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How to treat prostatitis?

I have suffered from chronic non-bacterial prostatitis for over two years now and though I've improved slightly, I still suffer regular flare ups of pain.

I have had many tests--chlamydia swab, EPS culture, cystoscopy, KUB x-ray, extensive blood tests--all coming back negative. Is this a sufficient workup to exclude anything sinister or serious?

My urologist believes anxiety is responsible for the continuity of the symptoms (by causing pelvic floor muscle tension and spasm), but how can anxiety cause dysuria and penile pain? I get scared sometimes that my prostate and urethra are being damaged when it hurts so much.

Also, will anal sex damage my prostate further? I haven't dared indulge in this for almost two years! Please help...

Dr. Franklin Lowe, a urologist in New York City, answered this question below:

First of all, it is highly unlikely that anything "sinister" (such as cancer) is lurking!

Your work-up seems most appropriate. The common treatments for this condition usually includes: antibiotics, non-steroidal anti-inflammatory drugs (such as ibuprofen or naprosyn), other prostate medications (such as finasteride and tamsulosin) as well as stress reduction and perineal physical therapy.

Avoidance of caffeine, alcohol and spicy foods is usually recommended along with frequent ejaculations (either through sexual activity or masturbation). Additionally, many men try a course of saw palmetto berry--an herbal extract to see if there is any benefit.

Unfortunately, chronic prostatitis (now known as chronic perineal pain syndrome) has a high recurrence rate.

Lastly, anal receptive or penetrative intercourse should not be harmful to your prostate, but remember safe sexual practices!

Spit or swallow?

I am an HIV-positive guy; is there any additional risk to swallowing my own cum?

None at all, so drink up if you like.

Guilt over rimming...

I gave a rim job to someone for the first time last night. When I woke up this morning my tongue was swollen and red and sore. It's not quite as bad as it was earlier but it is still sore when I lift my tongue.

Also, when I eat anything today I've been sick to my stomach. Now I'm scared and embarrassed to ask my doctor. Any advice?

RELAX.

It is almost impossible for an STD to show up so fast and it may either be from something you had before the rimming or from your nerves over what you did.

Rimming is one of the safest sexual acts you can do. You can catch parasites and other STD's including gonorrhea, syphilis, hepatitis and herpes if your partner has it but it is not that common.

HIV does not pass from rimming. Most STD's take at least 3-5 days to show up and many take longer. If you rim someone hard with your tongue you can get irritation from friction as well. I am sure that by the time you read this you are feeling fine, so relax.

If you still can't relax go to a doctor. If you don't think you can discuss your sexuality then don't feel the need to. Just say you were having oral sex--straight men do it too.

Take care.