Chronic Nonbacterial Prostatitis

Chronic nonbacterial prostatitis is a common referral to pelvic floor physical therapy clinics. Yet, the journey to find physical therapy, and to learn that your symptoms aren’t related to a UTI or STI, can be a long and frustrating process. There’s a common misconception that pelvic floor physical therapy is only appropriate for women, particularly related to pregnancy, postpartum care, or in relation to sexual dysfunction. Awareness that males, too, can struggle with pelvic floor dysfunction is improving, albeit slowly.

Males dealing with urinary issues report first seeing their general practitioner, a urologist, or sometimes even gastroenterology, but after a few negative tests, are likely sent on their way with medication(s). Most patients report that this process is repeated multiple times, prior to pelvic floor physical therapy being brought up at all. This can take consulting with multiple providers prior to finding a provider familiar with the connection to our pelvic musculature. It is a frustrating and drawn-out process for many.

If we dive a little deeper into why physical therapy can help, we can look to the muscles in our pelvis specifically. The muscles in the pelvic floor help us retain as well as release urine at the appropriate times. We get into “dysfunction” when these muscles are chronically tight, have poor coordination, or cause pain with urination or bowel movements due to an upregulated nervous system.

Chronic nonbacterial prostatitis, or chronic pelvic pain syndrome, accounts for almost 90% of individuals with a diagnosis of prostatitis according to NIH. Symptoms that you may be experiencing include frequency of urination (<3 hours between voids), a small amount of leakage or dribbling after urination, burning or pain during/after urination, or waking at night >1x to urinate. It is common, as was mentioned before, for these patients to be put through a number of tests, given a few medications that may mildly improve their symptoms, but truly find minimal to no real relief. Symptoms can come and go related to stress, changes in your diet, increase in activity, or may increase with prolonged pressure at the pelvic floor (ie. biking, sitting for extended periods, or chronic constipation/straining for bowel movements).

Pelvic floor physical therapy can help with your symptoms by teaching you to relax and stretch these muscles, improve your body awareness of how you manifest stress or anxiety, change urinary habits, improve coordination of the pelvic floor muscles, and improve your body’s ability to fully void as well as hold in urine with improved control. Additional symptoms may include difficulty with achieving erections, difficulty with ejaculation, low back or hip pain, testicular pain, pain to the tip of the penis, or pain at the groin line and abdomen.

If any of these symptoms sound familiar to you or someone you know, seek out a consultation with a pelvic floor physical therapist to start your journey towards an improved quality of life and reducing painful symptoms.