Many men suffering from chronic pelvic pain go years without receiving the correct diagnosis. Studies show that it can take up to seven years for men with these symptoms to get an accurate assessment of what’s truly going on. This delay is often due to the fact that pelvic pain symptoms in men mimic those of prostate infections, urinary tract infections, or sexually transmitted infections. As a result, many healthcare professionals skip comprehensive testing and instead prescribe antibiotics based on assumptions. Unfortunately, this tends to overlook the actual root cause—pelvic floor dysfunction. Adding to the challenge, most pelvic floor therapists receive training focused on treating female anatomy, which can leave men struggling to find qualified care. That’s not an issue at PHRC, where our clinicians are deeply knowledgeable in male pelvic health, and it’s not uncommon for our male caseload to exceed that of our female patients on any given day.
It’s very common for men experiencing pelvic discomfort to receive a misdiagnosis of “prostatitis” and be placed on rounds of antibiotics, only to find little or no relief. However, scientific studies have shown that over 90% of men with persistent genitourinary symptoms—such as pain in the pelvic area, testicles, or perineum—do not actually have a bacterial infection of the prostate. Instead, most of these cases are classified under Chronic Pelvic Pain Syndrome (CPPS), specifically falling into NIH-defined categories IIIa or IIIb. These forms of CPPS represent a non-infectious source of discomfort that requires a completely different treatment approach.
The National Institutes of Health outlines five categories of prostatitis:
Category I: Acute bacterial prostatitis – sudden and intense onset, accompanied by systemic symptoms and an acute urinary tract infection.
Category II: Chronic bacterial prostatitis – marked by the persistence of bacterial infections in the prostate and recurring urinary tract infections.
Category IIIa: Inflammatory CPPS – identified by the presence of white blood cells in semen, prostatic secretions, or urine, indicating inflammation.
Category IIIb: Non-inflammatory CPPS – similar symptoms but with no white blood cells found in diagnostic fluids, suggesting no inflammation is present.
Category IV: Asymptomatic inflammatory prostatitis – inflammation is discovered during testing, even though the individual reports no visible symptoms.