Prostatitis; acute

Treatment:

Mild cases of acute prostatitis may resolve completely with appropriate treatment.

MEDICATIONS:
Prostatitis is treated with antibiotics. Trimethoprim-sulfamethoxazole and tetracycline derivatives are commonly used. The course of antibiotic therapy is long, frequently 6 to 8 weeks and recurrence is common. In severe cases, broad spectrum intravenous (IV) antibiotics may be required while waiting for prostatic fluid culture results.

Stool softeners (such as colace) may be recommended to reduce the discomfort associated with bowel movements.

SURGERY:
Surgery or urethral instrumentation (urinary catheterization or cystoscopy) are not recommended in the presence of an acute prostatitis.

OTHER THERAPY:
Frequent and complete urination is recommended to decrease the symptoms of urinary frequency and urgency. Urinary retention, requiring the placement of a suprapubic catheter, may occur as a result of the swollen prostate occluding the urethra.

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

Preventive measures may reduce symptoms and may prevent recurrence of infection. Cleanliness of the genital area may help reduce the chances of introducing bacteria through the urethra. The genitals should be cleaned and wiped from front to back to reduce the chance of dragging E. coli bacteria from the rectal area to the urethra.

DIET:
Increasing the intake of fluids (2000 to 4000 cc per day) may allow frequent urination to flush the bacteria from the bladder and decrease urinary symptoms. Avoid fluids that irritate the bladder, such as alcohol, citrus juices, hot or spicy foods, and caffeine.

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

Expectations (prognosis):

The outcome for acute prostatitis is usually better than for chronic prostatitis. The majority of men who are diagnosed accurately become symptom-free after treatment.

Complications:

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

Calling your health care provider:

Call for an appointment with your health care provider if symptoms of prostatitis occur.