Prostatitis; chronic

Treatment:

Most antibiotics are not able to adequately penetrate the prostate tissue. Often, infectious organisms continue to persist in the prostatic tissue despite treatment. Once antibiotic treatment has ended, often the person may develop a recurrence of symptoms.

MEDICATIONS:
Chronic prostatitis is treated with an extensive course of antibiotics. Trimethoprim-sulfamethoxazole and tetracycline derivatives are commonly used. Other antibiotics that may be used include:

• carbenicillin
• erythromycin
• nitrofurantoin

The course of antibiotic therapy is long, frequently 6 to 8 weeks and recurrence is common.

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

SURGERY:
Transurethral resection of the prostate may be done if antibiotic therapy is unsuccessful. This surgical treatment is usually not performed on younger men because it carries potential risks for sterility, impotence, and incontinence.

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 expected to be better than for chronic prostatitis.

Complications:

Urinary retention may occur as a result of an enlarged prostate occluding the urethra.

Calling your health care provider:

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