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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.
- 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)
Therapies shown to be ineffective by randomized placebo/sham controlled trials:
Other articles from 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 infections may be helped in 80% of patients by the use of alpha blockers (tamsulosin (Flomax), alfuzosin), or long term low dose antibiotic therapy. Recurrent ...Section: Prostatitis
Acute prostatitis - signs and symptoms
Men with this disease often have chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night, burning or painful urination, body aches, and a demonstrable infection of the urinary tract, as evidenced by white blood cells and bacteria in the urine. Acute prostatitis may be a complication of prostate biopsy.Section: Prostatitis
Chronic bacterial prostatitis - prognosis
Over time, the relapse rate is high, exceeding 50%. A 2007 study showed that repeated courses of combination antibiotics may eradicate infection in 83.9% of patients with clinical remission extending throughout a follow-up period of 30 months for 94% of these ...Section: Prostatitis