What you have to understand first is that there are several forms of prostatitis. The two primary ones are chronic Bacterial Prostatitis and one called CPPS. In the first, if you hunt it down properly, you can often find evidence of bacterial infection. With CPPS, bacteria does not show up in tests however its symptoms are very similar in terms of pain and discomfort. With bacterial prostatitis, though, you more often experience fever (though you may not) and sometimes chills.
The pains of both are frequently what is known as “referred” pain. Your prostate itself may not hurt, but your back, your abdomen, testicles, penis shaft, pelvic floor, sciatic nerve down one leg, etc. may. I have talked with a couple doctors who seem to know their stuff and who believe that both forms start intitially with a bacterial infection of some sort. I tend to believe that myself.
The usual first test performed is a urine culture. These are routinely done over a three day period, not long enough to grow much unless you have very active bacterial prostatitis. Ask for a 5 day culture instead.
Another test is a culture of expressed prostate fluid. Again, ask for the longer culture.
A potentially more revealing test is a semen culture, but many doctors will not suggest these either because many of their male patients are somehow squeemish about giving a sample or because they themselves are squeemish about suggesting one be given. A semen culture though will give a better overall picture if there is bacteria since the fluid will include that of the seminal vessicles which can also be infected. Semen cultures are routinely done on a 3 day basis. 5 days is better. Bacteria which is not revealed in a urine culture will sometimes show up in a semen culture. At least that was so in my case. If you have bacterial prostatitis, knowing what strain(s) you are dealing with can lead you to the best antibiotic for getting rid of them.
The broccoli treatment is not all hokus-pokus. Many men with CPPS do find relief in eating broccoli in many forms, not just broth. My read is that with bacterial prostatitis the effect is not so noticeable but, hey, how can it hurt? Broccoli is good for you anyway. Guys on the prostate boards also say that drinking green tea helps some of them.
If bacteria is found, a short course of antibiotic is not going to help a whole lot, though it may temporarily. The prostate is a highly convoluted organ, many nooks and crannies; pockets in that organ are very resistant to the entry of most antibiotics. Very long courses of antibiotics work better with bacterial prostatitis. The urologist who finally got me out of the Round Robin of chronic bacterial prostatitis had me on Cipro for a solid 8 weeks. 10 day and 2 week courses previously did not work except temporarily. I was told to ejaculate frequently even if that was uncomfortable and to use condoms for sex, which I still do although I have no other reason to. This month marks the 2nd year anniversary of being completely prostatitis free, whereas I had been having bouts as frequently as once a month over a very uncomfortable 5 year period.
Kegel exercises can help if they are comfortable for you. If you get pain from them, avoid them because in doing them you are only further aggravating your already-painful BC muscle.
I was doing very active PE during three of the five years of my bacterial prostatis. PE never changed any aspect of prostate-related discomfort for me, nor did it make it worse.
This post is a little longer than I had planned but prostatitis is a very common problem in both younger and older men and a very mysterious one to many doctors, who often throw up their hands in frustration when it is chronic, sometimes telling you you will just have to live with it. I was told that by a very fine doctor but as I told him, that was not an option for me, the chronic discomfort being so very unpleasant. I kept hunting until I found a doctor curious enough to work with me in sorting things out.
