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Chronic prostatitis/chronic pelvic pain syndrome - pharmacological treatment


There is a substantial list of medications used to treat this disorder. Some of them are:

  • Quercetin has shown effective in a randomized, placebo-controlled trial in chronic prostatitis using 500 mg twice a day for 4 weeks Subsequent studies showed that quercetin, a mast cell inhibitor, reduces inflammation and oxidative stress in the prostate.
  • Pollen extract (Cernilton) has also been shown effective in randomized placebo controlled trials.
  • At least one study suggests that multi-modal therapy (aimed at different pathways such as inflammation and neuromuscular dysfunction simultaneously) is better long term than monotherapy.
  • Commonly used therapies that have not been properly evaluated in clinical trials although there is supportive anecdotal evidence are dietary modification, gabapentin, benzodiazepines and amitriptyline.
  • Therapies shown to be ineffective by randomized placebo/sham controlled trials:

    • Levaquin - antibiotics are generally not recommended. Any improvement on antibiotics is likely to be evanescent, and due to the anti-inflammatory effects of the antibiotic.
    • Alpha blockers for 6 weeks or less. The effectiveness of alpha blockers (tamsulosin, alfuzosin) is questionable in men with CPPS. A 2006 meta analysis found that they are moderately beneficial when the duration of therapy was at least 3 months. However a 2004 trial found no benefit from alfuzosin during 6 weeks of treatment and a 2008 clinical trial of alfuzosin found it was no better than placebo for treating CPPS in treatment naive recently diagnosed men.
    • Transurethral needle ablation of the prostate (TUNA)

Other articles from the section: Prostatitis

Acute prostatitis - treatment

  Antibiotics are the first line of treatment in acute prostatitis. Antibiotics usually resolve acute prostatitis infections in a very short time. Appropriate antibiotics should be used, based on the microbe causing the infection. Some antibiotics have very poor penetration of the prostatic capsule, others, such as Ciprofloxacin, ...

Section: Prostatitis

Chronic bacterial prostatitis - diagnosis

  In chronic bacterial prostatitis there are bacteria in the prostate but usually no symptoms. The prostate infection is diagnosed by culturing urine as well as prostate fluid (expressed prostatic secretions or EPS) which are obtained by the doctor doing a rectal exam and putting pressure on the prostate. If no fluid is recovered after this prostatic massage, a post massage urine should also contain any prostatic bacteria. Prostate specific antigen levels may be ...

Section: Prostatitis

Chronic prostatitis/chronic pelvic pain syndrome - nomenclature

  The name of this disorder is evolving. In 2007, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) began using the umbrella term Urologic Chronic Pelvic Pain Syndromes (UCPPS), for research purposes, to refer to pain syndromes associated with the bladder (i.e. interstitial cystitis/painful bladder syndrome, IC/PBS) and the prostate gland (i.e. chronic prostatitis/chronic pelvic pain syndrome, CP/CPPS).    

Section: Prostatitis

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