There is an overlap in presentation between chronic prostatitis and chronic pelvic pain syndrome in men. It presents in young and middle aged men at a prevalence rate of approximately six per cent. It can either be associated with an initial episode of prostatitis or mistaken for and treated as chronic prostatitis where there is no response to antibiotics and all other urology tests are negative. In this case there is no prostatitis at all. Chronic pelvic pain in men can be a painful debilitating condition. There are many cases where it is just related to posture and overactive pelvic floor muscles.

There are four major types of prostatitis.
Type I: Acute Bacterial Prostatitis – Caused by bacteria and treated with antibiotics men have severe urinary tract infections that may be accompanied by high fever, chills, and even the inability to urinate.
Type II: Chronic Bacterial Prostatitis – Typified by recurrent urinary tract infections an infection within the prostate gland causes the symptoms.
Type III A and III B: Chronic Non-Bacterial Prostatitis (CP/CPPS) – Type IIIA signs of prostate inflammation are present, but no obvious infection is found. Type IIIB symptoms of bacterial prostatitis are present, with no evidence of inflammation.
Type IV: Asymptomatic Inflammatory Prostatitis – Signs of inflammation within the prostate, however the patient experiences no symptoms.

For more information see www.prostatitis.org and www.ucpps.org

Sympthoms
Rectal pain
Perineal pain to behind the pubic bone
Pain to the tip of the penis
Lower abdominal pain
Associated lumbar spine, hip an inner thigh pain
Pain worse with or after erection or ejaculation
Decreased sexual desire
Pain is often worse with sitting but not always

Lifestyle and quality of life are almost always affected. Men usually present with an overactive pelvic floor on examination. Poor posture and abdominal and breathing holding patterns can often be found.

How do we help?
Treatment is to evaluate and correct:
Spinal posture
Abdominal holding patterns
Breathing patterns
Pelvic floor taut bands and trigger points

On this website the pathway of releasing the pelvic floor and abdomen should be followed and only then should pelvic floor and abdominal strengthening be considered as a part of core rehabilitation. If unsure as to when this should be then a physiotherapist with a special interest in this area will be able to advise. If you do not have access to a physiotherapist then try the exercises and stick with the release part until you experience an improvement in your symptoms before considering moving on to any strengthening.