Chronic prostatitis

Chronic prostatitis is a debilitating condition defined as at least 3 months of urogenital pain, which may be perineal (the space between the scrotum and anus), suprapubic, groin, rectal, testicular, or penile and is often associated with lower urinary tract symptoms (such as painful voiding, frequency, hesitancy, and urgency), and sexual dysfunction (erectile dysfunction, painful ejaculation, or postcoital pelvic discomfort).

In practice however a diagnosis of chronic prostatitis is often suspected after a shorter duration of symptoms.

Chronic prostatitis may be divided into two types: chronic bacterial prostatitis (CBP), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), in which a bacterial cause cannot be demonstrated, which accounts for approximately 90% of cases.

CP/CPPS is diagnosed by the presence of chronic urogenital pain with or without urinary tract symptoms and sexual dysfunction and the exclusion of urology conditions such as:

  • Urinary tract infection.
  • Urethritis.
  • Epididymo-orchitis.
  • Epididymitis.
  • Benign prostatic hypertrophy.
  • Cancer of the prostate, bladder, or colon.
  • Urethral stricture.
  • Obstructive calculus or a foreign body in the urinary tract.

The management of CP/CPPS is challenging and may include a number of treatments, including antibiotics, anti-inflammatories, nerve-blocking painkillers, and alpha-blockers (designed to relax the urination muscles). Some patients also respond to pelvic floor exercises and occasionally neurostimulation. Co-ordinating investigation and treatment for suspected CP/CPPS is difficult and it is generally recommended a urology specialist oversees patient care. At Nottingham Urology Group we have a number of prostate specialists with a clinical interest in this complex and difficult condition. We also work closely with anaesthetic colleagues with an interest in chronic pain conditions that we can refer patients to if clinically appropriate.

For further information about chronic prostatitis please see the selected resources below. Alternatively, if you wish to arrange an appointment to see one of our specialists, please contact Spire Nottingham on 0115 9377801, or BMI Park Hospital on 0115 9662113.

Further resources

  1. EAU (2019a) Chronic pelvic pain. European Association of Urology. [Free Full-text]
  2. Rees,J., Abrahams,M., Abu,V., et al. (2014) Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/ chronic pelvic pain syndrome: a consensus guideline. Prostate Cancer UK. [Free Full-text]
  3. Franco, J.V.A., Turk, T. and Jung, J.H.et al (2018) Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome (Review). Cochrane Database of Systematic Reviews. John Wiley & Sons Ltd. [Free Full-text]
  4. NICE Clinical Knowledge Summary. Prostatitis - chronic. https://cks.nice.org.uk/prostatitis-chronic#!topicSummary