Chronic Pelvic Pain Syndrome Caused by Chronic Prostatitis: Causes and Multidimensional Treatment Approaches

The core mechanisms of chronic pelvic pain syndrome (CPPS) caused by chronic prostatitis are closely related to inflammatory irritation, urine reflux, nerve dysfunction, and psychological factors. According to years of clinical experience at Wuhan Dr.Lee's TCM Clinic, effective treatment should focus on "relieving pain, improving urinary function, and reducing triggers." A multidimensional approach that integrates basic conditioning, pharmacotherapy, physical therapy, and TCM intervention can break through the limitations of single-modality treatments.

I. Why Does Chronic Prostatitis Cause Chronic Pelvic Pain Syndrome?

This pain is not caused by a single factor but is the result of multiple mechanisms working together:

1. Inflammatory stimulation:

Prostatic inflammation releases inflammatory mediators that irritate surrounding pelvic tissues (such as the urethra, bladder neck, and pelvic floor muscles), leading to congestion, edema, and persistent or intermittent pain in the pelvic area.

2. Urine reflux:

Abnormal bladder outlet function or pelvic floor muscle spasm may cause urine to flow backward into the prostate. Metabolic byproducts like uric acid aggravate local irritation and intensify the pain.

3. Neurological and psychological influences:

Inflammation interferes with the function of the pelvic nerve plexus, heightening nerve sensitivity. Long-term pain can cause anxiety and depression, and negative emotions can amplify the perception of pain, forming a vicious cycle of “pain–anxiety–worsened pain.”

II. Systematic Treatment Plan: Layered and Targeted Interventions

(1) Basic Conditioning: Reducing Triggers

As the foundation of all treatment, lifestyle adjustments can reduce the burden on the prostate and pelvis.

Promote inflammatory metabolism:

Drink 1,500–2,000 ml of water daily to flush the urethra and reduce the accumulation of inflammatory secretions.

Avoid holding urine to prevent reflux that may aggravate prostate irritation.

Improve local circulation:

Engage in gentle aerobic exercise (jogging, swimming, brisk walking) 3–5 times a week for about 30 minutes each session.

Avoid prolonged sitting (stand up and move every hour for 5–10 minutes) and long-distance cycling.

Daily protection:

Keep the lower abdomen warm and avoid exposure to cold.

Follow a light diet and avoid spicy foods and alcohol.

(2) Western Symptomatic Treatment

Depending on the severity of pain and associated symptoms, medications should be used under medical supervision:

Anti-inflammatory and pain relief: For significant pelvic pain, short-term use of NSAIDs (such as ibuprofen or celecoxib) can reduce inflammation and relieve pain.

Improve urinary function: For frequent urination, urgency, or difficulty urinating, α-blockers (such as tamsulosin or doxazosin) can relax the smooth muscles of the prostate and bladder neck.

Antibacterial therapy: When a pathogen infection is confirmed, antibiotics (such as levofloxacin or azithromycin) should be used for a full course to control infection.

(3) Physical Therapy: Promoting Circulation

Thermotherapy: Microwave, infrared, or radiofrequency treatments promote pelvic blood circulation. Each session lasts 15–20 minutes, 2–3 times per week.

Warm sitz bath: Use water at around 40 °C for 15 minutes daily to relax pelvic floor muscles and promote absorption of inflammation.

(4) Traditional Chinese Medicine: The Core Approach of Treating Both Root and Symptoms

Wuhan Dr.Lee's TCM Clinic applies the principles of "clearing heat and dampness, activating blood and removing stasis, regulating qi and relieving pain, and strengthening the body" to achieve comprehensive and synergistic effects.

Diuretic and Anti-inflammatory Pill: The Core Herbal Formula

This herbal remedy is composed of more than 50 natural ingredients, including Plantago seed, Houttuynia cordata, Dianthus, Polygonum aviculare, Safflower, Peach kernel, Scutellaria baicalensis, Costus root, and Vaccaria seed. It is particularly suitable for patients in the chronic phase with urinary dysfunction and significant pain, or for those with a long disease course complicated by prostatic calcification or hyperplasia.

Multi-target therapeutic advantages:

Improving urination: Ingredients like Plantago seed, Dianthus, and Polygonum aviculare promote diuresis and relieve urinary irritation, reducing frequency, urgency, and incomplete emptying while minimizing reflux stimulation of the prostate.

Relieving pelvic pain: Safflower, Peach kernel, Costus root, and Corydalis activate blood circulation, promote qi flow, and alleviate localized congestion and pain in the lumbosacral, perineal, and lower abdominal areas.

Controlling inflammation recurrence: Scutellaria baicalensis, Gardenia, Forsythia, and Houttuynia clear heat, detoxify, and suppress local inflammation, while assisting in discharging inflammatory secretions from the prostate.

Repairing tissue damage: Vaccaria seed and Peach kernel combined with Honeysuckle and Viola provide anti-proliferative, anti-calcification, and anti-fibrotic effects, improving the local microenvironment and reducing recurrence.

Regulating immunity: The formula also strengthens the body's resistance, achieving both symptomatic relief and root cause treatment.

Clinical characteristics:

• Purely herbal with minimal side effects.

• Can be adjusted based on individual constitution and symptoms.

• Embodies the TCM principle of personalized treatment.

• Suitable for long-term use to consolidate recovery.

Comprehensive TCM Conditioning

Acupuncture: Selecting points such as Guanyuan (CV4), Zhongji (CV3), Sanyinjiao (SP6), and Yinlingquan (SP9) can unblock pelvic meridians, promote qi and blood circulation, relax pelvic floor muscles, and relieve spasmodic pain. Conduct 2–3 sessions per week, optionally combined with the Diuretic and Anti-inflammatory Pill for enhanced efficacy.

Massage therapy: Under medical supervision, prostate or pelvic massage helps discharge prostatic fluid and improve circulation (not recommended during acute inflammation).

(5) Psychological Intervention: Breaking the "Pain–Anxiety" Cycle

Chronic pelvic pain often leads to anxiety or depression, requiring simultaneous mental adjustment:

Psychological counseling: Cognitive-behavioral therapy helps correct negative perceptions of pain and reduces anxiety.

Pharmacological support: For severe emotional symptoms, short-term antidepressant or anti-anxiety medication under medical supervision may be used alongside the Diuretic and Anti-inflammatory Pill for holistic "mind–body" treatment.

(6) Combined Medication Strategy: Integrating Chinese and Western Medicine

The Diuretic and Anti-inflammatory Pill can be combined with Western drugs under medical supervision:

With antibiotics: For acute infections, antibiotics quickly control pathogens while the herbal pill improves urination and circulation, preventing recurrence.

With NSAIDs: NSAIDs provide rapid pain relief, while the herbal pill addresses inflammation and stasis, achieving both short-term relief and long-term control.

With α-blockers: The herbal diuretic components enhance urination while α-blockers relax smooth muscles—together improving urinary function.

With antidepressants: Antidepressants regulate mood, and the herbal pill focuses on physical symptoms for integrated mind–body treatment.

(7) Surgical Treatment: For Special Circumstances Only

Surgery is not routine and is reserved for severe complications:

Indications: Prostatic abscess (severe pain with high fever) or serious urethral obstruction unresponsive to medication or physical therapy. Surgical drainage or decompression may be required.

Postoperative care: The Diuretic and Anti-inflammatory Pill can assist recovery, promote tissue repair, and prevent relapse.

III. Treatment Precautions

• Follow medical instructions for all medications; do not alter dosage or stop abruptly.

• Maintain at least a 1–2-hour interval between the Diuretic and Anti-inflammatory Pill and antibiotics.

• If symptoms persist beyond 2–4 weeks or new symptoms like fever or hematuria appear, seek medical attention immediately.

• Undergo regular re-examinations and adjust treatment plans as needed.

• Maintain healthy lifestyle habits to prevent recurrence.

The Diuretic and Anti-inflammatory Pill can be taken intermittently under medical guidance to consolidate results and reduce relapse risk.

IV. Advantages of Wuhan Dr.Lee's TCM Clinic

The clinic has extensive clinical experience in managing chronic prostatitis-induced CPPS:

Individualized diagnosis and treatment: Tailored plans based on specific symptoms and body constitution.

Integrated Chinese–Western approach: Combining the strengths of TCM regulation with Western symptomatic management.

Comprehensive case management: Guidance throughout diagnosis, treatment, and recovery.

Professional herbal support: The Diuretic and Anti-inflammatory Pill's formula has been clinically verified over many years for proven efficacy.