What are the treatment options for prostatitis?

The treatments you’re offered will depend on the type of prostatitis you’re diagnosed with.

Chronic pelvic pain syndrome (CPPS) and Chronic bacterial prostatitis can go on for a long time, even after initial treatment. They’re not well understood which can make it difficult for doctors to know how to treat them - this can be frustrating for men who have them. The treatments vary from man to man, and you’ll probably have a number of different treatments – it’s about finding what works best to control your symptoms.

Each man will respond to the treatments differently. If one thing doesn’t work, you should be able to try something else, and there are things you can try to help yourself.

If your symptoms are not improving with the treatment offered by your GP, ask them to refer you to a urologist who specialises in managing prostatitis.

Medicines
Other treatments
Lifestyle changes
Complementary therapies and relaxation techniques
Getting support

Medicines

You’re likely to be given the following medicines:

  • a course of antibiotics, which you’ll need to take for at least four to six weeks
  • pain-relieving drugs, if you need them.

You might also be offered medicinesto improve the symptoms such as pain and urinary problems, these include:

  • alpha blockers (such as tamsulosin)
  • 5-alpha-reductase inhibitors (such as finasteride)
  • non-steroidal anti-inflammatory drugs (NSAIDs).

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 Other treatments

If you have prostatitis that goes on for a long time, you might be offered the following treatments. Although there is no strong scientific evidence for them, some men have found them helpful.

  • Prostate massage. The doctor massages your prostate through the wall of the back passage. They will use gloves and gel to make it more comfortable.
  • Surgery.  Very occasionally, surgery is an option for men with CPPS. It usually involves removing the prostate gland or part of it. It isn’t often done because there is a risk it can make symptoms worse and cause a number of side effects.

You might also be offered the following to help with the effects of prostatitis.

  • Anti-depressants. If your prostatitis affects your mood and you become very low, depressed or anxious, your doctor might suggest you try taking anti-depressants.
  • Treatments for sexual problems. There is support available for sexual problems so do speak to your doctor or nurse about these. For example, your doctor can prescribe medications such as Viagra® or Cialis®.

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Lifestyle changes

There are a number of things you can try which other men have found helpful.

  • Watch what you drink. Drink plenty of water or other soft drinks (six to eight glasses a day) such as squash or fruit juice. Avoid alcohol, fizzy drinks and drinks containing caffeine, such as tea and coffee - they can irritate the bladder and make urinary symptoms worse.
  • Watch what you eat. You might find certain foods bring on a flare-up - watch out for these so you can avoid them.
  • Sit comfortably. If you need to sit for long periods during a flare-up, for example if you work in an office, take in a soft or inflatable cushion to make you more comfortable.
  • Get active. Exercise can help some men feel better and reduce symptoms, including pain.
  • Avoid cycling. Activities that put pressure on the area between your back passage and testicles (perineum), such as cycling, can make symptoms worse.
  • Keep a diary. It can help you spot something that brings on a flare-up, and can be a useful way of showing your doctor what you’re experiencing. Record things like food, drink, exercise, how stressed you feel and your symptoms.
  • Do pelvic floor muscle exercises. These muscles help control when you urinate. There are exercises you can do to strengthen them which can help with urinary symptoms. Speak to our Specialist Nurses for advice.

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 Complementary therapies and relaxation techniques

Although there isn’t much research behind them, some men find that complementary therapies can help them feel better about themselves and their treatment, and can help manage symptoms. They are used alongside conventional treatments, rather than instead of them.

  • Complementary therapies. You could try acupuncture, massage or reflexology (a type of massage), aromatherapy or hypnotherapy, for example. They might help to relieve stress, making you feel more relaxed.
  • Find ways to relax. Techniques such as deep breathing, relaxation tapes, meditation, taking a warm bath, yoga, or listening to music, can help you feel more comfortable and take your mind off any pain.
  • Supplements or herbal remedies. Some men have found that the plant extracts Quercetin and saw palmetto, and a pollen extract known as cernilton, help with symptoms.

Speak to your doctor or nurse if you’re thinking of using complementary therapies or supplements, as they may be able to advise you. You can get advice on finding a properly qualified therapist from the Complementary and Natural Healthcare Council, and advice on using supplements safely from the Medicines and Healthcare Products Regulatory Agency (MRHA).

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Getting support

As well as trying things to help yourself, some men find getting support is useful. You might get all the support you need from a friend or relative, or you may find it helpful to talk to your doctor or our Specialist Nurses about how you're feeling.

Some men find talking to a counsellor helpful. They can help you understand your feelings and find ways to deal with them. In particular, cognitive behavioural therapy (CBT) can help men find ways to deal with prostatitis. CBT focuses on your thoughts, beliefs and attitudes and how can these affect what you do and how you feel. It involves talking with a therapist who will help you come up with practical ways to tackle any patterns of behaviour or ways of thinking about your prostatitis that are causing you problems.

Your hospital doctor or nurse or your GP might be able to refer you to a counsellor, or you can get information about finding counsellors in your area from The British Association for Counselling & Psychotherapy. You can also get more information and support from the charity Mind.

You can read about treatments for prostatitis, and using complementary therapies safely, in our booklet, Prostatitis: A guide to infection or inflammation of the prostate.

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