Prostatitis - acute

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Male reproductive anatomy

Most cases of acute prostatitis clear up completely with medication and slight modification of diet and behavior.

MEDICATIONS:

Prostatitis is treated with antibiotics, most often trimethoprim-sulfamethoxazole (Bactrim), fluoroquinolones (Floxin or Cipro), and tetracycline derivatives.

For men with prostatitis caused by an STD, a 250 mg shot of ceftriaxone followed by a 10-day course of doxycycline or ofloxacin. For other bacterial causes, a standard course of treatment consists of Bactrim, Cipro, or Floxin for at least 4 weeks.

Because recurrence is common, some health care providers recommend even longer therapies -- 6 to 8 weeks -- to eliminate the infection. In severe cases, hospitalization and intravenous (IV) antibiotics may be required .

Stool softeners may reduce the discomfort associated with bowel movements.

SURGERY:

Surgery or urethral instrumentation (urinary catheterization or cystoscopy) are not recommended for patients with acute prostatitis.

OTHER THERAPY:

Frequent and complete urination is recommended to decrease the symptoms of urinary frequency and urgency.

If the swollen prostate restricts the urethra, it may be difficult to completely empty the bladder, and insertion of a suprapubic catheter (a drain that empties the bladder through the abdomen) may be necessary.

Warm baths may provide some relief of the perineal and lower back pain associated with acute prostatitis.

DIET:

Avoid substances that irritate the bladder, such as alcohol, caffeinated food and beverages, and citrus juices, and hot or spicy foods.

Increasing the intake of fluids (64 to 128 ounces per day) encourages frequent urination that will help flush the bacteria from the bladder.

MONITORING:

Follow-up should include an examination at completion of antibiotic therapy to ensure that infection is no longer present.

The majority of men who are accurately diagnosed with acute prostatitis become symptom-free after treatment.

Patients who have had acute prostatitis are prone to recurrence and are likely to develop chronic prostatitis.

Chronic prostatitis can develop. Urinary retention may occur as a result of the swollen prostate occluding the urethra.

Call your health care provider if symptoms of prostatitis occur.

Review Date: 06/13/2006
Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.