Prevention

Chronic prostatitis cannot be prevented.

Treatment

For many years, antibiotics have been the mainstay of treatment for chronic prostatitis. Antibiotics such as trimethoprim-sulfa (Bactrim, Septra) and the fluoroquinolones ("floxacins," sold under the brand names Floxin, Cipro, Levaquin and others) are used most often to treat chronic bacterial prostatitis. Because it is difficult for antibiotics to get into the prostate gland, they must be given at high doses for an extended period, often four or more weeks.

Antibiotics often are tried in men with chronic non-bacterial prostatitis, even though symptoms may not be caused by infection. Some men may be helped by this treatment, but in many cases, antibiotics alone will not eliminate the problem.

A variety of alternative treatments are available for those men not helped by antibiotics:

• Alpha-blocker medications, such as tamsulosin (Flomax) or terazosin (Hytrin), may be prescribed to relax the muscles that control the bladder. These may relieve symptoms of urgency, hesitancy or dribbling. Similar effects may be seen with drugs that shrink the size of the prostate, including finasteride (Proscar).

• Pain relievers, anti-inflammatories and muscle relaxants may help with pain and muscle spasms. Some men find relief with warm baths or with biofeedback programs designed to reduce tension in the pelvic muscles.

• Eliminating caffeine and alcohol may reduce irritation of the bladder and prostate.

• A variety of herbal remedies may be tried, including saw palmetto, quercetin and pollen extracts.

• Some physicians recommend reducing congestion in the prostate by ejaculating more frequently or by massaging the prostate regularly.

It is important to keep in mind that few of these treatments have been proven to be effective. Chronic prostatitis probably is caused by more than one condition, and not all men will respond to the same treatment. Some men will improve on their own or with the first treatment that is tried. Others will continue to experience symptoms despite a variety of treatments.