Most of the symptoms of pelvic pain or discomfort, urinary frequency and urgency, and pain related to sitting or sexual activity in cases diagnosed as prostatitis are not related to infection. They can be caused by chronically tightened muscles in and around the pelvis. Our natural protective instincts can tighten the pelvic basin, causing pain and other perplexing and distressing symptoms. Stress is intimately involved in creating and continuing these symptoms. Once the condition starts, the symptoms tend to have a life of their own.

And the good news is that it is possible for a large majority of sufferers to reduce and sometimes eliminate symptoms. A Headache in the Pelvis: A New Understanding and Treatment for Prostatitis and Chronic Pelvic Pain Syndromes, now out in the 6th edition, describes how chronic tension in the pelvic muscles can cause many of the bewildering symptoms of prostatitis and chronic pelvic pain syndromes.

In most cases of men with prostatitis, the prostate is not the problem.

In 95% of prostatitis cases, the prostate is not the problem. In the case of men with prostatitis and chronic pelvic pain syndromes, 95% of patients who are diagnosed with prostatitis do not have an infection or inflammation that can account for their symptoms. The prostate is not the issue.

Chronic Nonbacterial Prostatitis represents by far the largest number of cases of men with prostatitis. It has been estimated that this category involves 90-95% of all cases diagnosed as “prostatitis.” Studies have shown that men undergo impairment in their self-esteem and their ability to enjoy life in general because the pain and urinary dysfunction is so profoundly intimate and intrusive.

The effect on a person’s life of nonbacterial prostatitis has been likened to the effects of having a heart attack. This includes chest pain (angina) or having active Crohn’s disease (bleeding/inflammation of the bowel). If nonbacterial prostatitis moves from a mild and intermittent phase to a chronic phase, sufferers tend to have lives of quiet desperation. Having no one to talk to about their problem, usually knowing no one else who has it, and receiving no help from the doctor in its management or cure, they often suffer depression and anxiety. Symptoms may be intermittent or constant. Few sufferers have all of the following symptoms.

In the case of men with prostatitis and chronic pelvic pain syndromes, 95% of men with prostatitis symptoms do not have an infection or inflammation that can account for their symptoms. The evidence is compelling that in these cases, the prostate is not the issue. It is the muscles of the pelvis that have gone into a kind of chronic spasm or charlie horse that is responsible for the symptoms.

The Wise-Anderson Protocol was developed at Stanford University in the Department of Urology specifically to treat what has been diagnosed as prostatitis by relaxing the pelvis and stopping the chronic spasm in the muscles of the pelvic floor. Below is a list of symptoms that the Wise-Anderson Protocol can typically help in selected men with prostatitis:

Symptoms typically helped by the Wise-Anderson Protocol
NOTE: Most men have 2 or more of these symptoms

• Urinary frequency (need to urinate often, usually more than once every two hours)
• Urinary urgency (hard to hold urination once urge occurs)
• Sitting triggers or exacerbates discomfort/pain/symptoms
• Pain or discomfort during or after ejaculation
• Discomfort/aching/pain in the rectum (feels like a “golf ball” in the rectum)
• Discomfort/pain in the penis (commonly at the tip or shaft)
• Ache/pain/sensitivity of testicles
• Suprapubic pain (pain above the pubic bone)
• Perineal pain (pain between the scrotum and anus)
• Coccygeal pain (pain in and around the tailbone)
• Low back pain (on one side or both)
• Groin pain (on one side or both)
• Dysuria (pain or burning during urination)
• Nocturia (frequent urination at night)
• Reduced urinary stream
• Sense of incomplete urinating
• Hesitancy before or during urination
• Reduced libido (reduced interest in sex)
• Anxiety about having sex
• Discomfort or relief after a bowel movement
• Anxiety and catastrophic thinking
• Depression
• Social withdrawal and impairment of intimate relations
• Impairment of self-esteem