Treatment of Prostatitis and Pelvic Pain Care in NYC 

by Alex Shteynshlyuger MD


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-3025.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.


Prostatitis and Chronic Pelvic Pain Syndrome: What You Need to Know

shutterstock 284570099 300x200 - Prostatitis and Pelvic Pain Treatment in NYC - Top Prostatitis Doctors

The urologists at New York Urology Specialists are experienced in caring for men with symptoms of “prostatitis,” including pelvic pain, penile pain, testicular pain, and urinary problems

We treat men with chronic pelvic pain syndrome, acute prostatitis, and chronic prostatitis symptoms using proven methods.  We also treat symptoms of Interstitial Cystitis (IC) and Bladder Pain Syndrome (BPS).

Correct Diagnosis is the Key To Successful Treatment

The first step is to establish a correct diagnosis.  We fully evaluate each patient to elucidate the cause of their symptoms.  If an alternative diagnosis is found, that problem is addressed first. Example of alternative diagnoses includes urethral strictures, urinary tract infections, BPH and enlarged prostate, muscular-skeletal causes, and many other diagnoses.

We utilize a rational step-wise approach to prostatitis treatment.  The goal is to establish the cause of your symptoms. If you have prostatitis, we will determine whether you have acute prostatitis or chronic prostatitis.  

A thorough diagnostic evaluation is a crucial step in treatment selection. Confirmation of the diagnosis of chronic prostatitis involves a thorough evaluation to exclude other explanations and causes for symptoms of chronic prostatitis. These can be urinary tract infection, sexually transmitted diseases, prostate infection, prostate enlargement, nerve entrapment, or musculoskeletal causes.

Once a diagnosis is made, the symptoms are classified based on severity, and a step-wise approach to treatment is initiated.  The initial treatment selected is based on the most likely etiology and symptom patterns.  Typically a few treatments will be tried over a period of time until an appropriate response to treatment is achieved.  This requires some patience.

Where to Get Treatment for Prostatitis, Perineal Pain, Pelvic Pain, and Bladder Pain in NYC?

At New York Urology Specialists, we offer same-day treatment for prostatitis and pelvic pain.  Same-day virtual video appointments and in-person appointments are available.

Call/text today: 1-212-204-6300 or make an appointment online.  

We perform scrotal surgery, penile procedures, varicocele and hydrocele repair, and circumcision.  We offer treatment for phimosis, balanitis, missing testis, low testosterone, penile irritation, and redness. We treat sexual and erection problems and offer comprehensive STD testing for infections. We offer confidential appointments.

Our appointment costs are affordable with or without insurance.  We offer free insurance verification.

We perform a bladder, kidney, and testicular ultrasound in our office.  We offer microscopic spermatic cord denervation, kidney stone treatment, pelvic pain, and prostatitis in our office.   We treat urinary and erection problems. We offer confidential appointments.

What to Expect

Our experienced urologists at New York Urology Specialists offer a comprehensive evaluation of men with prostatitis, perineal pain, and pelvic pain symptoms. Many patients with pelvic pain also experience additional symptoms such as pelvic pressure and perineal discomfort. Some men experience prostate and penile pain.

Many patients see a dramatic improvement in their symptoms after a few visits with our doctors.

Many patients come to New York Urology Specialists after trying multiple treatment approaches and seeing dozens of doctors in the past.  Due to the complexity of the underlying condition in patients who have failed multiple treatment approaches in the past, a complete evaluation is necessary. Most patients will require multiple visits and need to try a few different approaches before we can establish the most effective approach to your individual needs.

We feel that it is important to set the expectations up-front.  We are not magicians and cannot offer you all the answers during the first visit.  Many patients come to us after seeing multiple doctors and have had pain for months or years. We ask for your patience while we do our best to help you.  For many patients with long-standing pain, it takes at least a few months, multiple tests, and visits to select a treatment that works.

It is also important to understand that the choice of treatment that will be offered to you is determined by the doctors.  The order of diagnostic tests and treatments is also determined by the doctor. While you will be given options and your voice is valued, there is no room for negotiations over medical decisions made by licensed physicians.  There is no a-la-carte ordering of treatments or diagnostic tests unless medically necessary and appropriate.

About the Prostate Gland

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The prostate, a part of the male reproductive system, is about the same size and shape as a walnut and weighs about an ounce. It is located below the bladder and in front of the rectum and surrounds the urethra, the tube-like structure that carries urine from the bladder out through the penis. The main function of the prostate is to produce ejaculatory fluid.

Because of its location close to the rectum, inflammation of the prostate can also cause rectal symptoms and vice versa.

Because of its location close to the bladder and surrounding the urethra, inflammation of the prostate often causes urinary symptoms such as slow urine stream, frequent urination, need to push to urinate, and pain during urination.

 

What Makes New York Urology Specialists Different?

  1. Use of methods proven to work in high-quality scientific studies, including randomized clinical trials.
  2. Experience and innovation.

Urology Care for Men

We use such proven methods to treat chronic prostatitis as pelvic massage/trigger point therapy and alpha-reductase inhibitors that have proven to benefit patients with chronic prostatitis.  We use neuromodulator therapy for pelvic pain, which is effective for some men and women with chronic pelvic pain / interstitial cystitis syndrome.

When in need of a second opinion for chronic prostatitis and chronic pelvic pain as well as interstitial cystitis, top physicians refer to New York Urology Specialists. When we meet challenging problems – we enjoy solving them.  Dr. Shteynshlyuger has published some of the most cited papers on fungal prostatitis and atypical infections of the prostate.

Learn about prostate anatomy.  Read about causes of prostatitis.

Treatment Options for Perineal Pain at New York Urology Specialists

  • Disease-specific Treatment
  • Symptom-targeted Treatment
  • Medical therapy
  • Minimally invasive therapy
  • Pelvic Floor Physical Therapy, Prostate massage
  • Shockwave therapy
  • Trigger point injections
  • Neuromodulation
  • Surgical Treatment – diagnosis and symptom-related
  • Oral, Intravenous, Intramuscular, intra-prostatic antibiotic injections

Did you know? Dr. Shteynshlyuger has treated thousands of men with pelvic pain and bladder pain, perineal pain, penile pain, scrotal pain, testicular pain, kidney pain, prostatitis, and prostate pain.  He performs 150-200 surgeries a year.

NIH Classification of Prostatitis Symptoms: 4 Types

Prostatitis can be classified into the following 4 types based on the National Institutes of Health International Prostatitis Collaborative Network classification system.

Acute Bacterial Prostatitis

Acute bacterial prostatitis is caused by bacteria.  It is a bacterial infection of the urinary tract that involves the prostate gland.  Bacteria can be cultured from urine, prostatic secretions, or semen. It is often associated with epididymo-orchitis.  Occasionally prostatic abscesses can develop, and this requires surgical treatment.  The signs of acute prostatitis include a sudden onset of difficulty urinating, burning with urination often accompanied by fevers and chills, as well as pain in the pelvis and lower back.  Sometimes acute bacterial prostatitis may be related to sexually-transmitted diseases.  Therefore a careful evaluation and testing are necessary. Treatment with antibiotics usually resolves acute prostatitis without any long-term consequences.

  • Acute bacterial prostatitis (ABP) accounts for approximately 5% of cases of prostatitis cases and results from the growth of bacteria within the prostate gland. It is often associated with UTI or STD (sexually transmitted diseases).  Men with urinary catheters, diabetes mellitus, immunosuppression are at higher risk for bacterial prostatitis.
  • Symptoms include fever, chills, lower abdominal pain, painful, frequent and urgent urination, painful ejaculation, and the presence of blood in semen (hematospermia). It may also be associated with testicular swelling and pain.
  • A prostatic abscess is a rare manifestation of acute bacterial prostatitis. Symptoms include pain, fever, malaise, and fluid collection in the prostate detected on DRE or CT scan.  Usually, patients are hospitalized, and treatment includes intravenous antibiotics and evacuation of the abscess fluid either percutaneously or surgically by TURP.
  • Diagnosis includes physical examination (abdomen, external genitalia, perineum, and prostate) for signs of tenderness, urine culture, blood culture, and C-reactive protein test.
  • Treatment includes antibiotic therapy, either intravenous or oral antibiotics such as Bactrim, Cipro, or doxycycline. In addition to antibiotic therapy, non-steroidal anti-inflammatory drugs (NSAIDs) and alpha-blockers may offer both pain relief and more rapid resolution of symptoms.

Chronic Bacterial Prostatitis (NIH Type II Prostatitis)

Chronic bacterial prostatitis is caused by persistent infection of the prostate gland or the urinary tract. Infection tends to be less severe, with mild to moderate symptoms that typically do not include fevers and chills.  It is typically manifested by recurrent urinary tract infections, burning with urination, and pelvic pain.

The diagnosis is made by a culture of bacteria for prostatic secretions after a prostatic exam. The physical exam may reveal bogginess, fluctuance, and tenderness of the prostate. Bacteria may also be present in semen culture.  The treatment is usually antibiotics however, surgical treatment with TURP may be beneficial to some men.

  • Chronic bacterial prostatitis (CBP): It may result from ascending urethral infection, a spread of rectal bacteria or from a remote source, undertreated acute bacterial prostatitis, or recurrent urinary tract infection.
  • Symptoms include genitourinary pain or discomfort, recurrent urinary tract infections, painful and frequent urination.
  • Diagnosis includes physical examination (abdomen, external genitalia, perineum, and prostate), pre-and post-prostatic massage urine samples for analysis and culture (prostate massage is performed by stroking the prostate with firm pressure from the periphery to the midline on both the right and left sides of the prostate gland. More than 20 leucocytes per high powered field on the post-massage urine sample is suggestive of chronic bacterial prostatitis), and microbial culture.
  • Treatment: Oral antibiotic therapy with trimethoprim, cephalexin, amoxicillin-clavulanic acid. In addition to antibiotic therapy, NSAIDs may alleviate pain; alpha-blockers may diminish urinary obstruction and reduce future occurrences.

Surgical therapy is only the last resort and is used for obstructions and prostatic calculi in conjunction with a persistent bacterial presence in the prostate. Transurethral resection of the prostate (TURP) is indicated only in men whose prostatic fluid persistently grows the same bacterium and only after the confirmation of the prostatic origin of the bacterium by prostatic biopsy.

Chronic Prostatitis and Chronic Pelvic Pain Syndrome (CP/CPPS)

Chronic prostatitis/chronic pelvic pain syndrome (Also known as Nonbacterial Prostatitis and Prostatodynia)

The “chronic prostatitis / pelvic pain syndrome,” commonly abbreviated as CP/CPPS, is the most common type of prostatitis. It is very prevalent among men, in particular, younger men in their 30s to 40s and 50s.  The diagnosis of CP/CPPS is more challenging.  Chronic prostatitis/pelvic pain syndrome is manifested by persistent or recurrent pelvic pain and may or may not be associated with painful ejaculation as well as urinary symptoms. Typically urine and semen cultures do not show the growth of any organism.

Chronic Prostatitis / Pelvic Pain Syndrome is likely an amalgam of problems that share similar symptoms.  It is likely that both infectious causes, such as viral and nano-bacteria, may be involved in some cases.  Neuromuscular causes likely cause symptoms in some other patients.  Auto-immune or inflammatory responses may also underlie symptoms in some men. In many cases, a combination of causes seems to be at work. As a result, a multi-modal approach is usually most successful.

CP/CPPS is more common than either acute bacterial prostatitis or chronic bacterial prostatitis.

Causes of CP/CPPS include musculoskeletal spasms as well as increased neural sensitivity of and around the prostate. Unrecognized bacterial or viral infections and inflammatory processes may also be contributory.

A variety of treatments are available for chronic prostatitis/pelvic pain syndromePelvic floor massage has been shown to be effective in alleviating pain and symptoms.  A variety of medications that affect the nervous system and pain perception can also be used, including SSRI.

  • Symptoms can vary widely and include pelvic pain or urinary symptoms for >3 of the previous 6 months with no evidence of bacterial prostatitis or urinary tract infection at that time. Symptoms may also include one or more of the following: painful, frequent, or urgent urination, weak urinary stream; pain in the perineum, pain in the lower abdomen, testicles, or penis; hematospermia (blood in semen or sperm ejaculate).
  • Diagnosis includes physical examination (abdomen, external genitalia, perineum, and prostate), pre-and post-prostatic massage urine samples for analysis and culture (prostate massage is performed by stroking the prostate with firm pressure from the periphery to the midline on both the right and left sides of the prostate gland. More than 20 leucocytes per high powered field on the post-massage urine sample is suggestive of chronic bacterial prostatitis (CBP) and microbial culture.
  • Treatment approaches vary but may include physical therapy with trigger point release, SSRI,  alpha-blockers (tamsulosin, alfuzosin, silodosin), and sometimes antibiotics used alone or in combination appear to have the greatest improvement. In addition, anti-inflammatory medications may also be useful.[1,2,5]

Asymptomatic Inflammatory Prostatitis

Asymptomatic inflammatory prostatitis is a pathological diagnosis usually made from the prostate biopsy specimen. The man is typically asymptomatic (has no symptoms), and no further evaluation nor treatment is necessary.

Asymptomatic inflammatory prostatitis (AIP): It is inflammation of the prostate in the absence of genitourinary tract symptoms (asymptomatic). It is often diagnosed incidentally during the evaluation of elevated PSA or abnormal DRE during prostate biopsy. The clinical significance of this type of prostatitis is unknown and is usually left untreated.  It may contribute to PSA elevation.

Cost of Pain Treatment without Insurance

At New York Urology Specialists, we offer affordable treatment for pain. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. 

At New York Urology Specialists, we offer flat-fee ‘all-cost-included’ procedures such as scrotal and testicular surgery, trigger-point injections, pelvic floor physical therapy, circumcision, spermatic cord denervation, kidney stone removal, vasectomy reversal, hydrocelectomy, varicocelectomy, clitoral phimosis hoodplasty, vulvodynia, vestibulodynia, lichen sclerosus, and many more.  Many procedures are performed in our office under local anesthesia or sedation. Men and women from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment.  Please contact us for current prices and discounts for patients without insurance or with high insurance deductibles.

Cost of Treatment and Insurances

Inexpensive Urologist Visit Cost At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. 

We accept many health insurance plans.  We would be happy to verify your eligibility and benefits and provide you with detailed information on your health plan’s coverage.  Financing options and credit options are available to help you pay for medical care.

Why Choose New York Urology Specialists for Treatment of Prostatitis and Pelvic Pain?

  • All treatment is performed by a board-certified urologist experienced in treating men and women with pelvic pain, chronic pelvic pain syndrome (CPPS), and perineal pain symptoms. We also treat pain in the urinary tract, external genitalia, kidneys, bladder, and prostate.  We treat scrotal and testicular pain, and urinary problems using medical therapy, minimally invasive therapies, lasers, and surgery.  We also treat bladder pain syndrome and interstitial cystitis (IC/PBS). 
  • We are one of the few practices in the region to offer a full range of options for the treatment of genital pain and urinary pain in men and women.
  • We offer treatment options for testicular pain, penis pain, painful urination in our office.  Office procedures avoid the risks, costs, and recovery from general anesthesia.  
  • We offer diagnostic testing in our office, which avoids hospital costs.
  • Extensive experience: Thousands of men and have been treated successfully for pain symptoms in the kidneys, bladder, pelvis, perineum, and genital areas.
  • Confidential and Understanding Care. We understand that most of our patients desire privacy.  We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
  • We are conveniently located within a 30-60 minute commute to men and women who are seeking treatment for chronic pelvic pain, bladder pain, and perineal pain.  We treat men with testicular pain, epididymitis, testicular torsion, post-vasectomy pain, and penile pain in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

What do Prostatitis Pain Problems Look Like?

You can find pictures of painful conditions as well as before and after treatment images in our image gallery.

Scheduling Appointments for Prostatitis, Pelvic and Perineal Pain Treatment at New York Urology Specialists


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-3025.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.

Dr. Shteynshlyuger MD is a board-certified urologist in NYC who specializes in treating men and women with pelvic pain, urinary pain, perineal pain, as well as chronic pelvic pain, and interstitial cystitis.   He has performed hundreds of bladder, penile and testicular surgeries for relief of pain and other symptoms.  


Patients Reviews

Overall Rating:

4

Total Ratings

4

Total Reviews

14

Ratings

Ease of Appointment: Bedside Manner:
Promptness: Spends Time with Me:
Courteous Staff: Follows Up After Visit:
Accurate Diagnosis:

Buen doctor
by on Jan 14, 2020

Muy buen doctor. Y sobre todo el personal muy amable se preocupan por uno buen servicio

Recommendation
by on Jul 18, 2019

Therefore I would like to recommend you to anyone who need your services.

Care at NY Urology Specialists
by on Jul 06, 2019

I am a 54 year-old male who is extremely happy with my care at New York Urology Specialists. I came to see Dr. Alex out of near desperation after consulting with three other urologists. Literally over one night, I began experiencing severe penile pain and burning. None of the other urologists were able to help diagnose what my problem was and seemingly didn't take my problem very seriously. In fact, one of them specifically told me at it had nothing to do with my prostate. After 6 weeks of suffering, I saw Dr. Alex. He examined me and gave me some tests and lab work. He very quickly ascertained that my problem was due to an enlarged prostate. He proscribed medicine to deal with my pain in the short-term and keep my prostate size in check over the long-term. My problem quickly disappeared. Today, 5 years later, I feel great. Dr, Alex listens to you as a patient, takes your opinion and health concerns seriously and knows his field inside-and-out so that you can get proper treatment for your problem. I can't thank him enough for diagnosing and solving my malady - you sometimes can't appreciate a problem until you have it. Getting rid of it and getting back to normal is so important - I am so glad that I saw Dr. Alex for my problem.

My experience
by on Nov 08, 2018

I had a Rezum procedure done a couple of months ago and now my symptoms have improved and quality of life has significantly changed. The Doctor and staff are excellent and I am very satisfied with the services - the surgery and post care. Would highly recommend Dr. Shteynshlyuger.

Friendly , courteous, effiecient and professional
by on Sep 15, 2018

Wyts Wyts recommends New York Urology Specialists via Facebook. September 15, 2018 · Friendly , courteous, effiecient and professional staff members. This office i highly recommend for any and all Urology matters. Dr Alex Shteynshlyuger is very professional and knowledgable easy to communicate with. Thanks Dr Alex

Review
by on Aug 16, 2018

Outstanding service

urology services
by on Apr 11, 2018

I am very satisfied with the treatment I received at new york urology specialist and would recommend them to other patients.they are the very best.

Review
by on Nov 19, 2017

I am writing to thank dr. Alex. He is thorough, professional, knowledgeable, helpful and friendly. I have seen him for ED and prostate issues, and he has explained all my options clearly, and found solutions that have been a great help. thank you! I highly recommend both Dr. Alex and his staff, which I find to be helpful, friendly, knowledgeable and very professional. They are a pleasure to deal with and all have been a great help.

Dr visit
by on Sep 14, 2017

I am very much thankful for meeting Dr Alex .I had a very serious medical problem I visited many doctors but none could not help me it was very difficult for me until I visited Dr Alex after a couple visits my medical problem is no more I feel very great also I felt almost 20 years younger Dr Alex is second to none fantastic doctor. Thanks again Dr Alex from my family.

Excellent doctor
by on Jul 03, 2014

I am feeling better now after visiting clinic New York urology specialists. Excellent staff and appointment on time.

My cramps and burning are gone
by on May 23, 2013

Dear Dr. Alex – Since starting the [treatment], my cramps and burning have mostly gone. The biggest benefit is my leaking has been reduced to the lowest amount in almost 10 years. Charles M. Date: 2013

Thank you for excellent care
by on Jan 07, 2013

Dear Dr. Alex: We want to thank you for the excellent care you provided for George during his emergency operation and the follow up treatment. Your quiet, confident manner was reassuring to us during a very scary time for us. We will never forget you. George Sally R. Date: 2013

We appreciate all that you did to help my dad
by on Sep 17, 2012

Dear Dr. Alex – I just wanted to write you a note to thank you for all of the care you have gave to my father during his illness. We appreciate all that you did to help my dad through his illness. We wanted to be sure to let you know how much it meant to us. Sincerely Joanne R.

We love you!
by on Feb 16, 2012

Dr. Alex Shteynshlyuger and Staff – Thank you so much for taking care of my husband Bob. Dr. Alex: I thank God everyday for you. You were an answer to prayer.

Treatment for Men With Fast Recovery at New York Urology Specialists

Excellence-Urology_Care-banner2At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of men’s health concerns including pain leading to sexual problems and urinary problems in men.  We understand the challenges that penile problems and testicular problems create for our patients, their relationships, and their self-esteem.  We help you find a treatment for penile problems and testicular problems, including appearance concerns, foreskin problems, premature ejaculation, testicular pain, and erectile dysfunction that fit your needs, lifestyle, and preferences.

Urologists are doctors specializing in the treatment of men with sexual problems that include penis problems, scrotal problems, and erectile dysfunction. By virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for any problem that affects the penis.  We offer medical and surgical treatment for men’s sexual problems.

We Treat Some of the Most Complex Pain Problems Including:

dr alex about banner large Copy 300x176 - Prostatitis and Pelvic Pain Treatment in NYC - Top Prostatitis DoctorsSchedule an Appointment with Dr. Shteynshlyuger:

Call/text today: 1-212-204-6300 or make an appointment online

Dr. Shteynshlyuger is a fellowship-trained board-certified urologist with expertise in the evaluation and treatment of sexual, urinary, and erection problems in men.  He uses modern, effective, and proven treatment methods.  We offer circumcision, circumcision revision, penile frenuloplasty, penoscrotal web repair, testicular implants, inflatable penile implant, shockwave therapy for ED, and treatment for Peyronie’s disease. We perform procedures such as Botox for OAB, Interstim neuromodulation, Rezum for BPH, prostate enucleation for enlarged prostate, and Urolift procedure.  

He has successfully treated hundreds of men with an enlarged prostate, testicular problems, low testosterone, erection problems with symptoms of frequent urination during the day, and excessive urination at night.

He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-3025.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Same-day virtual video appointments and in-person appointments are available.