Prostatitis Treatment

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Bacterial Prostatitis Treatment

With the bacterial forms of prostatitis the treatment goal is to eradicate the bacteria with antibiotics. This will usually involve taking an oral antibiotic prescription at home, but if the infection is severe, your doctor may order IV infusions in the hospital.

The antibiotics used for acute bacterial prostatitis treatment include:

Avelox (moxifloxacin)

Bactrim (trimethoprim-sulfamethoxazole (TMP-SMX))

Geocillin (carbenicillin)

Cipro (ciprofloxin)*

Levaquin (levofloxacin) Read more on prostatitis and levofloxacin

Rocephin (ceftriaxone)

Sumycin (tetracycline)

If pain is an issue, you may also be given pain medication.

*Ciprofloxacin is a fluoroquinolone antibiotic that is prescribed to treat a wide variety of bacterial infections, including those that cause bacterial prostatitis. Read more on Cipro for prostatitis

Nonbacterial Prostatitis Treatment/Chronic Pelvic Pain Syndrome

Nonbacterial prostatitis/chronic pelvic pain syndrome is the most difficult type of prostatitis to treat. Doctors will often prescribe antibiotics just to make sure they catch any bacteria that may be present, but if you really have nonbacterial prostatitis, the antibiotics naturally won’t do anything to help. That’s when doctors often turn to other medications,  including alpha-blockers and 5-alpha reductase inhibitors, which are also used to treat benign prostatic hypertrophy (BPH).

Alpha blockers (see Medications for BPH) work by relaxing the muscles in the prostate and the neck of the bladder so that urine flows more easily. Use of 5-alpha reductase inhibitors can slow the growth of the prostate and may even cause it to shrink by altering the actions of certain male hormones.

Other medications have proven to be less effective, but they can be helpful for some patients. Short-term use of cyclooxygenase type-2 drugs (e.g., celecoxib [Celebrex]), for example, may provide modest pain relief and an improvement in quality of life, although long-term use of these drugs is not recommended. (Nickel 2003; Canale 1993) During the early stages of chronic prostatitis/chronic pelvic pain syndrome, short-term use of nonsteroidal anti-inflammatory drugs may offer very modest relief. (Anothaisintawee 2011)

Other possible alternatives include baclofen (Lioresal), a skeletal muscle relaxant that showed some benefit in one study of men who had chronic nonbacterial prostatitis. (Osborn 1981) Other muscle relaxants that could be helpful include diazepam (Valium) and cyclobenzaprine (Flexeril). There is some evidence that tricyclic antidepressants (e.g., amitriptyline [Elavil], doxepin [Sinequan]) and gabapentinoids (e.g., gabapentin [Neurontin], pregabalin [Lyrica]) can help men who have a chronic pelvic neuropathic type of pain. (Pontari 2010)

Alternative and Natural Prostatitis Treatment

Numerous studies have been done on the effectiveness of alternative therapies for prostatitis treatment, including supplements, acupuncture, biofeedback, trigger point release therapy, exercise, high frequency stimulation, heat therapy (hyperthermia), homeopathy, prostatic massage, and reflexology. There are also a number of steps you can take to reduce your risk of getting prostatitis as part of your daily lifestyle.

More on Natural and Alternative Prostatitis Treatment

Supplements for Prostatitis Treatment

Several natural supplements are especially helpful if you have prostatitis as they can assist in reducing both inflammation and the symptoms associated with this disorder. Supplements that have been proven to be effective in clinical trials include Saw Palmetto, Quercetin, Rye grass pollen, Vitamin D, Zinc, indole-3-carbinol (DIM), Beta- sistosterol, Pygeum africanum, Stinging Nettle Root and Green tea extract but some have the potential to be harmful to prostate health, such as calcium. You need to be aware of all the facts about supplements so you can make an informed choice about what supplements you take and take them in the correct clinical dosage that has proven to be effective in the research studies.

Top Supplements for Prostatitis
Vitamin A, Carotenoids Reduce Lower Urinary Tract Symptoms

Surgery for Prostatitis Treatment

A minority of men fail to experience sufficient relief from nonsurgical prostatitis treatments. One group of men includes those with treatment-resistant chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS; category 3 prostatitis). In addition to the symptoms typically associated with this condition, these men also frequently report depression, fatigue, weakness, malaise, irritable bowel, and cognitive impairment. For these patients, a surgical procedure may be necessary for relief. One such procedure that has proven effective is minimally invasive laparoscopic radical prostatectomy (removal of the prostate).

The results of a study published in April 2011 in UroToday International Journal are an example of successful treatment of treatment-resistant category 3 prostatitis with laparoscopic prostatectomy. Unlike traditional radical prostatectomy, which requires a large incision and a long recovery period, laparoscopic prostatectomy involves tiny incisions, faster recovery, less pain, and less risk of infection.

The study included six men (average age, 48.5 years) with severe, treatment-resistant chronic prostatitis who were part of an ongoing Phase II clinical trial. Prior to surgery, the median Chronic Prostatitis Symptom Index (CPSI) score was 35. By 6 months postsurgery, the score was 10, and by month 12, the CPSI score was 7.5. The study’s authors noted that their results are preliminary, and that laparoscopic radical prostatectomy “should be seen as potentially appropriate as a treatment of last resort for those patients who have failed many other options.” (Krongrad 2011)

Infrequently, surgery may be necessary to treat chronic bacterial prostatitis that does not respond to long-term antibiotic treatment and in men who experience recurring urinary tract infections. Surgery may be performed to remove part of the prostate or to remove infected stones (prostatic calculi). This procedure, called transurethral resection of the prostate (TURP), involves removing part of the prostate gland through the urethra using a long, thin tube (cystoscope). TURP is not often performed for prostatitis, as it does not always cure the infection and can even make symptoms worse. Read more on TURP

Reference: Krongrad A, Lai S. Laparoscopic prostatectomy for severely symptomatic, treatment-refractory chronic prostatitis: preliminary observations from an ongoing Phase II clinical trial. UroToday Intl J 2011 Apr; 4(2): art 30. doi:10.3834/uij.1944-5784.2011.04.12

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See also

101 Ways to Love Your Prostate
46 Things to Avoid for Prostate Health
Cranberry and Prostate Health

References

Anothaisintawee T et al. Management of chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis. JAMA 2011; 305:76-86.

Canale D et al. Use of a novel non-steroid anti-inflammatory drug, nimesulide, in the treatment of abacterial prostatovesiculitis. Andrologia 1993; 25:163-66.

Nickel JC et al. A randomized, placebo controlled multi-center study to evaluate the safety and efficacy of rofecoxib in the treatment of chronic nonbacterial prostatitis. J Urol 2003; 169:1401-45.

Osborn DE et al. Prostatodynia–physiological characteristics and rational management with muscle relaxants. Br J Urol 1981; 53:621-23.

Pontari MA et al. A randomized placebo-controlled multicenter trial of pregabalin for the treatment of men with chronic prostatitis/chronic pelvic pain syndrome. Arch Intern Med 2010; 170:1586-93.