Prostatitis - some (hopefully) helpful observations after recovery

How it started; Having endured an extended bout of prostatitis I thought I would pass on some observations to those who also suffer from it. I acquired it after laser surgery for an enlarged prostate. The surgery trauma resolved itself in about two weeks but then a new pain kicked in. It started when my bladder sphincter closed after peeing and became increasingly painful over time. Heightened soreness followed each voiding. I had three courses of different antibiotics, to no avail. Over time, the nagging soreness extended into my crotch and rectum and was constant. It was exacerbated by constipation caused by antibiotics. Although the situation has finally resolved itself, with recovery starting some weeks after the last medication (Ofloxacin) ended. I tried suggestions from many websites to minimise the pain and aid recovery, so, what helped and what didn’t?

Keep hydrated; Caffeine is meant to be avoided so I tried decaf tea, coffee, colas or water. Tetley’s decaf tea tastes OK, as does M&S decaf brewing coffee but most decaf instant coffees seem to use chicory and taste awful so were avoided. Diet Coke decaf has a pleasant taste and tastes less “chemical” than normal Coke. Did they work? I think they helped, as there seemed to be less urgency to pee after drinking and cutting down on sugar helped too. I tried green tea but it was too disgusting to persevere. Hot drinks seemed to promote urgency and heightened the pain on peeing so I drank cooled hot drinks. Weaker than usual Earl Grey tea didn’t provoke an increased reaction.

Maintain a regular bowel; Part of the large bowel lies close to the bladder sphincter and urethra so pressure from the bowel will intensify the soreness and pain. Antibiotics can cause constipation, so you may need to consider the judicious use of a laxative, as overuse disrupts your natural rhythm. Old-fashioned Senna was the least disruptive and had a gentle action. Good hydration is essential, despite the consequent need to pee. Exercise helps, despite wanting to lie with your feet up to ease the discomfort. Yoghurt after my evening meal calmed my digestion. One thing to remember is that if prostatitis is associated with BPH (enlarged prostate) your regular toileting pattern may have been disrupted and become increasingly problematic, as did mine. However, after my TURP it has returned to normal and it still surprises me how much less troublesome this very basic function has become. The inexorable disruption caused by the enlarging prostate had made toileting a very uncomfortable experience.

Many sites advocate frequent ejaculation but, at 70, I thought it unnecessary to go there!

Alcohol; Firstly, I’m not an alcoholic but enjoy a sensible tipple! I avoided all for the first 10 weeks but then succumbed to a pint of John Smith’s. Sublime and no impact. I then tried small libations of various alcoholic beverages (in the cause of science). Red wine had a small impact but white a big impact. White wine also sensatised my bladder, making the need to pee more frequent and urgent (even for very small volumes). A weak whisky had no impact. A weak gin with lemon had an impact but almost no impact without. Sparkling wine had no discernible impact.

Foods; Acidic fruits are meant to be avoided and lots of protein means denser bowel contents. A lighter diet evolved with more pasta, fish, veggies and salads than usual. Check dressings, as they can contain vinegar or lemon juice. Raw onions had a significant impact, especially spring onions and both are best avoided. Cooked onions had no impact. Spicy foods are meant to be avoided but delicate spices had no impact. Plain cornflakes for breakfast definitely regularised and aided bowel movements. Milk appeared to have a calming effect on the intensity when peeing.

Coping with the “urgency” to get to a loo; This is a major problem. There is little or no urgency when lying or sitting but as soon as you stand there can be an overpowering need to pee, which rapidly becomes increasingly more painful. Pelvic floor exercises are recommended and they do help. It allows you to control the action of the bladder by suppressing the sphincter. However, it’s a difficult technique to maintain and the most you can expect is to get the loo in time. It has helped me to avoid soiling myself. However, you may wish to invest in incontinence pads “just in case”.

Clothing; Briefs and underpants are out and “Go commando” when you can. Loose cotton Boxers are best and not the clingy type. Loose trousers around the crotch are a must. The reason is that seams of trousers, briefs, and underpants put pressure on your crotch which increases when sitting, as you inevitably slide forward (especially when driving). To demonstrate this and when you are driving, slide your hand into your crotch. You will find that your seams are tight into your crotch.  You will notice the relief immediately when you change your style of dress.

Sleep; Constant discomfort makes sleep difficult but your body position can help. Sleep on your side with your lower leg straight down and your upper leg drawn towards your chest to a right angle. Resting the upper leg on a thin pillow makes this more comfortable. It will take pressure off your crotch, so won’t compress it. Holland & Barrett St. John’s wart is a useful aid to sleep.

Seating/sitting; Clothing comes into this too (as above). Any position that puts pressure on your crotch will cause discomfort and is exacerbated if you cross your legs whilst doing so. Downward pressure is the problem, which is made worse by low seating. Semi-recumbent or lying is the most comfortable position, where your weight is taken on your back rather than on your buttocks.

Posture; This may seem like an odd one but I found that when I bent forward at the waist I got a sense of urgency in my bladder, probably caused by the tensing of my lower abdominal muscles. It still happens, but to a much lesser degree now that I’m over this episode of prostatitis. Whether this absolves your from “kitchen sink duty” is for you to decide!

Sitz/spa baths; We don’t have bath but a shower, focused on the lower back, gave some relief.

Supplements; Unfortunately, many antibiotics preclude supporting your system with supplements. Commonly, zinc and iron fall into this category and must be excluded whilst on the medication. I tried using Saw Palmeto Complex from Nature’s Best (advocated to support prostate function) but as it left a constant, unpleasant and nauseous taste which dominates the flavour of any food, I stopped using it after four weeks.

Pain control; The constant soreness and intense pain during and after peeing is hard to medicate. Ibuprofen is recommended but is contra-indicated with many antibiotics, as the potential side effects included stomach ulcers and seizures. I was put on Amitriptaline, which is an antidepressant with the possible added affect of suppressing neural pain. Neither effect occurred with me so I went back to Ibuprofen but followed the usage instructions closely.

Lifestyle management; Taking liquids must be managed if you are to maintain any sort of “normal” lifestyle. I found that I couldn’t entertain activities away from home until I felt completely voided of urine. I planned all my tasks with loo availability in mind and you may want to invest in a travellers urine bottle “just in case”.

I am now, after five months, almost fully recovered but some small symptoms remain that I can manage effectively (posture awareness/diet/fluids etc.,). However, I am aware that prostatitis “can be for life” with recurring episodes. My past experience will, perhaps, help me to avoid the worst of the condition if this happens.

I hope the above helps and you are soon on the road to recovery.

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