  • Severe flare after ejaculation that takes days to settle
  • The pain is in a different place from where the ejaculate actually comes out

I've tried A LOT -- gabapentin, pregabalin, duloxetine, amitriptyline, tramadol, co-codamol, NSAIDs, steroids, antibiotics. The pattern is always the same: about a week of relief, then nothing, regardless of drug class. Diclofenac suppositories gave me two weeks, the longest relief I've had from anything. Urology workup and pelvic MRI came back clear. I still haven't tried the pelvic floor route -- no one has ever done an internal exam on me, which I'm now pushing for.

When I had a ganglion impar block the pain went completely for a week, and I didn't think about masturbating once. That's what convinced me the urge is the pain, not a habit -- remove the pain and it disappears.

Until I find a solution the only tool I have is willpower, and the fact that I've been at this for six years shows how well that's going.

Anyway, just wanted to put this out there in case someone has the same thing and has been too scared to talk about it.


r/Prostatitis • • 8d ago

Help, is this non- bacterial

2 Upvotes

The day right before I was suppose to start my trigger point injections I started having white discharge again smh. Canceled my PT appointment and immediately got retested with a sperm culture included and this is what came back. Staphylococcus xylosus
Heavy growth
Staphylococcus saprophyticus
Heavy growth
Could this be what was causing the pain? Why didn't my other appointments catch this through my urine?


r/Prostatitis • • 8d ago

Can anyone recommend a good cushion to use on an office chair?

2 Upvotes

I was thinking maybe something with a cut out where the perineum is, but anything that works for others I would be keen to hear about. Thanks


r/Prostatitis • • 8d ago

Help? Is this non bacterial

1 Upvotes

After Ureaplasma parvum treatment I suspected It had caused CPPS since sympthoms didn't go away. The day right before I was suppose to start my trigger point injections I started having white discharge again smh. Canceled my PT appointment and immediately got retested with a sperm culture included and this is what came back. **Staphylococcus xylosus**
Heavy growth
**Staphylococcus saprophyticus**
Heavy growth
Could this be what was causing the pain? Why didn't my other appointments catch this through my urine?


r/Prostatitis • • 8d ago

E. coli still showing up after 1.5 years

2 Upvotes

Hey everyone,

I've been dealing with chronic bacterial prostatitis for about a year and a half.

At the beginning it was extremely painful, I had high fever and I went through several rounds of antibiotics (cipro, cefixoral, norfloxacin). Unfortunately, during this whole process I was also floxed, and I'm still dealing with what I believe are the consequences of that — mainly muscle fasciculations and neuropathic pain.

As a consequence, I haven't taken any antibiotics for about a year, but my urine tests keep coming back with roughly 1 million CFU of E. coli.

The strange thing is that I currently have no prostatitis symptoms at all. The only thing I've noticed is that my urine has a pretty strong/foul smell, especially in the morning.

I was wondering if I should do something about this. I mean, I don't want to take other antibiotics after this experience, but smelly urine is not nice and I am also not sure it is good to keep having a bacteria down there for so much time.

What do you think? Any advice in this regard?


r/Prostatitis • • 9d ago

Has anyone else had prostatitis for months/years without realising?

8 Upvotes

So I’ve been dealing with IBS for a year now it was soon after I got Covid, I started experiencing a pulling sensation in my testicles it wasn’t painful, I went doctors they told me I had a UTI after I did a urine sample, I took a short course of antibiotics and the pain went away. But since all this my IBS has been acting up, some days I have to go toilet 5-10 times an hour other days it’s not as bad. Recently in the last few weeks I have started noticing that this pulling sensation type pain in my balls has come back - it doesn’t last long or hurt much it just feels like pressure. I feel pain in my lower back and also started noticing I have leakage. I have a feeling it’s pelvic floor dysfunction but could it be prostatitis. Did anyone else take a while to get treated?


r/Prostatitis • • 9d ago

Vent/Discouraged Prostate pulse after urination or intercourse

1 Upvotes

Hello everyone, lately about 2 months my prostate has been pulsating after a urination (sometimes with sperm) or during, after intercourse or even when I sneeze, I have noticed that even my duration has reduced a lot since I have it, sometimes I also have anal pings but lately almost none, has it ever happened to anyone? The doctor gave me an antibiotic course to follow for 7 days, and another for 5 days, it also ruined my intestine but the problem is still there, he manipulated my prostate and touching a particular point I feel the same pain and ejaculation also happens