Prostatitis Treatment

Prostatitis is swelling and irritation (inflammation or infection) of the prostate gland.  There are three types of prostatitis: 1. Acute infectious prostatitis, 2. Chronic infectious prostatitis, 3. Noninfectious prostatitis

Prostatitis is rare in young boys. Men ages 20 – 35 who have multiple sexual partners are at an increased risk. Also at high risk are those who engage in anal intercourse, especially without using condoms. Men age 50 or older who have an enlarged prostate (benign prostatic hyperplasia) are at increased risk for prostatitis due to their risk of urinary tract infection.

Because the treatment is different for the three types of prostatitis, the correct diagnosis is very important. Prostatitis can usually be treated with antibiotics, massage of the prostate or operations. Three types of drugs are usually employed in “Chronic Prostatitis”

• ANTIBIOTICS:
  Indicated in patients with Chronic Bacterial Prostatitis (extended treatment for several weeks). Most urologists try them independently from the presence of bacteria, which seems not very rational and has been critisized by researching urologists. Every urologist active in the field has, however, seen a certain percentage of his clientele without evidence of bacteria in the exprimate, especially NBP-patients, improving after a course of antibiotics (possibly because in some patients the concentration of microorganisms is too low to show up in the culture, but enough to maintain a low intensity inflammation). If indicated, most urologists would agree on a medium-term course of 3 weeks, in some cases 2-3 months or even longer if there is persistent evidence of infection. Later generation quinolones, especially those with activity against Chlamydia, are generally preferred, nowadays. Another antibiotic effective in this condition (i e able to enter the inflamed prostatic tissue) is trimetoprim-sulfamethoxazole.
• ANTIPHLOGISTICS:
  Anti-inflammatory drugs are often beneficial in reducing edema and pain and are often combined with antibiotics. Examples: ketoprofene, diclofenac. Draw-back: they often cause an inflammatory reaction of the stomach and are definitively contra-indicated in individuals with ulcer and gastritis.
• ALPHA-BLOCKERS:
  alfuzosine and terazosine are useful to improve relaxation of the smooth muscle cells, especially if there are irritative symptoms of the bladder neck (hesitancy, poor stream, frequent voiding).