The subset of prostatitis that we would treat is abacterial or non-bacterial prostatitis. Meaning, there was tenderness on the prostate in exam, however, the workup was negative for any prior infection. So the symptoms that we would see here in patients with abacterial prostatitis would often be testicular pain or burning, perineal discomfort or burning in the perineum, penile pain, pain with erection or ejaculation or post-intercourse, as well as urinary symptoms such as burning during urination or frequency or urgency.
Some potential causes is inflammation in the genitourinary system. From when there’s chronic pelvic floor tension and muscle dysfunction, you essentially get release of proinflammatory cytokines from the pelvic nerves. In addition, there’s been some recent research that has shown the importance of the descending modulation from the brain going down the spinal cord to the genitourinary system that can modulate pain and prostatitis itself and the overall urological chronic pelvic pain syndrome.
Therefore, when we do treat patients particularly with urologic chronic pelvic pain syndrome, we not only treat the peripheral nervous system and the muscles of the pelvis and the surrounding soft tissue, but we also treat the descending modulating signals from the brain. Here at Pelvic Rehabilitation Medicine, we work to relieve the symptoms of abacterial prostatitis as they’re intimately connected to tension in the pelvic floor muscles. And we work to relieve that tension and increase blood flow and decrease inflammation around the nerves that can ultimately help with the pain and inflammation associated with the prostatitis.