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Chronic prostatic inflammation most commonly results from inadequately treated
acute prostatitis, or genito-urinary tuberculosis.
Presentation is usually
with chronic, low grade perineal pain, usually varying in severity and frequency.
The pain may be exacerbated by sitting on a hard chair. Other features may include
low back pain, which may extend down the leg, mild bouts of fever and dysuria.
Rectal examination usually reveals an enlarged, firm, and irregular prostate.
Massage exudes a purulent urethral discharge.
Treatment chronic bacterial
prostatits is with the use of an appropriate antibiotic, generally a fluroquinolone
such as ciprofloxacin, for a course of 4-8 weeks
- use of a fluoroquinolone
is associated with a remission rate of about 70% in this condition (1)
of antibiotics may need to be combined with a programme of regular prostatic massage
in particularly resistant cases (1)
- there is evidence that the combination
of an alpha blocker and antimicrobial therapy in chronic bacterial prostatitis
is more effective than antimicrobial therapy alone (2)
should be checked to exclude diabetes mellitus.
- a systematic review found "found low- to very low-quality evidence that alpha blockers, antibiotics, 5-ARI, anti-inflammatories, phytotherapy, intraprostatic BTA injection, and traditional Chinese medicine may cause a reduction in prostatitis symptoms without an increased incidence of adverse events in the short term, except for alpha blockers which may be associated with an increase in mild adverse events (3)"
(2000); 60 (41): 120.
GA, Nikiforidis G, Liatsikos EN. Alpha-blockers for the treatment of chronic prostatitis
in combination with antibiotics. J Urol 1998;159:883–887
- ranco JVA et al. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Reviews 08 October 2019
Last edited 07/2020