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Chronic Nonbacterial Prostatitis

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Chronic Nonbacterial Prostatitis

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Created OnJuly 12, 2020
byPHS Team

Chronic Nonbacterial Prostatitis

What is it?

Chronic nonbacterial prostatitis is one sub-category (3B) underneath the categorization of different types of prostatitis. It accounts for as many as 95% of all cases diagnosed as “prostatitis” and is commonly referred to as “chronic pelvic pain syndrome.”

  • Category 1: Acute bacterial prostatitis
  • Category 2: Chronic bacterial prostatitis
  • Category 3: Chronic prostatitis/Chronic pelvic pain syndrome
    • A: Inflammatory
    • B: Non-inflammatory (formerly referred to as prostatodynia)
  • Category 4: Asymptomatic inflammatory prostatitis

It’s not uncommon for a male with category 3B prostatitis to be prescribed antibiotics, which initially appear to resolve the symptoms, but then for the same symptoms to reoccur. In some cases, antibiotics are repeatedly prescribed. However, in this situation, repeat urine cultures are often negative for any sign of bacterial growth or infection. Other investigations typically come back as normal as well. The cause of and risk factors for chronic nonbacterial prostatitis continue to remain unknown.

Symptoms

Urinary

  • Urinary hesitancy
  • Dysuria: painful urination
  • Nocturia: waking up with a need to void (urinate) at night
  • Increased urinary frequency and urgency
  • Decreased urine stream
  • Feeling of incomplete emptying after voiding

Pain

  • Rectal
  • Suprapubic: above the pubic bone
  • Perineal: area between base of penis and anal opening
  • Penile
  • Coccyx: tailbone
  • Groin
  • During and after ejaculation
  • Low back pain
  • Feels like sitting on a golf ball (or another foreign object)

Physiotherapy Treatment

First off, it is imperative to have the necessary medical investigations conducted to rule out the presence of an infection or underlying medical condition. However, in the presence of negative lab and examination results and subsequent diagnosis of chronic nonbacterial prostatitis, pelvic health physiotherapy is integral to a patient’s recovery plan.


Areas of treatment and techniques in physiotherapy may include:

  • Breathing techniques.
  • Bowel and bladder education:
    • Bladder irritants.
    • Bladder diary.
  • Toileting/voiding positioning and techniques.
  • Diet modification:
    • Adequate water and fiber intake.
  • Therapeutic exercise:
    • Whole body reconditioning.
  • External myofascial techniques.
  • Internal myofascial techniques.
  • Pelvic floor muscle training:
    • Proprioceptive training.
    • Lengthening/relaxing muscles.
      • Pelvic pain.
  • Tips for intimacy.
  • Mindfulness/meditation:
    • Pain.
    • Anxiety/stress/depression.
    • Relaxation.
  • Visceral mobilization.
  • Pain education.
  • Treatment of the nervous system.

Treatment of chronic nonbacterial prostatitis requires a collaborative approach, one that addresses the physical, psychological, and social aspects of the symptomatic individual. Living with chronic nonbacterial prostatitis can have a major impact on daily life, but the treatments above can offer understanding of how the body works, ways to improve its function, and increased control over one’s symptoms. 

  • For the Patient
    • For The Patient
  • What is Pelvic Floor Health Physiotherapy?
    • What is Pelvic Floor Health Physiotherapy
  • Why Do We Do an Internal Exam?
    • Why Do We Do an Internal Exam?
  • The Biopsychosocial Approach
    • The Biopsychosocial Approach
  • Incontinence – Urinary and Fecal
    • Incontinence: Urinary and Fecal
    • Facts and Myths About Pelvic Floor Dysfunction
    • Pelvic Floor Muscle Weakness
    • Pelvic Floor Muscle Strengthening (Kegels) for Females (Or If You Have a Vulva/Vagina)
    • Pelvic Floor Muscle Strengthening (Kegels) for Males (or if you have a Penis)
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  • Overactive Bladder (OAB)
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    • Bladder Irritants
    • Nocturia
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    • Pelvic Floor Muscle Strengthening (Kegels) for Males (or if you have a Penis)
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    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
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    • Pelvic Floor Muscle Weakness
    • Pelvic Floor Muscle Strengthening (Kegels) for Females (Or If You Have a Vulva/Vagina)
    • Pelvic Floor Muscle Strengthening (Kegels) for Males (or if you have a Penis)
    • The Knack
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    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
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    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
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    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Pudendal Nerve Irritation
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
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    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
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    • Sleep
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    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
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    • Laughter
    • Sleep
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    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
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    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Sleep
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    • Understanding Pain Better
    • Laughter
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    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
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    • Vulvodynia
    • Vulvar Care
    • Pelvic Tissue Dysfunction
    • Deep Breathing Exercises
    • Pelvic Floor Muscle Tightness
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
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    • Laughter
    • Sleep
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    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
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    • Dyspareunia
    • Vulvar Care
    • Accommodators and Dilators
    • Lubricants and Moisturizers
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
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  • Interstitial Cystitis and Bladder Pain Syndrome
    • Interstitial Cystitis (IC) and Bladder Pain Syndrome (BPS)
    • Diet Modification for IC/BPS
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
    • Nutrition and Persistent Pain
    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
    • Catastrophization
  • Pudendal Nerve Irritation
    • Pudendal Nerve Irritation
    • Pelvic Tissue Dysfunction
    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
    • Types of Pain
    • Understanding Pain Better
    • Laughter
    • Sleep
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    • Connective Tissue Dysfunction
    • What Are My Myofascial Tender Points?
    • Self-Treatment Techniques for Foam Rolling
    • Pain Education in a Nutshell
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    • Pregnancy
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  • Rectus Diastasis
    • Diastasis
  • Pelvic Girdle Pain (PGP)
    • Pelvic Girdle Pain
  • Tailbone (Coccyx) Pain
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    • Deep Breathing Exercises
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    • Sensitive Nervous System
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    • Pelvic Floor Muscle Tightness
    • Deep Breathing Exercises
    • Reverse Kegels (Pelvic Floor Drops)
    • Sensitive Nervous System
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    • Reverse Kegels (Pelvic Floor Drops)
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