Chronic Prostatitis (CP/CPPS): Symptoms, Causes, Diagnosis and Treatment

By Mr Neil Haldar, Consultant Urological Surgeon

Chronic prostatitis and chronic pelvic pain syndrome (CP/CPPS) is one of the most frustrating and misunderstood conditions I see in urological practice.

Many men come to see me after months — sometimes years — of pelvic or genital discomfort. They may have received several courses of antibiotics, undergone numerous tests and been repeatedly told that they have “prostatitis”, without anyone clearly explaining why the symptoms continue.

The most important point to understand is that chronic prostatitis is usually not simply an ongoing infection of the prostate.

In most men with CP/CPPS, several mechanisms may be interacting: pelvic floor muscle overactivity, altered pain signalling within the nervous system, urinary symptoms, inflammation in some cases, sexual difficulties, stress and the consequences of living with persistent pain.

That is why successful treatment usually requires identifying which factors are driving the symptoms in that particular patient, rather than simply prescribing another course of antibiotics.

Current European Association of Urology guidance on chronic pelvic pain similarly recognises chronic pelvic pain as a complex pain syndrome rather than assuming that persistent symptoms necessarily represent ongoing infection or inflammation.

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What is chronic prostatitis?

The word prostatitis literally means inflammation of the prostate.

Unfortunately, it has traditionally been used to describe several very different conditions.

The National Institutes of Health classification divides prostatitis into four broad categories.

Category I — Acute bacterial prostatitis

This is a genuine bacterial infection of the prostate.

Men are often suddenly and significantly unwell, with symptoms such as:

• fever
• rigors or shivering
• pelvic or perineal pain
• painful urination
• difficulty passing urine
• urinary retention

This requires urgent medical assessment and antibiotic treatment and occasionally hospital admission.

Category II — Chronic bacterial prostatitis

This is a persistent bacterial infection of the prostate.

A typical clue is recurrent urinary tract infections caused by the same organism.

Unlike CP/CPPS, chronic bacterial prostatitis should have microbiological evidence of infection and is treated with appropriately selected antibiotics.

Men experiencing repeated proven urinary infections may also benefit from a structured recurrent UTI assessment.

Category III — Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

This is by far the most important category when discussing persistent “prostatitis” symptoms.

Men experience persistent or recurrent pain in the pelvis, perineum, penis, testicles or surrounding areas, often accompanied by urinary or sexual symptoms, without a bacterial infection adequately explaining the problem.

European guidelines increasingly describe related presentations using terminology such as primary prostate pain syndrome, reflecting the fact that the prostate itself may not be the principal source of the problem.

Category IV — Asymptomatic inflammatory prostatitis

Here inflammation is discovered incidentally — for example in prostate tissue — despite the man having no prostatitis symptoms.

It generally requires no treatment in its own right.

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Why the term “chronic prostatitis” can be misleading

One of the most useful things I can explain to a man who has struggled with this diagnosis is:

The prostate may not actually be the main source of the pain.

For many years, persistent pelvic pain in men was assumed to represent a prostate infection that conventional tests simply could not detect.

That assumption led many men to receive repeated, prolonged courses of antibiotics.

We now recognise that CP/CPPS is much more complicated.

Several different mechanisms can contribute.

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Pelvic floor muscle dysfunction

The pelvic floor is a complex group of muscles that supports the bladder, bowel, and pelvic organs.

Like muscles elsewhere in the body, pelvic floor muscles can become:

• excessively tense
• shortened
• tender
• painful
• poorly coordinated.

Painful myofascial trigger points can develop.

Pressing one of these areas during examination may reproduce the patient’s exact pain — sometimes in the penis, testicle, rectum or perineum rather than directly where the muscle is being examined.

This phenomenon is called referred pain.

It can explain why a man may have spent months believing that his prostate or testicle is painful when the principal problem lies elsewhere in the pelvic floor.

Current EAU guidance specifically recommends considering pelvic-floor overactivity and myofascial trigger points in chronic pelvic pain, with specialist physiotherapy aimed at relaxation and restoration of normal muscle function.

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Altered pain processing and central sensitisation

Persistent pain can also change how the nervous system processes pain signals.

Repeated signals from the pelvis may gradually make nerves, the spinal cord and the brain more responsive.

A stimulus that previously produced very little discomfort can then produce considerable pain.

This is often described as central sensitisation.

It helps explain why chronic pelvic pain can sometimes coexist with other long-standing pain disorders such as:

• irritable bowel syndrome
• chronic headache
• fibromyalgia
• chronic back pain
• widespread muscular pain.

This does not mean the pain is psychological or imagined.

The pain is real.

It means that pain processing itself has become part of the condition.

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An initial trigger

Some men can identify a clear event around the time their symptoms began.

Examples include:

• a genuine urinary or prostate infection
• prolonged cycling
• heavy exercise or lifting
• a period of prolonged sitting
• pelvic trauma
• surgery
• intense psychological stress.

The initiating event may subsequently resolve while pelvic-floor tension and altered pain signalling continue.

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Inflammation

Inflammatory signalling may contribute in some patients even when no bacterial infection can be identified.

This is one reason why the term “non-bacterial” should not necessarily be interpreted as meaning that nothing physical is happening.

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Psychological and social factors

Persistent pain affects mood, sleep, work, relationships and sexual function.

Anxiety can then increase muscular tension and heighten awareness of symptoms, creating a self-perpetuating cycle:

pain → anxiety → muscle tension → increased pain → increased anxiety

Recognising this does not mean telling a patient that the condition is “all in his head”.

Quite the opposite.

It means treating all of the factors capable of amplifying a genuine chronic pain condition.

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What are the symptoms of chronic prostatitis/CPPS?

The symptoms vary considerably between men.

Pelvic and genital pain

Pain is usually the dominant symptom.

It may be felt in the:

• perineum — the area between the scrotum and anus
• lower abdomen
• penis, particularly the tip
• testicle or scrotum
• groin
• inner thighs
• lower back
• rectum.

Some men describe a sensation of pressure or of “sitting on a golf ball”.

The pain may be:

• aching
• burning
• pressure-like
• tingling
• intermittently sharp.

Symptoms are often aggravated by prolonged sitting or driving.

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Can chronic prostatitis cause pain after ejaculation?

Yes.

Pain during or after ejaculation is a particularly characteristic symptom of CP/CPPS.

Some men experience pain at the moment of ejaculation.

Others develop a gradually increasing ache over the following minutes or hours.

Because sex becomes associated with pain, men may understandably begin avoiding sexual activity, which can subsequently affect libido, erections and relationships.

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Urinary symptoms

CP/CPPS can also produce lower urinary tract symptoms including:

• urinary frequency
• urgency
• getting up at night to pass urine
• hesitancy
• weak urinary stream
• interrupted flow
• discomfort passing urine despite negative urine cultures
• a feeling that the bladder has not emptied properly.

These symptoms can also occur with bladder dysfunction or benign prostate enlargement, which is why it is important not simply to assume that every urinary symptom is caused by prostatitis.

Men with significant urinary symptoms can read more about my Specialist LUTS and Urinary Symptoms Clinic.

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Sexual symptoms

CP/CPPS can be associated with:

• painful ejaculation
• erectile dysfunction
• premature ejaculation
• occasionally delayed ejaculation
• reduced libido
• anxiety about sexual activity
• blood in the semen.

Sexual symptoms are important and should form part of the assessment rather than being regarded as an unrelated problem.

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How is chronic prostatitis/CPPS diagnosed?

There is no single test that confirms CP/CPPS.

Diagnosis involves recognising the characteristic symptom pattern while excluding other conditions that can produce it.

This is important because “chronic prostatitis” should never become a convenient label applied to unexplained pelvic symptoms without proper assessment.

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Taking a detailed history

I want to understand:

• exactly where the pain occurs
• when it started
• what makes it worse
• whether sitting affects it
• whether ejaculation triggers pain
• associated urinary symptoms
• bowel symptoms
• sexual function
• previous urinary infections
• previous antibiotics
• previous surgery
• musculoskeletal problems
• how sleep and stress affect symptoms.

Patterns frequently emerge from a careful history.

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The NIH Chronic Prostatitis Symptom Index

The NIH Chronic Prostatitis Symptom Index (NIH-CPSI) is a useful questionnaire covering three areas:

1. pain
2. urinary symptoms
3. quality of life.

The maximum score is 43.

I find repeated scoring particularly useful because CP/CPPS fluctuates.

Patients can have one particularly bad week and feel that nothing has improved, even when their overall symptom trajectory over several months is considerably better.

A fall of around six points is generally regarded as a clinically meaningful improvement.

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Physical examination

A proper physical examination is particularly important.

It may include:

Abdominal examination

Looking for bladder distension, abdominal tenderness or other abnormalities.

Genital examination

To exclude conditions affecting the testicle, epididymis, spermatic cord or groin.

Digital rectal examination

This allows assessment of the prostate and can identify significant tenderness, enlargement or an abnormality requiring further investigation.

Pelvic floor examination

This is particularly important in suspected CP/CPPS.

I assess pelvic floor muscle tone and tenderness and look for trigger points.

If pressure on a particular muscle reproduces the man’s familiar penile, perineal or rectal pain, that finding can substantially change the treatment strategy.

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What tests might be required?

Investigations are tailored to the individual rather than performed indiscriminately.

They may include:

Urine testing

Urinalysis and mid-stream urine culture help exclude a genuine urinary infection.

STI testing

Testing for sexually transmitted infection may be appropriate, particularly where there is urethral pain, discharge or relevant sexual exposure.

Urinary flow rate and bladder scan

A flow test and post-void residual measurement can identify poor bladder emptying, obstruction or dysfunctional voiding.

PSA testing

PSA is not a test for CP/CPPS.

Inflammation and other benign prostate conditions can affect PSA, so the result needs careful interpretation in its clinical context.

If you have already had an elevated result, my Rapid Access Elevated PSA Clinic provides structured consultant-led assessment of PSA, prostate cancer risk and the need for further investigations.

Tests for bacterial prostatitis

Where genuine chronic bacterial prostatitis is suspected, further urine testing before and after prostatic massage may occasionally help identify an infection.

Cystoscopy, ultrasound, CT or MRI

These investigations are not routinely required solely to diagnose CP/CPPS.

They are used when another diagnosis needs to be excluded.

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Conditions that can mimic chronic prostatitis

This is one of the most important parts of the assessment.

I may consider:

• bacterial prostatitis
• recurrent urinary tract infection
• urethritis
• urethral stricture
• benign prostate enlargement
• bladder neck dysfunction
• dysfunctional voiding
• bladder pain syndrome
• bladder or ureteric stones
• chronic testicular or scrotal pain
• inguinal hernia
• pudendal neuralgia
• lumbar spine disease
• sacroiliac joint pathology
• bowel disorders
• post-vasectomy pain
• bladder cancer
• and, where appropriate, prostate cancer.

You can read more about the wider range of problems I assess on my General Urology page.

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When should pelvic pain be investigated urgently?

Seek urgent medical assessment if pelvic pain is associated with:

• fever or rigors
• feeling seriously unwell
• inability to pass urine
• severe rapidly worsening symptoms
• new neurological symptoms such as leg weakness or numbness.

Visible blood in the urine should also be properly investigated rather than assumed to be caused by prostatitis.

I provide a dedicated Rapid Access Haematuria Service for patients with visible or unexplained microscopic blood in the urine.

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The UPOINT approach: treating the patient rather than the label

One of the major advances in our understanding of CP/CPPS is recognition that it is not one single disease.

Two men can have almost identical symptoms but completely different underlying drivers.

The UPOINT system helps divide patients into different clinical domains.

U — Urinary

Symptoms include:

• urgency
• frequency
• weak flow
• difficulty emptying the bladder.

Treatment may involve bladder retraining, an alpha blocker or treatment of coexisting bladder or prostate problems.

P — Psychosocial

This includes:

• anxiety
• low mood
• fear associated with pain
• poor sleep
• pain catastrophising.

Pain-focused psychological treatment, cognitive behavioural approaches, mindfulness, improving sleep and restoring normal activity can be helpful.

O — Organ-specific

Evidence may suggest a greater contribution from the prostate or surrounding structures.

Anti-inflammatory treatments or selected phytotherapy may sometimes have a role.

I — Infection

This domain applies when there is genuine evidence of infection.

Treatment should then target the identified organism rather than repeatedly prescribing empirical antibiotics.

N — Neurological/systemic

Some patients have:

• neuropathic burning pain
• pain extending outside the pelvis
• widespread tenderness
• irritable bowel syndrome
• other chronic pain conditions.

These patients may require treatment directed towards abnormal pain processing rather than the prostate itself.

T — Tenderness

This refers to:

• pelvic floor muscle spasm
• muscular tenderness
• trigger points.

Specialist pelvic-floor physiotherapy may be particularly important.

Sexual dysfunction

I also believe sexual symptoms deserve to be considered separately because erectile dysfunction, painful ejaculation and the effects of pain on relationships can otherwise be overlooked.

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Why chronic prostatitis treatment often fails

This is perhaps the most important practical lesson.

Treatment fails surprisingly often because the wrong mechanism is being treated.

For example:

• repeated antibiotics are prescribed despite negative cultures
• urinary medication is prescribed when the main problem is pelvic floor spasm
• pelvic floor strengthening is recommended when the muscles are already excessively tense
• the prostate is treated while neuropathic pain is ignored
• persistent sleep disturbance and stress amplification are never addressed
• painful ejaculation and erectile dysfunction are not discussed
• one treatment is tried after another rather than several relevant mechanisms being treated together.

This is why I prefer a phenotype-directed, multimodal approach.

The question is not simply:

“What drug treats chronic prostatitis?”

The better question is:

“What is driving this particular man’s chronic pelvic pain?”

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Treatment for chronic prostatitis/CPPS

No single treatment works for every man.

Select treatment based on the clinical pattern.

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Antibiotics

Antibiotics are appropriate for bacterial prostatitis.

They are much less useful when repeated investigations show no bacterial infection.

Current European guidance acknowledges modest evidence from some antimicrobial studies in selected treatment-naïve patients but also stresses the importance of avoiding unnecessary antibiotic use.

For UK patients, an additional safety consideration applies.

Fluoroquinolone antibiotics such as ciprofloxacin and levofloxacin were historically prescribed very frequently for prostatitis.

The MHRA has substantially restricted their use because they can rarely cause serious, disabling, long-lasting and potentially irreversible adverse effects. UK guidance specifically retains restrictions against their use for non-bacterial chronic prostatitis.

Repeated speculative courses of antibiotics for culture-negative chronic pelvic pain are therefore not an appropriate long-term strategy.

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Alpha blockers

Drugs such as:

• tamsulosin
• alfuzosin
• silodosin

relax smooth muscle around the bladder outlet and prostate.

They can be useful when urinary symptoms are an important part of the patient’s phenotype, particularly in men who have not previously received them.

They are much less likely to transform long-standing pelvic pain in someone without meaningful urinary symptoms.

Possible side effects include:

• dizziness
• nasal congestion
• changes in ejaculation.

European evidence suggests a modest overall benefit, with response likely to depend partly on selecting men with relevant voiding symptoms.

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Pelvic floor physiotherapy

For the right patient, pelvic floor physiotherapy can be one of the most valuable treatments available.

However, this needs to be specialist male pelvic-pain physiotherapy, rather than generic pelvic floor strengthening.

Treatment may involve:

• pelvic floor relaxation
• breathing techniques
• stretching
• posture and movement work
• myofascial treatment
• biofeedback
• management of painful muscular trigger points.

The objective is to interrupt the:

pain → muscle spasm → further pain

cycle.

EAU guidance specifically recommends addressing pelvic-floor overactivity and notes evidence for myofascial treatment and biofeedback in selected pelvic-floor dysfunction.

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Should I do Kegel exercises for chronic prostatitis?

Not automatically.

Kegel exercises strengthen the pelvic floor and are extremely useful in certain circumstances — for example during rehabilitation following prostate surgery.

But CP/CPPS is different.

In men with a high-tone or overactive pelvic floor, repeatedly contracting already tense muscles may aggravate symptoms.

Treatment in that situation should initially concentrate on:

• relaxation
• breathing
• restoring muscle length
• releasing excessive muscle tension.

The pelvic floor should therefore be properly assessed before deciding whether strengthening is appropriate.

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Neuropathic and pain-modifying medication

If the pain has features suggesting altered nerve signalling — for example:

• burning
• shooting
• tingling
• extreme sensitivity
• pain extending beyond the pelvis

— medication used for neuropathic pain can sometimes be considered.

Options in selected patients may include drugs such as:

• low-dose amitriptyline
• duloxetine
• gabapentin
• pregabalin.

These are not being prescribed because the pain is imagined or because the patient is necessarily depressed.

They modify the way pain signals are processed.

However, the evidence specifically in CP/CPPS varies considerably.

For example, an adequately powered trial of pregabalin did not demonstrate a significant overall NIH-CPSI benefit in unselected men, although the EAU notes that it may still have a role in selected patients.

This is another reason to match treatment to the individual pain phenotype.

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Anti-inflammatory treatment and phytotherapy

A short course of an anti-inflammatory drug may occasionally help during a symptom flare, if medically appropriate.

Some plant-derived therapies have also been studied.

These include:

• quercetin
• pollen extracts
• Serenoa repens (saw palmetto).

Evidence is not strong enough to regard supplements as a cure, but trials and systematic reviews suggest that some men may experience symptom improvement.

More recent evidence is particularly interesting because a multicentre randomised study of 221 men found improvement with Serenoa repens compared with placebo, while quercetin and pollen preparations have also demonstrated benefits in clinical studies.

I regard these as potential adjuncts to treatment rather than alternatives to properly diagnosing the main cause of symptoms.

Supplements can also interact with medications and are not automatically risk-free, so it is sensible to discuss them with your doctor.

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Psychological treatment and pain management

Psychological treatment is frequently misunderstood by patients with chronic pain.

The suggestion of cognitive behavioural therapy or pain psychology does not mean:

“We cannot find anything wrong, therefore the pain must be psychological.”

That is not the model.

Persistent pain alters:

• sleep
• muscle tone
• activity
• anxiety
• attention
• relationships
• the nervous system’s response to pain.

Those changes can then reinforce the pain.

Pain-focused CBT, acceptance-based therapy, relaxation techniques and structured pain management can help interrupt this cycle.

Current European guidance recommends chronic pelvic pain-focused psychological treatment where significant psychological distress is present.

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Acupuncture

Acupuncture has better evidence in CP/CPPS than many patients — and some clinicians — realise.

Several controlled trials have shown symptom improvement, including a large multicentre sham-controlled study.

European guidance concludes that acupuncture is superior to sham acupuncture for improving symptoms and quality of life in primary prostate pain syndrome.

It can therefore be a reasonable component of multimodal treatment for selected patients.

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Extracorporeal shockwave therapy

Extracorporeal shockwave therapy has also been studied for CP/CPPS.

Several sham-controlled trials suggest improvement in pain and quality of life, particularly in the shorter term, although long-term evidence is less convincing.

Availability remains variable.

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Botulinum toxin

Botulinum toxin injections have occasionally been considered for particularly refractory pelvic-floor spasm or prostate pain.

However, the evidence remains limited.

Trials of pelvic-floor botulinum toxin have not demonstrated convincing sustained improvement in pain despite reducing muscle pressure. It should therefore be regarded as a specialist treatment for carefully selected refractory cases rather than routine therapy.

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Is surgery a treatment for chronic prostatitis?

Usually, no.

CP/CPPS is not generally a surgical condition.

Removing or resecting prostate tissue does not address the mechanisms responsible for chronic pelvic pain.

Surgery may be necessary if investigations demonstrate another genuine structural problem — for example significant bladder outlet obstruction, a urethral stricture or stone disease — but surgery should not be undertaken simply because a man has unexplained chronic pelvic pain.

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What can I do myself to help chronic prostatitis?

Self-management is an important part of treatment.

It is unlikely to solve every problem on its own, but it can significantly reduce symptom flares.

Reduce prolonged sitting

Take regular breaks if you work at a desk or drive for long periods.

Reducing sustained pressure on the perineum can help some men.

Modify cycling

Cycling does not automatically need to stop permanently.

During a flare, however, reducing mileage and perineal pressure can help.

Bike fitting and saddle design may also make a difference.

Use warmth

A warm bath or heat pack can help relax tense pelvic-floor muscles during a flare.

Avoid constipation

Constipation and straining increase pelvic-floor loading.

Adequate fluids and dietary fibre are therefore important.

Look for individual dietary triggers

Some men find symptoms are aggravated by:

• caffeine
• alcohol
• spicy food
• acidic drinks
• artificial sweeteners.

Rather than imposing an unnecessarily restrictive diet, it is often more useful to eliminate one suspected trigger at a time and assess the effect.

Exercise

Regular aerobic activity is generally beneficial.

Walking, swimming and moderate cardiovascular exercise are often better tolerated during symptomatic periods than heavy lifting or exercises that repeatedly increase pelvic-floor tension.

Sexual activity

Men do not generally need to avoid sexual activity simply because they have CP/CPPS.

If ejaculation does not trigger symptoms, there is usually no reason to restrict it.

If ejaculation causes significant flares, frequency can be adjusted temporarily while the underlying pelvic-floor or pain mechanisms are being addressed.

Improve sleep

Poor sleep increases pain sensitivity.

Treating sleep disturbance can therefore form an important part of chronic pain management.

Recognise stress-related flares

Many men notice that symptoms worsen during periods of:

• work pressure
• anxiety
• family stress
• poor sleep
• prolonged travel.

Recognising this relationship does not mean stress caused the original condition. It simply identifies another factor you can modify.

Keep a symptom diary

A simple record of:

• pain
• urinary symptoms
• sexual symptoms
• exercise
• sitting
• sleep
• stress
• treatment

can reveal patterns that are otherwise surprisingly difficult to recognise.

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Can chronic prostatitis be cured?

Many men improve substantially, and some eventually become symptom-free.

However, CP/CPPS is usually better understood as a condition that improves progressively rather than one cured by a single tablet or procedure.

Recovery commonly involves:

• less intense pain
• fewer flares
• shorter flares
• improved urinary symptoms
• restoration of sexual activity
• increased confidence
• returning to normal exercise and work.

For many patients, the crucial change occurs when treatment stops concentrating exclusively on the prostate and starts addressing the combination of factors maintaining the pain.

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Does chronic prostatitis cause prostate cancer?

There is no evidence that CP/CPPS causes prostate cancer.

The two conditions are separate.

Inflammation and prostate conditions can sometimes influence PSA levels, which is why an abnormal PSA must be interpreted correctly rather than automatically attributed either to prostatitis or to cancer.

Men concerned about their PSA can read more about raised PSA assessment here.

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Is chronic prostatitis contagious?

CP/CPPS is not contagious.

You cannot transmit chronic pelvic pain syndrome to your partner.

Sexually transmitted infection can produce some similar symptoms, which is why STI testing is appropriate in selected patients, but CP/CPPS itself is not an STI.

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Does chronic prostatitis cause erectile dysfunction?

It can be associated with erectile dysfunction.

Several factors may contribute:

• pelvic-floor dysfunction
• pain
• fear of provoking pain
• altered nerve signalling
• sleep disturbance
• anxiety
• avoidance of sexual activity.

Painful ejaculation can be particularly disruptive.

Sexual function should therefore be discussed as part of treatment rather than left unaddressed.

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Does chronic prostatitis affect fertility?

CP/CPPS is not generally a common cause of male infertility.

Inflammation or infection can occasionally affect semen parameters, but most men with CP/CPPS remain fertile.

Where fertility is a specific concern, semen analysis can provide useful information.

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Frequently Asked Questions

When should I see a urologist?

I would recommend specialist assessment if you have:

• pelvic, perineal, penile or testicular pain lasting several months
• pain during or after ejaculation
• persistent urinary symptoms
• recurrent urinary infections
• unexplained blood in your urine or semen
• continuing symptoms despite repeated antibiotics
• an existing diagnosis of chronic prostatitis without a clear treatment plan.

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A structured approach to chronic pelvic pain

The most important message I give patients is that persistent chronic prostatitis symptoms do not mean that you have an infection that nobody has managed to eradicate.

In many men, CP/CPPS is a combination of pelvic-floor dysfunction, pain sensitisation, urinary symptoms and other individual factors.

Once you identify those drivers, treatment can become much more logical.

Instead of asking:

“Which antibiotic should I try next?”

we can ask:

“What is maintaining the pain — and what can we do about each part of it?”

That change in approach can make a significant difference.

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Arrange a private urology consultation for chronic prostatitis or male pelvic pain

If you have persistent pelvic, penile, perineal or testicular pain, painful ejaculation, urinary symptoms, or have received repeated courses of antibiotics without a clear diagnosis, I would be happy to assess you.

A consultation allows us to:

• review your previous investigations and treatment
• exclude bacterial infection and other urological conditions
• assess urinary symptoms
• examine the prostate where appropriate
• assess the pelvic floor
• consider whether pain sensitisation or neuropathic mechanisms are present
• formulate a structured, individual treatment plan
• arrange specialist pelvic-floor physiotherapy or other treatment where required.

I also welcome patients seeking a second opinion after previous treatment for chronic prostatitis or chronic pelvic pain. Please check the locations of our clinics as well as information on fees.

Mr Neil Haldar
Consultant Urological Surgeon
MBBS MD FRCS (Eng) FRCS (Urol)
GMC 3683914

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Further authoritative information

• European Association of Urology — Chronic Pelvic Pain Guidelines
• MHRA — Current Fluoroquinolone Antibiotic Safety Advice
• NHS — Prostatitis

This article provides general medical information and does not replace an individual consultation or medical examination. Seek urgent medical attention if you develop fever with severe pelvic pain, become unable to pass urine, or are acutely unwell.