Board-certified evaluation for bacterial prostatitis and chronic pelvic pain syndrome (CPPS). Antibiotic prescriptions and multimodal management — from home. Serving DE, MD & WA.

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What Is Prostatitis?

Prostatitis refers to inflammation of the prostate gland and is the most common urologic diagnosis in men under 50 years of age. It affects up to 15% of men at some point in their lives and is categorized by the NIH/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Classification into four types. Type I (Acute bacterial prostatitis) is an acute infection of the prostate most commonly caused by gram-negative uropathogens, particularly Escherichia coli (most common), Klebsiella, Proteus, and Pseudomonas species. It presents with sudden onset high fever, chills, perineal or pelvic pain, lower urinary tract symptoms (frequency, urgency, dysuria), and sometimes obstructive symptoms. Type II (Chronic bacterial prostatitis) involves recurrent urinary tract infections with the same uropathogen causing intermittent symptoms. Type III (Chronic prostatitis/Chronic Pelvic Pain Syndrome, CP/CPPS) is the most common form — accounting for 90–95% of all prostatitis diagnoses — and involves pelvic pain persisting for at least 3 months without evidence of bacterial infection. Type III is divided into IIIA (inflammatory) and IIIB (non-inflammatory). Type IV (Asymptomatic inflammatory prostatitis) is identified incidentally on biopsy or semen analysis.

The pathophysiology of CP/CPPS remains incompletely understood and is thought to involve a combination of neurogenic inflammation, pelvic floor muscle dysfunction, psychological factors, and — in some cases — an initial bacterial trigger that resolves but leaves sensitized pain pathways. This complexity explains why CP/CPPS often requires a multimodal management approach.

your board-certified provider, provides telehealth evaluation for men with prostatitis symptoms in Delaware, Maryland, and Washington, following AUA guidelines and current evidence-based practice. An important telehealth limitation to acknowledge: the digital rectal exam (DRE) — used in-person to assess prostate tenderness and size — cannot be performed via telehealth. This limitation means that some aspects of the physical examination relevant to prostatitis diagnosis require in-person evaluation. your provider will clearly communicate when in-person evaluation is needed.

Common Symptoms of Prostatitis

How Innocre Treats Prostatitis Online

For acute bacterial prostatitis (Type I), when symptoms are mild to moderate (no high fever, no urinary retention, not systemically unwell), antibiotic therapy can be initiated via telehealth pending urine culture. Per AUA guidelines and CDC recommendations, fluoroquinolones are the preferred class due to their excellent prostate tissue penetration: ciprofloxacin 500 mg twice daily or levofloxacin 500 mg once daily for 4–6 weeks is the standard course. Trimethoprim-sulfamethoxazole (Bactrim DS) is an alternative for susceptible organisms. Urine culture with sensitivity testing should ideally guide antibiotic selection — your provider can order this lab simultaneously with initiating empiric therapy. NSAIDs (ibuprofen, naproxen) may be recommended for pain and inflammation management during treatment.

For chronic prostatitis/CPPS (Type III), management is multimodal and tailored to the individual's predominant symptom profile. Evidence-based options include: alpha-blockers (tamsulosin, alfuzosin, silodosin) for urinary obstruction and pelvic floor relaxation — these improve voiding symptoms and may reduce pelvic pain; NSAIDs for anti-inflammatory analgesia; pelvic floor physical therapy — highly effective and often underutilized, involves specialized physiotherapy to relax hypertonic pelvic floor muscles; and in some cases 5-alpha reductase inhibitors (finasteride, dutasteride) for men with concurrent BPH. Psychological approaches including CBT have demonstrated benefit for the significant anxiety and depression that frequently co-occur with CPPS. A short empiric course of antibiotics (4–6 weeks) is often tried for new CPPS to rule out an occult bacterial component, even when cultures are negative.

Telehealth is well-suited for the ongoing management of chronic prostatitis, medication adjustment, and care coordination — including referrals to pelvic floor physical therapists and urology specialists when warranted. your provider will provide a clear management plan during your visit, with realistic expectations about symptom timelines for each prostatitis type. Prescriptions are sent electronically to your pharmacy in DE, MD, or WA.