This is a bit complicated. I'm 36, and work in a job that's fast-paced and high-volume, so for years I've been drinking a lot of caffeine--and then having to hold in urine for some time. Over the years I've occasionally had spasms in the bladder after holding it in; I've mentioned this to doctors and they've said, "yeah, that can happen if you hold it in too long." Didn't seem worried. We're talking about a couple of hours of mild bladder aches, maybe every couple of months when I pushed it too far.
This past December (2019), it got worse, to the point where I could barely move for the pain extending from my testicles all the way up to my lower back. I felt like I had to urinate, which offered partial relief but also hurt itself. I asked a pharmacist, who said yep, that's a UTI. It was not a burning-type pain, but I assumed it just manifested differently for men. Azo offered middling relief. I went to a walk-in clinic and got Bactrim DS, which had no discernible affect; however, symptoms did get better after I started abstaining from sex and caffeine.
Went to see a doctor, who confirmed prostatitis--not BPH--with digital probing, and gave me azithromycin, then levaquin, ten day courses of each. Neither had any noticeable effect beyond making me constipated. I did online research and found out that most prostatitis is not bacterial, a possibility the doc (who was elderly) did not even appear to consider. Consulted a different doc over the phone (pandemic), who said it was unusual to get non-bacterial prostatitis at my age, but said that the courses of antibiotics were too short to make a difference anyway. Suggested referral to urologist, because I refused more antibiotics. This does not act like an infection at all.
I think it might be VERY slowly self-resolving, but it's hard to tell. Haven't had a bit of caffeine since early January. Prostate is fine--I feel nothing--unless I provoke it. If I have sex once a week, I get mild and passing twinges I can ignore. More than once a week is worse, and if I compound it by holding in urine, it's still worse. Abdominal pressure from gas or bowel movements is likewise a stressor. When flares get bad, I can dispel the pain with a single ibuprofen. What I read of prostatitis sounds worse than this--but I rather miss tea, and regular sex. I'm as sure as I can be that it's not VD; I haven't strayed and my wife, morals aside, wouldn't have time, since she watches the kids.
I'd be out of pocket, so a urologist might set me back $500. I can afford it, but I'd rather not blow that kind of cash if he'll just say, "yeah, better leave it alone and it'll resolve itself." What I read about treatments for NBP sounds dismal anyway; lots of people try alternative medicine stuff because mainstream treatments don't do much. Anybody else have an experience like this?