Monday, December 22, 2014

Prostatitis - chronic

Table of Contents

Alternative Names

Chronic bacterial prostatitis


Treatment

Treatment options for chronic prostatitis include a combination of medication, surgery, and lifestyle changes.

MEDICATIONS

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:

  • Carbenicillin
  • Erythromycin
  • Nitrofurantoin
  • Tetracycline

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.

SURGERY

Transurethral resection of the prostate may 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.

OTHER THERAPY:

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.

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Review Date: 09/30/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)