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Prostatitis - nonbacterial - chronic - Treatment

Alternative Names

NBP; Prostatodynia; Pelvic pain syndrome; CPPS; Chronic nonbacterial prostatitis; Chronic genitourinary pain

Treatment:

Treatment for nonbacterial prostatitis is difficult. The goal is to control symptoms, because a cure is difficult to achieve.

MEDICATIONS:

Many patients are treated with long-term antibiotics to make sure that bacteria are not causing their prostatitis. However, patients who have had symptoms for a long period of time and do not seem to benefit from antibiotics should stop taking them.

See: Chronic bacterial prostatitis

Medications called alpha-adrenergic blockers help relax the muscles of the prostate gland. They include:

  • Doxazosin (Cardura)
  • Tamsulosin (Flomax)
  • Terazosin (Hytrin)

It usually takes about 6 weeks before these medicines start working.

Aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs) may relieve symptoms in some patients.

Some people have had limited success with pollen extract (Cernitin) and allopurinol. Stool softeners may be recommended to reduce discomfort with bowel movements.

SURGERY:

Transurethral resection of the prostate may be done in rare cases if medical therapy is not successful. This surgery is usually not performed on younger men, because it may cause retrograde ejaculation, which can lead to sterility, impotence, and incontinence.

OTHER THERAPY:

Warm baths may help relieve some of the perineal and lower back pain. A number of other therapies have been used, such as prostatic massage, acupuncture, and relaxation exercises. However, none of these therapies have been proven beneficial.

Expectations (prognosis):

Many patients respond to treatment. However, others do not get relief even after many attempts at treatment. Symptoms often come back after treatment, and may eventually not be treatable.

Complications:

Untreated symptoms of nonbacterial prostatitis may lead to sexual and urinary problems, which can affect your lifestyle and emotional well-being.

Calling your health care provider:

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

  • Reviewed last on: 9/30/2009
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Nickel JC. Inflammatory conditions of the male genitourinary tract: Prostatitis and related conditions, orchitis, and epididymitis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 9.

Barry MJ, McNaughton-Collins M. Benign prostate disease and prostatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 130.

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