Prostatitis: Causes, Symptoms, Treatments

Prostatitis is a term given to a set of symptoms caused by an infection or inflammation of the prostate.

This disease is different from an enlarged prostate or benign prostatic hyperplasia (BPH), which involves an increase in prostate cells.

It’s also different from prostate cancer. This is when malignant cells form, multiply, and spread.

Due to the nature of the disease being complex, the symptoms depend on the cause and type.

Thus, doctors must know what the cause is for it to be effectively treated. This article will discuss the symptoms, causes, and treatment options for prostatitis.

Types of Prostatitis

There are four main types of prostatitis, and each has its own set of causes and symptoms.

Prostatitis is an inflammation of the prostate gland. 

Acute Prostatitis

Acute prostatitis is an uncommon type of prostatitis that is caused by bacteria. It develops very quickly, and the infection can be severe. Therefore, it requires prompt treatment.

Men with this type often experience a high fever (above 38°C). There might be pain between the anus and testicles, along with the scrotum and penis.

Pain can also be felt on the muscles and joints of the pelvic area, thighs, and legs. Additionally, some experience frequent night-time urination (nocturia) and find it painful to urinate.

Moreover, about 10% of cases experience acute urinary retention. This condition needs to be treated straight away, as it could lead to complications.

A typical procedure is for the doctor or nurse to pass a thin, flexible catheter from the penis into the bladder to drain the urine.

Acute bacterial prostatitis develops when certain types of bacteria get into the prostate. Some bacteria that typically thrive in the bowel may spread to the urethra and into the bladder and prostate. Microbes in the blood may also infect the prostate.

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Chronic Bacterial Prostatitis

Chronic bacterial prostatitis involves a prostate infection that lasts at least three months. It also tends to come and go, causing flare-ups or episodes. Like the acute type, it isn’t common.

Bacterial infection also causes chronic bacterial prostatitis. It’s seen in men who’ve had frequent UTIs (urinary tract infections). The same microbe often causes each episode if the antibiotics were not successful in killing the previous infection.

This is why it’s essential to adhere to the treatment. Since stopping it too early will lead to microbial resistance from drugs.

Chronic Non-bacterial Prostatitis (Chronic pelvic pain syndrome (CP/CPPS)

Chronic Prostatitis, also known as chronic pelvic pain syndrome (CPPS), is the most common type of prostatitis.  About 9 in 10 men with an inflamed prostate have this type. It often leads to urinary symptoms such as urgency, frequency, and painful urination.

It’s important to note that because a bacterial infection does not cause this type of prostatitis, it cannot be treated with antibiotics.

Therefore, it is crucial to determine whether or not the prostatitis is bacterial or not. There is no single test to diagnose chronic prostatitis.

Your doctor needs to rule out other possible causes of the symptoms to make a diagnosis. And they will do this by asking about your symptoms, checking your medical history, and doing a physical exam.

A urine sample may be taken to determine whether or not you have a UTI. Since it is a chronic condition, men often have symptoms for three months or longer.

Asymptomatic Prostatitis

Asymptomatic Prostatitis doesn’t have any symptoms and is often diagnosed by chance. Usually, doctors spot this condition when you’re having tests for other diseases, such as prostate cancer.

As the name indicates, symptoms of this type don’t exist as specific symptoms. Men do not often know they have this type of prostatitis.

Regardless, some men who have this type have high PSA levels and white blood cells or pus cells in their urine. Some reports say that one-third of men with an elevated PSA level have asymptomatic prostatitis.

Symptoms of Prostatitis

Prostatitis can affect men at any age, but it’s most common in younger and middle-aged men, typically between 30 and 50.

For men over the age of 50, it is the third most common urinary tract issue. Prostatitis accounts for about two million visits to health care providers in the United States each year.

The symptoms of prostatitis will vary in their severity, depending on the type you have.

Here are some of the most common symptoms you may experience:

  • Painful urination.  

  • Frequent urination.  

  • Blood in the urine/Cloudy urine.  

  • Pain in the abdomen, groin or lower back.  

  • Pain in the area between the scrotum and rectum (perineum).  

  • Discomfort or pain of the penis or testicles.  

  • Fever, chills and, body aches / flu-like symptoms.  

  • Urethral discharge.  

  • Burning sensation while ejaculating or sexual dysfunction.  

  • Pain during sexual intercourse.
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Prostatitis is a complicated condition, and the exact cause is difficult to uncover.

The origins vary according to the type and are as follows:

Acute Prostatitis

Prostatitis acute is usually caused by the same bacteria that cause urinary tract infections (UTIs) or sexually transmitted diseases (STDs).

The bacteria might reach your prostate. This can be because of a urine infection, a prostate biopsy, or possibly from the regular use of a catheter.

Chronic Bacterial Prostatitis

A bacterial infection causes chronic bacterial prostatitis. It tends to affect men who’ve had lots of urine infections or an inflamed urethra (urethritis) in the past.

Each episode tends to be caused by the same bacteria, which also cause urine infections. It can develop from acute bacterial prostatitis if antibiotic therapy does not get rid of all the bacteria.

This could be because the bacteria were resistant to antibiotics or because the treatment ended too early.

Chronic Non-bacterial Prostatitis (Chronic pelvic pain syndrome (CP/CPPS

The exact cause is unknown, unlike the other types, which are due to microbes. However, experts found that certain things trigger it. These include urine getting into the prostate, previous UTIs, and nerve dysfunction.

There is also some research indicating that CPPS may be linked to and triggered by other conditions such as stress, irritable bowel syndrome (IBS), and chronic fatigue syndrome.

Asymptomatic Prostatitis

The exact cause of asymptomatic inflammatory prostatitis is not known.

The research team looked at the semen of 37 men with asymptomatic prostatitis and found that the semen had about eight different types of bacteria. The bacterial count was also related to the high white blood cell count.

What are the risk factors?

Factors that increase your risk of UTIs and sexually transmitted diseases (STDs) also increase your risk of having an inflamed prostate. These include:

  • Not drinking enough fluids.  

  • Using a urinary catheter.  

  • Multiple sexual partners.  

  • Unprotected vaginal or anal intercourse.  

  • Old age.  

  • Recurring UTIs (urinary tract infection).  

  • Previous cases of prostatitis.  

  • Having certain genes can make you more prone to have prostatitis.  

  • Pelvic injuries.  

  • Inflamed testicles.  

  • HIV/AIDS infection.  

  • Stress and mental distress


If you are experiencing any of the symptoms of prostatitis, you should see your doctor so that further tests can be taken to confirm whether you have it.

Urine test

A urine test can be beneficial for diagnosing bacterial prostatitis. Bacteria and excessive white blood cells are found in the urine in people with bacterial prostatitis.

Blood PSA test

Most men with acute prostatitis experienced a steep rise in PSA levels. So a PSA test in conjunction with other examinations may help diagnose bacterial prostatitis. In the vast majority of cases, this elevation is due to inflammation in the prostate.


Digital Rectal Exam

A Doctor/urologist may undergo a digital rectal exam (DRE) to assess whether your prostate is enlarged, swollen, or tender. Your doctor can also rule out other severe prostate conditions during this examination.

Urodynamic tests

Measuring post-void residual urine is useful for measuring bladder emptying capabilities.

Urinary retention can cause prostatitis if the urine is infected with bacteria. Therefore, the inability to empty your bladder may lead to prostate infection.

Moreover, post-void residual urine measurement provides useful information to determine whether a patient has incomplete bladder emptying. Urinary retention can cause recurrent urinary tract infections.

The UPOINT System

The UPOINT system can clinically profile a patient’s symptoms into six categories to allow a more individualized therapy.

The six categories include urinary signs, psychological dysfunction, organ-specific symptoms, infectious causes, neurological dysfunction, and tenderness of pelvic floor muscles.

Multiple clinical trials have externally validated the UPOINT system, and it is gaining increasing widespread use and effectiveness.

Prostatitis can affect men at any age, but it’s most common in younger and middle-aged men, typically between 30 and 50.

For men over the age of 50, it is the third most common urinary tract issue. Prostatitis accounts for about two million visits to health care providers in the United States each year.

Are BPH and Prostatitis the same thing?

BPH (Benign Prostatic Hyperplasia) and Prostatitis are two common conditions that affect the prostate. They can both cause painful symptoms, such as difficulty urinating, but they have very different causes and are two distinct conditions.

Benign Prostatic Hypertrophy is called BPH for short.

It is an enlargement of the prostate caused by the growth of prostate cells. Eventually, the increased size squeezes your urethra.

The body adapts by making the bladder walls thicker. The bladder weakens over time, leading to incontinence and the constant feeling that you have to urinate. A man with BPH often gets up in the middle of the night to urinate several times.

The symptoms of BPH and Prostatitis are similar.

For more information on BPH (Benign Prostatic Hyperplasia), click here.

Does Prostatitis increase your risk of Prostate Cancer?

According to a recent clinical study, there may be an increased risk of prostate cancer if you have prostatitis. The real answer is broad – and it’s based on the type you have.

The two types of prostatitis are clinical prostatitis, when you have symptoms, and histological prostate inflammation.

Histological prostatitis is where the prostate cells show inflammation underneath the microscope, but you don’t have symptoms.

Studies in the past have found that histological prostate inflammation is 4-5 times more common in men WITHOUT prostate cancer than those with cancer.

Doctors commonly think that having a history of clinical prostatitis increases prostate cancer risk, but histological prostatitis decreases the risk.

However, some doctors and researchers find different results.

These researchers examined the difference between histological prostatitis and clinical prostatitis – and cancer.

First, they found that the proportion of men with histological prostatitis that developed clinical prostatitis varied by race. 28% of African American men developed symptoms of prostatitis compared to 17% in white men.

The researchers also revealed no association between a history of clinical prostatitis and prostate cancer risk overall. However, when they separated their statistics by race, a different picture emerged.

In white males, the risk for cancer was elevated, although not statistically significant. It was only 2%. In African American men, those who had chronic prostatitis showed a significantly decreased risk of developing cancer.

Recurrent cases of prostatitis and chronic prostatitis increase the risk of suffering from prostate cancer, especially in patients with a family history of prostate cancer. Inflammation (which is basically what happens in prostatitis) is exactly what cancer cells need to thrive.

Will Prostatitis resolve itself on its own?

To answer this question, we have to consider the cause of prostatitis and whether or not anything was done about it.

If you take an antibiotic, it may wipe out the specific bacteria causing your prostatitis right now. However, it’s also affecting the whole microbiome of probiotics living in your urinary tract.

This could reduce the protective bacteria to seriously low numbers, leaving harmful fungi to grow – and potentially cause more chronic prostatitis.

The latest statistic I’ve seen is that one dose of an antibiotic is enough to kill 50% of the probiotics living in the gut. That means you’re in between a rock and a hard spot – do you take the antibiotic or not?

The answer may be that you could merely alter your microbiome with probiotics and fermented foods such as kefir milk (the best solution), homemade sauerkraut, yogurt, kimchee, miso, and kombucha tea. You could also try a probiotic supplement.

By influencing what is happening with your microbiome, you can increase your chances of prostatitis going away on its own. As you can see, there is a bit of work to do to get the remission to occur.

Another supplementary solution can be a series of colonic hydrotherapy sessions.

This will “wash out” any overgrowth of waste matter in the colon and rectum, thus helping to restore the environment so the right probiotics can grow and protect your prostate.

Men’s symptoms for BPH and prostatitis decreased quickly with colonics or colon cleanses. One report by the Kellogg Clinic stated the complete resolution of BPH with colonics.


The treatment for an inflamed prostate depends on the type.

Acute Bacterial Prostatitis

Antibiotics are the primary treatment for this type of prostate disease. The duration of therapy is often 4-6 weeks.

You need to finish the course of antibiotics. If not, the infection may recur, and the microbe will develop drug resistance.

Seek advice from your doctor if the drugs are not working well. In severe cases, the Doctor will prescribe intravenous antibiotics, wherein the drugs will be passed through the blood for a much faster effect.

If a patient remains resistant to prolonged antibiotic therapy, the possibility of a prostatic abscess should be considered.

Chronic Bacterial Prostatitis

To treat this chronic condition, your doctor will prescribe antibiotic treatment for at least 4-6 weeks.

Urine tests will be done to see if the infection is gone. In case the symptoms come back, the Doctor prescribes more antibiotics over an extended period.

However, the outcome of antibiotic treatment is not as simple as with chronic cases.

Chronic bacterial prostatitis involves prolonged and recurrent symptoms. It requires prolonged therapy with an antibiotic that penetrates the prostate.

These antibiotics should be highly soluble in lipids, have a smaller molecular size, and a low protein binding quality.

While antibiotics can cure prostatitis, they are still drugs that have certain side effects. However, an inflamed prostate can also be treated by natural means.

Chronic Non-bacterial Prostatitis (Chronic pelvic pain syndrome (CP/CPPS)

Treatment for chronic prostatitis varies from person to person. Though it won’t treat the cause, it can control its symptoms.

The doctor may prescribe drugs like alpha-blockers, 5-alpha reductase inhibitors, and pain relievers to help relieve painful symptoms. However, it is important to note that these medications can have side effects.

Long-term prostatitis can be a difficult condition to live with, and the painful flare-ups can make it hard to carry out everyday tasks.

You may also experience feelings of stress and anxiety, which in turn may trigger chronic prostatitis.

To help, your doctor may refer you to a counselor to help cope with the symptoms and to help manage pain.

Physiotherapy and prostate massage may also be needed to treat problems with the pelvic floor muscles. In rare cases, surgery might be required.


As it doesn’t cause symptoms, it usually doesn’t need any treatment. However, antibiotics may be necessary if you have high levels of prostate-specific antigen (PSA) in the blood. Or if you have a high white blood cell count in your urine or semen.

How long the treatment lasts depends on these conditions but often takes around 4-6 weeks.

Prostatitis and antibiotics

In most cases, if you have been diagnosed with prostatitis, your doctor’s first course of action will be to prescribe antibiotics.

Antibiotics are prescribed in cases of bacterial prostatitis.

However, some urologists will still prescribe antibiotics even in cases of non-bacterial prostatitis. This is to rule out the possibility of infection.

However, several studies have indicated excessive antibiotic use in men with prostatitis.

Antibiotics are not effective for the treatment of non-bacterial chronic prostatitis.

As such, their use should be limited to individuals with confirmed positive cultures on expressed prostatic fluid or associated urinary tract infection.

This is as excessive antibiotic use can lead to antibiotic resistance.

A study published in The American Journal of Medicine stated that despite evidence that antibiotics are not effective in most men with chronic pelvic pain syndrome, they were prescribed in 69% of men with this diagnosis.

Overall the researchers concluded that improvement strategies to reduce unnecessary antibiotic use in men with chronic prostatitis are needed.

Commonly prescribed antibiotics

Alpha-blocking agents like tamsulosin (Flomax) are sometimes used to reduce abnormal urinary symptoms in men with prostatitis.

These medications are used to help men who experience pain and discomfort when urinating.

Side Effects

Although they may help to relieve symptoms, you should be aware of the potential side effects:

  • Ejaculation and orgasm problems

  • Peyronie disease

  • Blood pressure changes

  • Blurred vision

  • Dizziness, drowsiness, and falls

  • Headache, chest pain and back pain

  • Nausea, diarrhea

  • Fever, chills and flu symptoms

For certain types of prostatitis, such as bacterial prostatitis, antibiotic treatment will be necessary. However, it is essential to be aware of the potential side effects of antibiotics.

Fluoroquinolone drugs, in particular, can have severe side effects and have an FDA black box warning.

This warning states that these drugs can cause severe tendon damage and permanent peripheral neuropathy. This is a type of nerve damage that results in tingling, numbness, pain, and weakness.

A further issue with taking antibiotics is that while it kills harmful bacteria, it can also kill some good bacteria and microflora in your gut.

Your gut microflora modulates your immune system. The greater the number of good bacteria or probiotics you have in your gut, the fewer harmful bacteria that cause infection you’ll have.

Are there any natural treatments for Prostatitis?

Making changes to your lifestyle may help to alleviate prostatitis symptoms. Some of the following include:


In some cases, certain foods may cause your prostatitis to flare up; this could include spicy or foods or citrus.

So, keep a food diary and make a note of any foods that seem to irritate your bladder.

An analysis was undertaken to determine the effectiveness of dietary changes to treat prostatitis in men and urethral syndrome in women. 2,385 patients, 1710 men, and 675 women with symptoms of prostatitis and urethral syndrome were followed.

All patients had a strict diet, eliminating caffeine, alcohol, and all hot and spicy food for 12 weeks.

The results showed an 87% success in men and an 89% success rate in women.

During the study, none of the patients received antibiotics or were treated with medications such as alpha-blockers, 5-alpha reductase inhibitors, or phenazopyridine.

Food that causes allergies can also worsen the symptoms of the disease. So, you have to avoid food that causes vomiting, diarrhea, nausea, or abdominal pain.

It is also important to consume fruits and vegetables. They are high in vital nutrients, vitamins, and minerals and help fight infection and inflammation. It would help to drink 1.5 to 2 liters of water a day. Avoid drinks such as coffee, alcohol, and sodas, which can inflame your urinary tract.

best vitamins for men over 50


Being active helps to maintain a healthy weight, which benefits your overall health. Aerobic exercises, in particular, can relieve prostatitis symptoms.

Italian researchers randomly assigned 231 men with prostatitis to do exercises three times a week for 18 weeks. One group participated in aerobic exercise, and the other group did non-aerobic exercise.

The researchers found that although both groups felt better, the group that had done aerobic exercise experienced significantly more significant improvements in CPPS pain levels, as well as improvements in anxiety and depression.

Pelvic floor exercises can also benefit some men with urinary symptoms.

Experts estimate that pelvic tension and pelvic floor muscle disorders are responsible for pain in about 50% of CP/CPPS cases. Therefore, strengthening the pelvic floor muscles could help.

Following this, it is a good idea to avoid prolonged sitting. Sitting for long periods can put pressure on the prostate gland, eventually leading to inflammation over time. Sitting on a bike seat can have a similar effect, so it is also a good idea to limit cycling.

For more information on pelvic floor exercises, click here.


The benefits of probiotics for treating bacterial prostatitis are present in human clinical research.

One study looked at the effects of supplementing with probiotics alongside antibiotics for treating chronic bacterial prostatitis. 210 men affected by chronic bacterial prostatitis were randomly allocated to receive a lactobacillus supplement with antibiotics or antibiotics alone for 30 days.

At the end of the study, 27.6% of the group that received only antibiotics had a UTI recurrence, while only 7.8% of the combination group experienced a recurrence.

Probiotics can protect against harmful bacteria and restore the loss of healthy-supporting bacteria lost to antibiotic treatment. This makes probiotics one of the best treatments for bacterial prostatitis.


Curcumin is a potent bioactive constituent in the spice Turmeric. People in India regularly use turmeric for cooking and in traditional medicine.

Curcumin is well-known for its potent anti-inflammatory effects. Curcumin also has a very good safety profile, and it serves as a viable alternative to anti-inflammatory drugs.

The effects of curcumin alone on treating prostatitis are yet to be studied. However, using curcumin with other natural anti-inflammatory ingredients, such as quercetin and saw palmetto, can improve the symptoms of chronic non-bacterial prostatitis.  


Quercetin is a flavonoid we can find in high concentrations in capers and red onion. A human clinical showed that 1 gram of quercetin daily for four weeks significantly symptoms of chronic non-bacterial prostatitis.

For quercetin to be effective, you would require either a high dose (1 gram per day) or a lower dose when combined with other ingredients like curcumin and saw palmetto.

For more information on quercetin, click here.

Pollen extract

Pollen extract is another natural anti-inflammatory. This extract reduced inflammation in rats induced with prostatitis.

In a human clinical study, patients given pollen extract reported more significant improvement in symptoms of chronic non-bacterial prostatitis and quality of life compared with men given a placebo.

Saw palmetto

Saw palmetto is a common treatment for prostate enlargement. This is because of its ability to reduce DHT, which is a hormone that plays a vital role in prostate enlargement.

Saw palmetto also has potent anti-inflammatory properties and may be useful for treating prostatitis.

Prostate Healer

prostate healer

We formulated Prostate Healer to effectively combat BPH and prostatitis and provide symptomatic relief from urgency, frequency, and nocturia.

It works on the prostate, kidney, and bladder simultaneously, coaxing cells gently to resume normal function.

So, by this action, you’re fighting against prostatitis and BPH.

If you’re like many men that use the formula, you’ll see a reduction in the number of times you get up to go to the bathroom to urinate.

Plus, you’ll see an improvement in the flow of your urine.

Find out more about Prostate Healer.


So, although it is not a life-threatening condition, it does have a debilitating effect on the quality of life.

There are several natural remedies for treating prostatitis. For anyone suffering from a form of bacterial prostatitis, you must supplement with probiotics.

A combination of saw palmetto, curcumin, and quercetin is clinically effective at reducing pain and should be used by men suffering from any form of prostatitis.

Using these natural supplements can also prevent you from having an unnecessary PSA test by reducing inflammation and PSA levels.  

It takes a holistic approach that can benefit not just the prostate, but your entire body.  

Explore More

prostatitis treatment natural

8 Natural Ways To Relieve Prostatitis Symptoms.


Prostatitis- Types, Causes, Diagnosis

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  2. Sandhu J and TU HYV. Recent advances in managing chronic prostatitis/chronic pelvic pain syndrome [version 1; peer review: 2 approved]. F1000Research 2017, 6(F1000 Faculty Rev):17

Does Prostatitis Increase Your Risk of Prostate Cancer?

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Prostatitis and Antibotics

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  2. Fasugba, O., Gardner, A., Mitchell, B. G., & Mnatzaganian, G. (2015, November 25). Ciprofloxacin resistance in community-and hospital-acquired Escherichia coli urinary tract infections: A systematic review and meta-analysis of observational studies. BMC Infectious Diseases, 15, 545.
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Natural Treatments

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  2. Cai T, Mazzoli S, Bechi A, Addonisio P, Mondaini N, Pagliai RC, Bartoletti R. Serenoa repens associated with Urtica dioica (ProstaMEV®) and curcumin and quercitin(FlogMEV®) extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients: results from a prospective randomised study. International journal of antimicrobial agents. 2009 Jun 1;33(6):549-53.
  3. Cai T, Verze P, La Rocca R, Palmieri A, Tiscione D, Luciani LG, Mazzoli S, Mirone V, Malossini G. The clinical efficacy of pollen extract and vitamins on chronic prostatitis/chronic pelvic pain syndrome is linked to a decrease in the pro-inflammatory cytokine interleukin-8. The world journal of men’s health. 2017 Aug 1;35(2):120-8.
  4. Chung JH, Yu JH, Sung LH, Noh CH, Chung JY. Effect of prostatitis on lower urinary tract symptoms: retrospective analysis of prostate biopsy tissue. Korean J Urol. 2012;53(2):109–113. doi:10.4111/kju.2012.53.2.100
  5. Giubilei G, Mondaini N, Minervini A, et al. Physical Activity of Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome Not Satisfied with Conventional Treatments — Could It Represent a Valid Option? The Physical Activity and Male Pelvic Pain Trial: A Double-Blind, Randomized Study. Journal of Urology 2007;177:159–65. PMID: 17162029.
  6. Kamijo T, Sato S, Kitamura T. Effect of cernitin pollen‐extract on experimental nonbacterial prostatitis in rats. The Prostate. 2001 Oct 1;49(2):122-31.
  7. Mändar R, Punab M, Korrovits P, Türk S, Ausmees K, Lapp E, Preem JK, Oopkaup K, Salumets A, Truu J. Seminal microbiome in men with and without prostatitis. International Journal of Urology. 2017 Mar;24(3):211-6.
  8. Meng LQ, Yang FY, Wang MS, Shi BK, Chen DX, Chen D, Zhou Q, He QB, Ma LX, Cheng WL, Xing NZ. Quercetin protects against chronic prostatitis in rat model through NF‐κB and MAPK signaling pathways. The Prostate. 2018 Apr 13.
  9. Milton, K. (2002). A Dietary Cure For Prostatitis and the Urethral Syndrome. Infectious Diseases in Clinical Practice. 11 (3), p107-110.
  10. Morgia G, Russo GI, Urzì D, Privitera S, Castelli T, Favilla V, Cimino S. A phase II, randomized, single-blinded, placebo-controlled clinical trial on the efficacy of Curcumina and Calendula suppositories for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome type III. Archivio Italiano di Urologia e Andrologia. 2017 Jun 30;89(2):110-3.
  11. Paulis G. Inflammatory mechanisms and oxidative stress in prostatitis: the possible role of antioxidant therapy. Research and reports in urology. 2018;10:75.
  12. Rees J, Abrahams M, Doble A, Cooper A; Prostatitis Expert Reference Group (PERG). Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015;116(4):509–525. doi:10.1111/bju.13101
  13. Shoskes DA, Zeitlin SI, Shahed A, Rajfer J. Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial. Urology. 1999 Dec 1;54(6):960-3.
  14. Stamatiou K, Pierris N. Serenoa repens extract additionally to quinolones in the treatment of chronic bacterial prostatitis. The preliminary results of a long term observational study. Archivio Italiano di Urologia e Andrologia. 2013 Dec 31;85(4):190-6.
  15. Smith CP. Male chronic pelvic pain: An update. Indian J Urol. 2016;32(1):34–39. doi:10.4103/0970-1591.173105
  16. Wagenlehner FM, Schneider H, Ludwig M, Schnitker J, Brähler E, Weidner W. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis–chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study. European urology. 2009 Sep 1;56(3):544-51.

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