Chronic Non-Bacterial Prostatitis & Pelvic Health Physiotherapy

Prostatitis

Prostatitis is a common condition affecting men’s pelvic health. It is the most frequent urinary tract issue in men under 50 and the third most common in men over 50. Four main subtypes of prostatitis are recognized:

1. Chronic Non-Bacterial Prostatitis*

2. Acute Bacterial Prostatitis

3. Chronic Bacterial Prostatitis

4. Asymptomatic Inflammatory Prostatitis

Acute and Chronic Bacterial Prostatitis

These forms of prostatitis are caused by bacterial infection, which can occur when bacteria travel up the urethra into the prostate. Treatment typically involves consulting your family doctor to determine the appropriate care plan, which may include antibiotics or a referral to a urologist.

Chronic Non-Bacterial Prostatitis

Chronic Non-Bacterial Prostatitis, also known as Chronic Pelvic Pain Syndrome (CP/CPPS), is a condition characterized by pelvic or prostate-related pain without evidence of infection. It affects an estimated 10–15% of men.

Common symptoms may include persistent discomfort (lasting three months or longer) in one or more of the following areas:

• Between the scrotum and anus

• Lower abdomen

• Penis

• Scrotum

• Lower back

• Other symptoms can include:

• Pain in the urethra or penis during or after urination

• Frequent urination (eight or more times a day)

• Urgency or a weak, intermittent urine stream

• Pain during or after ejaculation

• Ongoing pelvic or lower abdominal pain

How Pelvic Physiotherapy Can Help

Research suggests that prostatitis may be linked to pelvic floor muscle dysfunction, particularly pelvic floor hypertonicity (overactive or tight pelvic muscles). Evidence shows that targeted pelvic floor physiotherapy can significantly improve symptoms in men with chronic prostatitis or chronic pelvic pain syndrome.

At Ottawa Pelvic Health, our physiotherapists are specially trained in pelvic health and use evidence-based techniques — including manual therapy, muscle relaxation, flexibility exercises, and gentle aerobic activity — to help reduce pain, improve bladder control, and enhance sexual function.

What to Expect at Your Appointment

During your initial consultation, your Pelvic Health Physiotherapist will begin with a detailed health history and assessment. This includes evaluation of the muscles, ligaments, and connective tissues of the pelvis, hips, lower back, and abdomen.

With your consent, an internal exam may be performed to assess pelvic floor muscle tone, contraction, and areas of discomfort. If preferred, external assessment options are also available to help identify the cause of your symptoms.

What Treatment Involves

Your treatment plan will be customized to your specific needs and goals. This may include:

• Education about your condition and management strategies

• Bladder retraining and bowel management

• Targeted manual therapy and myofascial release

• Visceral mobilization

• Pelvic floor muscle relaxation and strengthening

• Deep core and postural retraining

• Diastasis recti rehabilitation

• Neuromuscular re-education and stimulation

• Collaboration with your other healthcare providers for a holistic care approach

Not Sure if Pelvic Physiotherapy Can Help?

If you’re uncertain whether pelvic floor physiotherapy is right for you, Ottawa Pelvic Health offers a complimentary 15‑minute phone consultation. One of our experienced Pelvic Health Physiotherapists will discuss your symptoms, answer your questions, and help determine the best next steps for your care.

References

1. van Reijn-Baggen DA, Han-Geurts IJM, Voorham-van der Zalm PJ, Pelger RCM, Hagenaars-van Miert CHAC, Laan ETM. Pelvic Floor Physical Therapy for Pelvic Floor Hypertonicity: A Systematic Review of Treatment Efficacy. Sex Med Rev. 2021 Jun 11:S2050-0521(21)00012-3. doi: 10.1016/j.sxmr.2021.03.002. Epub ahead of print. PMID: 34127429.

2. Cornel EB, van Haarst EP, Schaarsberg RW, Geels J. The effect of biofeedback physical therapy in men with Chronic Pelvic Pain Syndrome Type III. Eur Urol. 2005 May;47(5):607-11. doi: 10.1016/j.eururo.2004.12.014. Epub 2005 Jan 22. PMID: 15826751.