Last updated: May 18, 2026
As I’ve mentioned earlier about the complication of the improper acute prostate infection’s treatment which is highly skyrocket to 10% of chances that can be twisted into chronic issue which in medical term we called it as a “Chronic prostatitis”. In this topic we’ll extremely focus only on a chronic inflammation of the prostate gland once some man got through this suffering and they will literally realized it. For the aspect and nature of the history disease, it has dragging down the quality of lifestyle and affected almost the whole angles of lives.
The Chronic prostatitis has been reported for up to 9% in male patients and could possibly rise up to 50% for the recurrent rate. First of all, I have to divide the chronic prostatitis into 2 main factors category;
- Chronic bacterial prostatitis – We can get the evidences of the bacterial-involved infection from the culturing.
- Chronic pelvic pain syndrome – There’s an absence evidence of bacterial-involved infection from the culturing. Unfortunately, most of patients are categorised in this group, and generally it makes the patients getting confused about the plan of treatment.
Unfortunately, symptomatic of these diseases are identical and can be something as below;
Possible symptoms of Chronic prostatitis
- Urinary symptoms: urge to urinate and frequent urination, especially at night
- Sexual symptoms: premature ejaculation, unusual sexual stimulation
- Pain symptoms: genital pain, rectal pain, prostate pain, bladder pain
- Neurological symptoms: neuropathic pain
- Infectious symptoms: pain while urinating with positive bacterial culture
- Psychosocial symptoms: depression, anxiety, or stress
Once urologist being taken a clear medical history and physical examination, the investigations working up will be tailor-made based on the symptoms the patient has complained about. Definitive treatment will be synchronised with the evidences gathered.
Here are the treatment modalities;
- Anti-inflammatory drug
- Anti-neuropathic pain drug
- Prostate disease medication
- Erectile dysfunction medication
- Oral steroid
- Herbal extraction
- Physiotherapy – Extracorporeal shockwave, Microwave thermotherapy, Acupuncture
- Psychological support
You will realized that chronic prostatitis is a very hard-treated disease which normally cannot be well-controlled with simple monotherapy alone. It needs longer duration of trial and adjustment to reach the proper treatment. It requires a strong relationship between patients and doctor. If you have any issue like this, you might be having a better discussion with your trusted urologist or it would be my honour if you’d like to text me.
If you have been struggling with chronic pelvic pain, prostatitis symptoms, or have not responded to repeated antibiotic courses, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. Book a Consultation.
Frequently Asked Questions about Chronic Prostatitis
Chronic prostatitis is a long-term inflammation of the prostate gland that significantly impacts quality of life. It is reported in up to 9% of men, with a recurrence rate as high as 50%. It is divided into two main categories: chronic bacterial prostatitis, where a bacterial cause is confirmed by culture, and chronic pelvic pain syndrome, where no bacterial infection is found.
Chronic prostatitis can cause a wide range of symptoms including urinary urgency and frequency (especially at night), pelvic and genital pain, rectal discomfort, painful ejaculation, premature ejaculation, and neuropathic pain. It can also lead to psychological effects such as depression, anxiety, and stress due to its chronic and often frustrating nature.
Chronic bacterial prostatitis is confirmed when bacterial cultures from urine or prostatic secretions test positive. Chronic pelvic pain syndrome (CPPS) presents with the same symptoms but without any evidence of bacterial infection. CPPS is the more common category, yet more difficult to treat, as there is no specific bacterial target and the underlying mechanism involves nerve sensitization and inflammation.
Treatment is highly individualized and often requires a combination of therapies. Options include anti-inflammatory medications, neuropathic pain drugs, alpha-blockers for urinary symptoms, erectile dysfunction medications, oral steroids, herbal extracts, physiotherapy (including shockwave therapy, microwave thermotherapy, and acupuncture), and psychological support. Monotherapy alone is rarely sufficient, and a trial-and-adjust approach over time is typically needed.
Chronic prostatitis, particularly the chronic pelvic pain syndrome type, is difficult to cure completely due to its multifactorial nature and high recurrence rate. However, most patients can achieve significant symptom relief with proper multimodal treatment. Long-term follow-up with a urologist, patient education, and a strong doctor–patient relationship are essential for managing this chronic condition effectively.
Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medical treatment.
Medically written & reviewed by: Dr. Soarawee Weerasopone (Dr. Pom) — Board-Certified Urologist, Bangkok Hospital Headquarters. International Fellow: Baylor College of Medicine (USA) · Juntendo University (Japan) · Chang Gung Memorial Hospital (Taiwan).
Dr. Soarawee Weerasopone (Dr. Pom) is a board-certified urologist at Bangkok Hospital Headquarters, specializing in Men’s Health, Robotic Surgery (Da Vinci System), and Kidney Stone treatment. He has completed international fellowships at Baylor College of Medicine (USA), Juntendo University Hospital (Japan), and Chang Gung Memorial Hospital (Taiwan). All medical content on this site is written and reviewed by Dr. Soarawee based on his clinical experience and international training.
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