Chronic Prostatitis

Prostatitis is a misleading and frequently misused diagnosis. It is a term which implies that the source of male urological pain syndromes is arising from an inflamed/infected prostate. Unfortunately, this misconception has led to the erroneous "prostate-centric" approach and treatments typically targeting an infection which is never proven.

Genuine prostatitis may occur in only 5% of men who receive this diagnosis. Patients will present with urinary symptoms and discomfort. In acute cases, fever may occur. The urinalysis is usually abnormal and cultures are positive. I always recommend a localization culture, involving prostate massage, to prove an infectious cause, whenever there is doubt about the diagnosis and the practitioner is tempted in any way to prescribe antibiotics. Why do I feel this way? Because genuine prostatitis requires a longer course of antibiotics, and one of the preferred medications has a black box warning (meaning "may cause serious adverse effects"). In other words, if one feels compelled to commit a patient to 4-6 weeks of any antibiotics, one better be certain about what they are treating!

The other 95% of men with symptoms of prostatitis have Chronic Pelvic Pain Syndrome, or what we call today, Urological Chronic Pelvic Pain Syndrome (UCPPS). Men may experience discomfort or sharp pain in the groin, testicles, penis and/or the perineum (the space between the anus and the scrotum). Pain may be associated with bowel movements, urination and/or sexual activity. About 50% of patients with this condition complain of urinary problems as well as sexual dysfunction.

Urinary complaints include difficulty starting a urinary stream, urinary frequency and urgency and pain or burning when voiding. UCPPS can affect sexual functioning in the following ways: decreased arousal, painful erections, painful ejaculation or dysorgasmia, pain or soreness of the pelvic are after sex.

But please note, a syndrome is a constellation of symptoms affecting an individual and does not represent a final diagnosis. UCPPS is an umbrella designation for a myriad of diagnoses which may be urological, neurological, muscular, colorectal, psychological or a combination of any of these.

Our clinic is dedicated to finding the root cause(s) for the symptoms so that the therapeutic strategies \and prescriptions can be individualized. It is not enough to say, "You have Prostatitis," or, "You have Pelvic Pain Syndrome". In fact it is inappropriate.

In order to effectively treat the condition, we formulate the diagnosis by conducting a thorough interview and by performing a meticulous comprehensive clinical exam. In this manner, we not only avoid unnecessary invasive procedures and testing, we also avoid one size fits all therapies which are expensive and of no benefit.

  • Does the patient have an undiagnosed urological condition?
  • Is it a primary colorectal issue?
  • Is it anatomical or is it a functional problem?
  • Are the symptoms arising from abnormalities of the back, torso, legs or feet?
  • Are there predisposing factors due to occupation or recreational activities?
  • Is it caused by an orthopedic issue? The spine or by the peripheral nerves?
  • What role are the muscles and connective tissue playing in causing or perpetuating symptoms?
  • And what about sleep? Stress? Family dynamics?

Men suffering from UCPPS require more than a prostate examination.They require a diagnosis and tailor-made treatment. 

Over 20 years ago, Dr. Potts developed her signature mind-body approach to more thoroughly evaluate men with UCPPS. She also has extensive experience in obtaining and interpreting microbiological tests such as localization cultures of the prostate fluid and testing for atypical organisms such as Ureaplasma and Mycoplasma.