As a small number of my readers may know, I've been going through a bit of chronic prostatitis lately. Two courses of antibiotics seemed to improve the symptoms, and then they returned. Now I'm on round 3. After reinitiating this 3rd round, the symptoms again improved.
However, I started to think.
The antibiotic I'm taking, called Bactrim, has anti-inflammatory effects. My urinalysis was negative twice. I never had classic urinary tract infection symptoms (although there was some overlap at one point). Could it be that this prostatitis is not the result of an infection? Could it be that there's some inflammatory cause to all of this?
I got to reading other people's experiences and found out that most cases of chronic prostatitis are, in fact, not bacterial. A lot of it could be caused by imbalances in the musculature of the pelvic floor, which can sometimes compress the pudendal nerve, and in other cases create tightness in muscles which cause genitourinary symptoms.
I recalled that my symptoms would tend to be slightly worse if I was acutely stressed about something, and better if I was truly calm and relaxed. Not to say that the symptoms were completely gone, but they were just slightly better. Muscle relaxation may be the key to my problem.
So I started doing pelvic floor stretches. I already feel more flexible, but that's a secondary goal. I'm going to continue doing these for a while.
I do intend to continue taking the antibiotics until my next appointment with the urologist. At that time, I'm going to discuss the anti-inflammatory effects I was considering, and see whether we might trial a short course of anti-inflammatory medications (something like Motrin, or Meloxicam) instead of antibiotics. Possibly even muscle relaxants. If these work to improve my symptoms, then I know we're dealing with a non-bacterial cause, and I'll stop taking antibiotics altogether.
Of course, I'll continue doing the pelvic floor stretches all through this. Hopefully I'll be able to get off the antibiotics and anti-inflammatories at some point in the near future. In order to keep the positive effects of stretching, I'll also have to maintain relatively low levels of stress (which requires a mind-shift in how I handle it - back to meditation!), not overstressing the pelvic floor muscles, and certainly drinking more water than I do now.
It's not going to be a quick process to fix all of this. However, I want to remain optimistic that I won't suffer from this problem forever. At its worst, it's a tremendous nuisance and very distracting in normal day-to-day activities. At its best, I can handle using the restroom slightly more frequently than the average person - big deal!
Wish me luck in this coming journey... I will definitely take it!