Prostatitis - bacterial chronic
Chronic bacterial prostatitis
Treatment options for chronic prostatitis include a combination of medication, surgery, and lifestyle changes.
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 medications, NSAIDs such as Aleve and Motrin, and alpha adrenergic blockers, such as doxazosin (Cardura), tamulosin (Flomax), or terazosin (Hytra), may also be used.
Transurethral resection of the prostatemay be necessary if antibiotic therapy is unsuccessful or the condition keeps returning. This surgery is usually not performed on younger men because it carries a risk of retrograde ejaculation, which can lead to sterility, impotence, and incontinence.
Prostate massage and myofascial release are other treatments that may help this condition.
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.
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.
See your health care provider for an exam after you finish taking antibiotics to make sure that the infection is gone.
It is common for symptoms to return.
If the prostate is very large, it can slow urine flow through the urethra and cause the backward flow (reflux) of urine toward the kidneys, which can cause kidney damage.
If the flow of urine completely stops, it is considered an emergency.
Calling your health care provider
Call your health care provider if you have symptoms of chronic prostatitis.