Prostatitis is used to describe almost all pelvic complaints in men, making it the most common urologic diagnosis in men younger than age 50 and the third most common in those older than 50.
"Frankly, it’s a garbage term," said Dr. J. Quentin Clemens, one of the nation’s leading experts on the subject of male pelvic pain.
....
Dr. Clemens said that his typical approach with CP/CPPS patients is to start with alpha blockers and physical therapy if pelvic floor muscle tenderness is present. "There is no good evidence to suggest that alpha blockers work better than placebo, but I still use them," he said. "There is some effect and they are relatively benign, especially compared with gabapentin and pregabalin."
Amitriptyline (Elavil) can be useful, as is pregabalin, if burning pain is present. For particularly difficult-to-treat cases, Dr. Clemens recommends referral to a pain specialist, but he said that narcotics should be used as a last resort because of long-term use issues.
From Internal Medicine News
He also says some things with which I disagree:
- Dr. Clemens and his colleagues suggested that the prevalence increases with age, peaking between at age 71-75 years (it's much younger, and I think he's conflating BPH with CPPS)
- "When Dr. Clemens’ talk proceeded to "proven effective treatments," a blank slide appeared before the audience." (there are effective treatments, you have to keep trying them all until you find the one that's effective for you)