Treatment:

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

MEDICATIONS

Chronic prostatitis is treated with a long course (6 - 12 weeks or longer) of antibiotics. Trimethoprim-sulfamethoxazole (Bactrim) and ciprofloxacin (Cipro) are commonly used. Other antibiotics that may be used include:

• Carbenicillin
• Erythromycin
• Nitrofurantoin
• Tetracycline

Most antibiotics do not get into the prostate tissue well. Often, the infection continues even after long periods of treatment. After antibiotic treatment has ended, it is common for symptoms to return.

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

Nonsteroidal anti-inflammatory medications (NSAIDs such as Aleve and Motrin) and alpha blockers (such as Hytrin, Flomax, and Cardura) may also be used.

SURGERY

Transurethral resection of the prostate may be necessary if antibiotic therapy is unsuccessful or the condition keeps returning. This surgery is usually not performed on younger men because it carries a risk of retrograde ejaculation, which can lead to sterility, impotence, and incontinence.

Prostate massage and myofascial release are other treatments that may help this condition.

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. Inserting 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 beverages, citrus juices, and hot or spicy foods.

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

MONITORING:

See your health care provider for an exam after you finish taking antibiotics to make sure that the infection is gone.

Expectations (prognosis):

It is common for symptoms to return.

Complications:

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

Calling your health care provider:

Call your health care provider if you have symptoms of chronic prostatitis.