Chronic bacterial prostatitis medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Treatment options for chronic prostatitis include a combination of medication, surgery, and lifestyle changes.
Medical Therapy
Pharmacotherapy
Chronic prostatitis is treated with a long course (6 - 12 weeks or longer) of antibiotics. Trimethoprim-sulfamethoxazole (Bactrim or Septra) and ciprofloxacin (Cipro) are commonly used. Other antibiotics that may be used include:
Most antibiotics do not get into the prostate tissue well. Often, the infection continues even after long periods of treatment. After antibiotic treatment has ended, it is common for symptoms to return.
Sometimes small stones form in the prostate gland, making it harder to clear the infection.
Stool softeners may be recommended to reduce discomfort with bowel movements.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aleve and Motrin and alpha adrenergic blockers such as doxazosin (Cardura), tamsulosin (Flomax), or terazosin (Hytra) may also be used.
Follow-up
See your health care provider for an exam after you finish taking antibiotics to make sure that the infection is gone.
Non-Pharmacotherapy
Frequent and complete urination is recommended to decrease the symptoms of urinary urgency. If the swollen prostate restricts urine flow through the urethra, the bladder may not empty. Inserting a suprapubic catheter, which allows the bladder to drain through the abdomen, may be necessary.
Diet
Avoid substances that irritate the bladder, such as alcohol, caffeinated beverages, citrus juices, and hot or spicy foods.
Increasing the intake of fluids (64 - 128 ounces per day) encourages frequent urination. This will help flush bacteria from the bladder.
Prostate Massage
The addition of prostate massage to courses of antibiotics was previously proposed as being beneficial.[1][2] However, in more recent trials, this was not shown to improve outcome compared to antibiotics alone.[3]
References
- ↑ Nickel JC, Downey J, Feliciano AE, Hennenfent B (1999). "Repetitive prostatic massage therapy for chronic refractory prostatitis: the Philippine experience". Techniques in urology. 5 (3): 146–51. PMID 10527258.
- ↑ Shoskes DA, Zeitlin SI (1999). "Use of prostatic massage in combination with antibiotics in the treatment of chronic prostatitis". Prostate Cancer and Prostatic Diseases. 2 (3): 159–162. doi:10.1038/sj.pcan.4500308. PMID 12496826.
- ↑ Ateya A, Fayez A, Hani R, Zohdy W, Gabbar MA, Shamloul R (2006). "Evaluation of prostatic massage in treatment of chronic prostatitis". Urology. 67 (4): 674–8. doi:10.1016/j.urology.2005.10.021. PMID 16566972.