Prostate pain when sitting is most often associated with inflammation of the prostate, or prostatitis. According to the Prostatitis Foundation, pain or discomfort, between the penis and rectum (perineum) that feels like you are sitting on a golf ball or something sharp are hallmark symptoms of prostatitis.
Bacterial Infection
According to the American Urological Association Foundation, prostatitis can have both bacterial and non-bacterial causes. Acute (temporary) and chronic (ongoing) bacterial infection occurs as a result of back flow of urine leaking into the prostate ducts. Bacterial prostatitis is not a sexually transmitted disease, nor is it contagious. Whether the infection is acute or chronic, inflammation of the prostate results in tenderness and swelling that can cause prostate pain, or pain in the perineum. According to Dr. Daniel Shoskes the Chronic Prostatitis Cohort study found that patients who chose sitting as a means of coping with prostate pain were most likely to develop disabling prostatitis pain.
Non-bacterial Infection
Non-bacterial prostatitis or chronic pelvic pain syndrome is the most common type of prostatitis. The American Urological Association Foundation says the causes of the non-bacterial infections are unknown. Theories include persistent infection by organisms such as chlamydia that are not usually found in the prostate, inflammation due to an immune system response to an injury or previous infections, or muscle spasms in the pelvis that irritate the prostate. All of these can cause perineal tenderness or discomfort that can be aggravated by prolonged sitting or activities that put pressure on the perineum such as bicycling.
Pinched Nerve
The pudenal nerve serves the genitals in both men and women, as well as the lower rectum and the perineum. In an article in the American Journal of Roetgenology by the Department of Radiology at Mayo Clinic, a pinched or compressed pudenal nerve is a recognized cause of chronic perineal pain, which is aggravated by sitting and relieved by standing. The symptoms of pudenal nerve entrapment, as it is called, are similar to those of chronic non-bacterial prostatitis. As a result it can be difficult to diagnose pudenal nerve entrapment or prostatitis.
References
- Prostatitis Foundation: The Other Prostate Problem
- American Urological Association Foundation: Causes and Management of Prostatitis
- "Chronic Prostatitis/Chronic Pelvic Pain Syndrome", by Daniel A. Shoskes, 2008; pg. 153
- "American Journal of Roentgenology", Chronic Perineal Pain Caused by Pudendal Nerve Entrapment: Anatomy and CT-Guided Perineural Injection Technique; 2003; 181:561-567
