Medically reviewed by Dr. Paul Song M.D
Article at a Glance
- Chronic prostatitis treatment can be complicated and frustrating for patients and their doctors.
- Many times pelvic pain is unrelated to the prostate and is caused by another situation in the body.
- A whole-body wellness approach that employs many different treatments is usually the best course for chronic prostatitis.
- It is important to address psychological factors such as stress, anxiety, or depression when treating chronic prostatitis.
Managing chronic prostatitis treatment is complicated and frustrating for patients and their doctors. Because there are so many different chronic prostatitis causes, there is no single pill or treatment that works for every man. Even the same treatments will work differently for different men. This frustration at finding a treatment that works and dealing with ongoing chronic pelvic pain can really affect a man’s quality of life and lead some men to become depressed or to suffer anxiety from the pain and lack of traditional treatment options. Even though there is not one cure-all treatment, there is an approach that usually works best for most men, and that is to follow a multimodal treatment plan. A multimodal approach incorporates a mix of traditional, natural, and alternative therapies that can treat a case of prostatitis from a variety of angles recognizing the true cause of the symptoms.
Chronic Prostatitis Treatment
The old standard approach to pelvic pain and chronic prostatitis treatment was to simply prescribe antibiotics (whether or not the cause was bacterial) and if the symptoms didn’t go away then reevaluate and go from there, using a variety of traditional medications and pain killers. A modern diagnostic and treatment approach employs the UPOINT system for prostatitis treatment. This individualized system looks at a patient’s symptoms, determines what might be causing the symptoms, and recommends treatments that work for those specific symptoms individually. This helps the patient avoid taking unnecessary antibiotics and saves time and money by avoiding treatments that don’t work for those specific symptoms. Another individualized program is Dr. Geo’s NPAT Prostatitis Program, which looks at a patient’s overall health, lifestyle, and diet to determine what could be causing the symptoms.
What is unique and important about both UPOINT and Dr. Geo’s NPAT Prostatitis Program is that these systems recognize that the majority of the factors that cause chronic prostatitis symptoms are actually unrelated to the prostate itself. That may sound counter-intuitive, but these modern-day treatments of what was once considered a “prostate disease” focus more and more on a man’s whole-body health and the factors that lie “outside of the prostate.” A successful chronic prostatitis treatment plan considers the whole person and what is right for his symptoms, his possible causes, his psychological state, his stress level, his possible dietary triggers, and his health history (including his urinary history, sexual past and current habits, lifestyle, activities, and other factors).
The most clinically backed chronic prostatitis treatments include the following therapies:
- Geo’s NPAT Program for Prostatitis
- Renew XY Health Program for Men™
- UPOINT System for Prostatitis Treatment
- The Wise-Anderson Protocol
- Medications and Drugs
- Natural Prostatitis Treatments
- Alternative Prostatitis Treatments
- Natural Supplements
- Pain Medication
These treatments provide relief for diverse prostatitis symptoms and causes, including those that do not even relate to the prostate itself.
Dr. Geo’s “NPAT” CPPS treatment program helps both doctors and patients recognize that that the chronic pain and pelvic discomfort are grounded in a man’s lifestyle, diet, nutrition, stress level, and other factors. These aspects of a man’s overall health may contribute to the chronic tension in the pelvic area. The program employs alternative and natural treatments in an individualized total treatment plan that may use dietary changes, acupuncture, pelvic physiotherapy and rehabilitation, trigger point release, phytotherapy, training in stress management, and other remedies, depending on a man’s symptoms and causes.
The letters in NPAT stand for:
- Natural treatments (including ALCAT, elimination diets, and wheat-free diets),
- Phytotherapy (with pollen and quercetin together with probiotics),
- Alternative Treatments (such as acupuncture, prostate massage, pelvic rehabilitation and therapy), and
- Total body (exercise, chronic stress management, lifestyle changes)
Using phytotherapy for chronic prostatitis involves using the natural supplements quercetin and pollen (combined with probiotics) to treat prostatitis. There are numerous studies touting the powerful antioxidants and anti-inflammatory properties of quercetin and the effects of pollen extracts in improving pain level and quality of life for men with prostatitis. That is why phytotherapy is recommended as a therapy in both the UPOINT and NPAT programs.
The Renew XY Health Program for Men™ is a physiotherapy program that works on the patient’s mind-body connection. It promotes a “whole body” approach to healing men’s pelvic pain and pelvic disorders, which are commonly disguised/misdiagnosed as prostatitis. This Program focuses on physiotherapy and breathing exercises for pelvic floor muscle dysfunction in order to teach and train the patient to relax or strengthen pelvic muscles so he can achieve relief from pelvic and related pain.
The UPOINT system for prostatitis treatment is a system used by doctors to classify prostatitis symptoms and direct treatments that have been shown to be most effective for those symptoms. The UPOINT system recognizes that other conditions in the body and other health problems can cause prostatitis symptoms. The system helps doctors to customize a multimodal treatment plan to attack areas causing those symptoms. There are six domains of the UPOINT system. The six domains are:
- Organ Specific
- Tenderness of Skeletal Muscles
How does UPOINT work? A doctor will analyze the results from your NIH Chronic Prostatitis Symptom Index along with the results of other diagnostic tests to determine the severity of a patient’s symptoms and recommend specific treatments based on those results. The UPOINT system is used as a diagnostic guide to systematically review each patient’s specific symptoms to determine the potential causes of those symptoms. This narrows down treatment options to the right treatments for the patient.
The Wise-Anderson Protocol is an alternative treatment for men who suffer from pelvic pain due to tension. Pelvic pain is a complicated issue that can often involves tension in the pelvic muscles and is challenging to treat. That is why this protocol was developed by urologists, psychologists, and physical therapists. The treatment involves using trigger point release, physical therapy, and the treatment for any psychological and behavioral issues that could be contributing to prostatitis symptoms, hopefully attacking the source of the problem. Patients are trained to use an internal trigger point wand so that they can continue the therapy at home.
Using medications and drugs for chronic prostatitis may be helpful for treating some symptoms of CPPS, but many of the commonly prescribed drugs come with side effects. Sometimes doctors overprescribe medications for patients who don’t need them. The biggest example of this is with antibiotics. Many doctors have been prescribing antibiotics just “to rule out infection” for many years, but a better plan is to use tests and lower urinary tract cultures to rule that out or determine their necessity. Plus, if the doctor orders cultures, you can find out which type of bacteria you have and then find the right antibiotic. Knowing the source of your bacterial prostatitis may help you change some lifestyle habits so you can prevent it from coming back again.
If you really do have bacteria present then antibiotics are generally the first level of treatment. If the results are negative, however, you need to question your doctor as to why you should take antibiotics. Taking antibiotics when you do not have a bacterial infection wastes your time and money. Plus, there are many detrimental long-term effects to your health from taking antibiotics, such as immune system problems, fungal infections, and antibiotic resistance (which means that if you do need antibiotics for a future infection or prostate biopsy, the drugs will not work as well for you). Antibiotics kill off the beneficial bacteria in your gut (which affects your gut health and immunity), and some drugs, like Cipro, have very serious side effects. Any time you complete a round of antibiotics make sure that you replenish the beneficial bacteria in your gut with a course of quality probiotics specifically formulated for men.
The other drugs that doctors may prescribe are medications that can help with urinary symptoms of prostatitis. Doctors may prescribe drugs for urinary symptoms such as alpha blockers and 5 alpha reductase inhibitors, which are commonly used to treat enlarged prostate. Keep in mind that these drugs are generally not recommended as the first line of therapy. Some of these medications can also cause some seriously unpleasant side effects such as long-term sexual dysfunction (erectile dysfunction—ED) and ejaculation problems. They also come with a high risk of prostate cancer (in the case of Proscar/Finasteride).
If you experience urinary symptoms such as an overactive bladder or a sudden urge to urinate with your prostatitis, your doctor may recommend anticholinergic agents to help control them. Whenever your doctor recommends that you take medication for prostatitis, exercise some caution by asking about the potential side effects and long-term risks associated with their use.