I'm currently 3 years in. My worst causes of pain are sex/ejaculation, prolonged sitting and caffeine. Probably in that order. But it took a long while to figure that out.
I'm currently on nortryptiline. I've tried alpha blockers, antibiotics. Had a cystoscopy, MRI (which confirmed inflammation and prostatitis). Physio and counselling did help a bit but I still get bad days quite often. Waiting for prostatic massage as the specialists next shot at it.
I would really encourage physio and internal trigger point release. It was the only thing that seemed to take a positive step forward. But I had to pay private and travel quite far to get it as it's massively underrepresented area of physio for men. Also managing stress and anxiety.
I honestly would have mine removed if they'd let me do it. Purely because of the number of people I've read saying it either massively helped or solved the issue entirely. Also the years I've had it and the persistency. I'm 37, my partner and I don't want kids and I'd be willing to risk the side-effects at this point. Plus, I'd not need to get the tubes tied which I keep putting off!