What Is Chronic Prostatitis?
Chronic prostatitis, particularly chronic pelvic pain syndrome (CPPS), is one of the most common and most difficult-to-treat urological conditions in men. It is estimated to affect up to 15% of men at some point in their lives, with the highest prevalence between the ages of 30 and 50.
The term “chronic” reflects the reality of the condition: most patients experience symptoms for months or years without meaningful relief from conventional treatments.
Clinically, it presents with a combination of pelvic pain, which may be felt in the perineum, rectum, testicles or penis, dysuria, urinary frequency, sexual dysfunction and psychological distress.
Its cause remains complex. In many cases, no bacterial cause is identified, and the condition is attributed to a combination of neuromuscular dysfunction, immune activation and local ischaemia.
Characteristics of Chronic Prostatitis
A central pathophysiological feature of chronic prostatitis, and one of the reasons it is so difficult to treat, is the inadequate blood supply to the prostate. The gland naturally has limited microcirculation, which may deteriorate further in the presence of chronic inflammation.
As a result, antibiotics may not reach sufficient concentrations within the gland, inflammatory cytokines accumulate without being cleared effectively and the tissue becomes trapped in a state of persistent inflammation.
The resulting local hypoxia favors anaerobic bacteria, impairs white blood cell activity and creates an environment of neural sensitization that may explain persistent pain even in the absence of active infection. This cycle of ischaemia, inflammation and pain are a central therapeutic target.
Scientific Studies
Clinical studies evaluating hyperbaric oxygen therapy in patients with chronic prostatitis or CPPS have reported significant reductions in pelvic pain, improvements in urodynamic parameters and better sexual function.
Of particular interest is the reported reduction in the NIH Chronic Prostatitis Symptom Index (NIH-CPSI), the established measure of symptom severity, among patients who had not responded adequately to antibiotic or anti-inflammatory treatment.
Increased oxygen tension within prostatic tissue, improved antibiotic penetration, bactericidal activity against anaerobic pathogens and suppression of inflammation are the documented mechanisms that may explain the clinical benefit.
The Role of Hyperbaric Oxygen Therapy
In chronic prostatitis, hyperbaric oxygen therapy may be used as an adjunctive option, particularly in patients who have not responded adequately to antibiotic treatment or who have a non-bacterial form of the condition, such as CPPS. It does not replace urological assessment or pharmacological management.
Each session improves oxygen delivery to prostatic tissue, creating unfavorable conditions for anaerobic pathogens while supporting white blood cell activity.
Its anti-inflammatory effects may also reduce the cytokines that sustain pain and neural sensitization. Over the longer term, neovascularisation may improve the gland’s microcirculation and reduce the risk of recurrence.
A typical treatment course consists of 20 to 30 sessions planned in collaboration with the urologist.