Harvard Men's Health Watch

Pain beyond the prostate

Consider alternative therapies for chronic pelvic pain.

Prostatitis means pain and swelling near the prostate gland. If the cause is a bacterial infection, antibiotics can often clear up the problem. But for 90% or more of men with pain near the prostate, it isn't that simple. The pain and soreness is more widespread, affecting the groin, genitals, and area behind the scrotum. Some men even develop nausea and other flu-like symptoms. Doctors call it chronic pelvic pain syndrome (CPPS).

It is sometimes misdiagnosed as bacterial prostatitis and treated (unsuccessfully) with antibiotics. Doctors can offer no cure that works reliably in all men. "It's a tough problem because there's just not a lot out there," says Dr. Michael O'Leary, professor of surgery at Harvard Medical School and a urologist at Brigham and Women's Hospital.

In addition to antibiotics, standard approaches include anti-inflammatory drugs, injected pelvic nerve blocks, and medications normally prescribed for prostate enlargement, such as alfuzosin (Uroxatral). Despite these therapies, urinary symptoms and pain may persist. It frustrates doctors, too.

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