Prostatitis - chronic

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Male reproductive anatomy

Chronic bacterial prostatitis

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

MEDICATIONS:

Chronic prostatitis is treated with an extensive course of antibiotics. Trimethoprim-sulfamethoxazole (Bactrim) and ciprofloxacin (Cipro) are commonly used. Other antibiotics that may be used include:

• Tetracycline
• Carbenicillin
• Erythromycin
• Nitrofurantoin

The course of antibiotic therapy is long -- frequently 6 to 8 weeks -- but may be continued much longer. Most antibiotics are not able to adequately penetrate the prostate tissue. Often, infectious organisms persist despite long periods of treatment.

After antibiotic treatment has ended, recurrence of symptoms is common.

Stool softeners may be recommended to reduce the discomfort associated with bowel movements.

SURGERY:

Transurethral resection of the prostate may be necessary if antibiotic therapy is unsuccessful or recurrence occurs frequently. This surgical treatment is usually not performed on younger men because it carries potential risks of sterility, impotence , and incontinence .

OTHER THERAPY:

Frequent and complete urination is recommended to decrease the symptoms of urinary urgency. If the swollen prostate restricts the urethra, the bladder may not empty. Insertion of 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 food and beverages, 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.

Recurrence of symptoms is common.

If the enlarged prostate restricts the flow of urine through the urethra, urinary retention may cause kidney damage.

Call your health care provider if symptoms of chronic prostatitis occur.

Review Date: 06/14/2006
Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.