QUESTION: What causes prostatitis if not a bacterial infection from external source? Would urine back flowing into prostate be a cause? If so how can that be prevented? When I masterbate I always put my finger over the end of my penis when I cum so I can direct the mess elsewhere. It occured to me that maybe most guys don't do this. Could this be a cause of my prostatitis-like pains?

ANSWER: James:

Prostatitis is a syndrome of any inflammatory process involving or appearing to involve the prostate.  The majority may not demonstrate any bacteria.  The exact cause is not always known.  Reflux or chemical prostatitis is known and this can be caused by ejaculation with an obstruction but probably not by just directing the semen flow.

I suggest you have this checked by your local physician or consult a urologist.

Typical Treatments for Prostatitis Include:
Avoid caffeine which irritates the prostate and bladder.
Hot sitz baths.  Sitting in a very hot tub for 10 minutes really seems to reduce pelvic pain, inflammation and discomfort.  We recommend twice or even three times a day for severe cases or flare-ups, but at least once a day for most prostatitis patients.
Avoid hot spices which tend to irritate the prostate.
Avoid sitting on hard surface; use an inflatable donut to spread the pressure away from the prostate.
Use NSAIDs like ibuprofen (Motrin, Advil) or naprosyn (Aleve) to help reduce discomfort and inflammation.
Antibiotics as prescribed by your physician.
Alpha blocker medications such as tamsulosin and alfuzosin will help relax muscle tension in the prostate.
Avoid high potassium foods that some people are sensitive to and which can be irritating.
Less alcohol and smoking.
Use quercetin which is a natural anti-inflammatory herbal supplement that has been shown to help reduce inflammation in the prostate.

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QUESTION: Would you recommend cumming into a condom from now on? I don't see my urologist often. Will see him again in mid april.  Still not terribly pleasurable to ejaculate.

ANSWER: James:

I'm not sure using a condom will help much, but it's recommended for other reasons.  Try sitting in a hot tub.  This almost always causes some immediate relief.

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QUESTION: The hyophen works well enough. I'm lucky enough to find time for a shower every other day. A bath 3 times a day would not  be possible. I can endure the pain. I just want a cure. Not pain remedies that take away things in my life that make me happy.


Read my previous answer again.  Hot tub baths three times a day are only recommended for the most severe cases.  The hyophen is not a curative agent; it's a type of pain remedy.  Try some of the other treatments which can potentially offer a cure. Good luck.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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