Treatment of Prostatitis

Treatment depends on the type of prostatitis that the patient has. It may sometimes be a challenge to treat prostatitis especially if it has resulted from a non-bacterial cause. Treatments also differ amongst urologist.  Sometimes, it is not possible to treat prostatitis but it is possible to manage it so that the patient’s symptoms are much improved.  The management an treatment of prostatitis is briefly discussed.

Medication

medication

Anti-inflammatory drugs, Pain Medication, Muscle relaxants, Antibiotics, Alpha Blockers, Proscar, Amitriptyline, Fluoxetine

  • Anti-inflammatory drugs
  • Anti-inflammatory drugs (like Brufen and Aspirin) help to decrease inflammation and help in the management of pain and fever.

  • Pain Medication
  • Additional pain medication may be added to an anti-inflammatory drug if needed when the patient’s pain does not respond on an anti-inflammatory drug alone. Pain management helps manage the symptoms of prostatitis and is not a specific treatment.

  • Muscle relaxants
  • Drugs which cause relaxation of the pelvic muscles help to relieve the pain caused by prostatitis.

  • Antibiotics
  • Antibiotics are used for infectious prostatitis and even sometimes for non-bacterial prostatitis if no other cause can be found.

    Acute infectious prostatitis is usually treated with an anti-biotic for 14 days. If the infection is not severe enough for hospital admission, the patient is treated as an outpatient with oral antibiotics, usually a Fluroquinolone. (eg. Ciprofloxacin) Fluroquinolone is a broad-spectrum antibiotic used for gram positive and gram negative organisms.

    For chronic infectious prostatitis antibiotics are prescribed for longer than 14 days, usually 1 to 3 months. 75% of chronic prostatitis infections clear up with prolonged antibiotic therapy. For those infections that don’t resolve, low dose antibiotics may be needed for extended periods to relieve symptoms. It is very important for the patient to always complete the course of antibiotics as prescribed by their doctor because even when the condition feels better, the infection may still be present. If the antibiotics are stopped prematurely the patient may develop an infection which is resistant to that particular antibiotic.

  • Alpha Blockers
  • Alpha blockers act as a smooth muscle relaxer and may help relax the prostate gland which will cause pain relief. Alpha blockers are also used in the treatment of hypertension. Hytrin and Cardura are alpha blockers which cause the muscles of the prostate and the bladder to relax. They therefor improve the flow of urine and other symptoms of prostatitis in some men. It is mostly used in chronic non-infectious prostatitis.

  • Proscar
  • Proscar (Finasteride) is used to help shrink the prostate gland. Proscar is a 5-alpha-reductase inhibitor and is used if prostatic hypertrophy is present.

  • Amitriptyline
  • Amitriptyline may relieve chronic pain, help with bladder problems and assist with sleep. Amitriptyline is effective if pain has a neurological origin. It is also used as an antidepressant although the dose needed for an antidepressant effect is usually much higher. Patients may feel better from improvement in sleep alone.

  • Fluoxetine
  • Fluoxetine is a selective serotonin anti-depressant medication. Doctors have reported that some men find relief from their symptoms when using fluoxetine.

  • IVI Treatment
  • If acute bacterial prostatitis is suspected, patients are usually treated in the hospital with intravenous antibiotics, fluids and pain relievers. Acute bacterial prostatitis may be treated with oral antibiotics on an outpatient basis if the patient is not severely ill.

 

Sitz baths

sitz_bath

Sitz baths cause some relief from discomfort and pain

A sitz bath is usually a warm, shallow bath which submerges the perineal area.  Sitz baths cause some relief from discomfort and pain.  Some patients like to alternate between warm and cold sitz baths.  Antiseptic liquid is often added to a sitz bath to help clean the area.
 
 
 
 
 
 

Surgical Management of Prostatitis

Surgical removal of the infected parts of the prostate may be recommended by an urologist.  Surgical treatment is used in severe chronic prostatitis or when an enlarged or swollen prostate blocks the flow of urine.  Surgical management of prostatitis is usually only used as a last resort. The whole prostate may be removed with surgery or part of the prostate.
 

Supportive Therapy for Prostatitis

  • Stool softeners
  • The patient may experience pain when passing a stool in prostatitis and keeping the stools soft will prevent constipation and prevent painful defecation.

  • Prostate massage
  • Prostatic massage can help relieve pain in chronic prostatitis.  It is done by massaging the prostate for a few minutes.  Patients should discuss prostate massage with their urologist.  It is not a good idea to use prostate massage in acute bacterial prostatitis because pain will be increased and infection might spread.

 

Diet modification

coffee_and_spice

Avoid caffeine and spicy foods

  • Avoid spicy foods
  • Spicy foods can irritate the bladder and prostate, worsening prostatitis.

  • Avoid Caffeine
  • Caffeine may also worsen prostatitis by irritating the prostate and may also worsen symptoms by increasing the feeling of stress.

 
 
 
 

Lifestyle modification

  • Avoid certain activities
  • Avoiding activities which may aggravate prostatitis should be considered.  Cycling is one of the activities which may be aggravated in prostatitis.

  • General healthier lifestyle
  • Maintaining a healthy weight, exercising regularly and eating a healthy balanced diet have been shown to improve symptoms of prostatitis.

  • Practising safe sex
  • Using condoms and avoiding unprotected sex with multiple partners decrease a man’s chances of contracting bacteria which may lead to prostatitis.

  • Learning Progressive relaxation training techniques
  • Relaxation techniques help relieve symptoms of prostatitis by helping the patient relax psychologically as well as helping the pelvic muscles relax.  These techniques may be taught to the patient by a psychologist or life coach.

Men who think they may have prostatitis should seek medical advice and treatment because prostatitis can be well managed and treated.  Prostatitis does not increase a man’s risk for developing prostate cancer or kidney disease. The symptoms of prostatitis can be dramatically improved with the correct management. A man will be able to live a relatively normal life with prostatitis.