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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

Chronic prostatitis/chronic pelvic pain syndrome - diagnosis

  There are no definitive diagnostic tests for CP/CPPS. This is a poorly understood disorder, even though it accounts for 90%-95% of prostatitis diagnoses. It is found in men of any age, with the peak onset in the early 30s. CP/CPPS may be inflammatory (Category IIIa) or non-inflammatory (Category IIIb), based on levels of pus cells in expressed prostatic secretions (EPS), but these subcategories are of limited use ...

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, Co-trimoxazole and tetracyclines penetrate well. In acute prostatitis, penetration of the prostate is not as important as for category II because the intense inflammation disrupts the ...

Section: Prostatitis

Chronic bacterial prostatitis - treatment

  Treatment requires prolonged courses (4-8 weeks) of antibiotics that penetrate the prostate well (?-lactams and nitrofurantoin are ineffective). These include quinolones (ciprofloxacin, levofloxacin), sulfas (Bactrim, Septra) and macrolides (erythromycin, clarithromycin). Persistent ...

Section: Prostatitis

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