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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 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 infections may be caused by inefficient urination ...

Section: Prostatitis

Chronic prostatitis/chronic pelvic pain syndrome - treatment

  A 2007 review article by Drs Potts and Payne in the Cleveland Clinic Journal of Medicine states: "Indeed, chronic abacterial prostatitis (also known as chronic pelvic pain syndrome) is both the most prevalent form and also the least understood and the most challenging to evaluate and treat. This form of prostatitis may respond to non-prostate-centered treatment strategies such as physical therapy, myofascial trigger point release, and relaxation techniques."    

Section: Prostatitis

Chronic prostatitis/chronic pelvic pain syndrome - signs and symptoms

  These patients have no history of genitourinary pain complaints, but leukocytosis is noted, usually during evaluation for other conditions.    

Section: Prostatitis

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