Prostatitis is a condition affecting the prostate gland that can cause bothersome urinary symptoms and pelvic pain. The best approach to treatment depends on the type of prostatitis. Although asymptomatic inflammatory prostatitis usually requires no treatment, acute and chronic bacterial prostatitis--both caused by bacterial pathogens--typically require intervention to address underlying infection. Chronic nonbacterial prostatitis can be the most difficult type of prostatitis to treat, often requiring experimentation with a variety of medications, surgery or both.
Antibiotics
Doctors usually treat patients with acute or chronic bacterial prostatitis with oral antibiotics such as ciprofloxacin or ofloxacin. Those with acute prostatitis may take the medication daily for up to one month in an effort to prevent chronic prostatitis, and those who already have chronic prostatitis may take antibiotics for up to 6 weeks, according to Merck. Bacterial infections that have spread to the bloodstream may require intravenous antibiotics such as ampicillin and gentamycin for up to 2 days followed by a longer course of oral antibiotics.
Alpha Blockers
According to Merck, treatment of patients with chronic nonbacterial prostatitis with antibiotics is not particularly effective. Instead, doctors may prescribe alpha blockers, a class of medications that works by relaxing the muscles of the bladder and prostate gland. Relieved muscle tension can make it easier and less painful for men to urinate. Commonly prescribed alpha blockers include doxazosin, alfuzosin, terazosin and tamsulosin, according to MedlinePlus.
Adjunctive and Second-Line Medications
Doctors may recommend adjunctive medications in addition to antibiotics or alpha blockers to treat the symptoms of prostatitis. For example, over-the-counter and prescription pain relievers, including aspirin and nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen, may help to relieve pain in the pelvic region, according to the Mayo Clinic. Stool softeners may also help to treat pain associated with bowel movements.
If alpha blockers fail to improve symptoms of chronic, nonbacterial prostatitis, the doctor may prescribe muscle relaxants such as cyclobenzaprine to relieve muscle spasms in pelvic muscles, according to Merck. Alternatively, some patients may find symptom relief by taking anxiolytics, or anti-anxiety medications, including benzodiazepines and selective serotonin reuptake inhibitors (SSRIs).
MedlinePlus reports that bee pollen and allopurinol--a drug normally used to prevent conditions such as gout that are caused by the overproduction of uric acid--may be effective in treating some men with chronic prostatitis.
If alpha blockers fail to improve symptoms of chronic, nonbacterial prostatitis, the doctor may prescribe muscle relaxants such as cyclobenzaprine to relieve muscle spasms in pelvic muscles, according to Merck. Alternatively, some patients may find symptom relief by taking anxiolytics, or anti-anxiety medications, including benzodiazepines and selective serotonin reuptake inhibitors (SSRIs).
MedlinePlus reports that bee pollen and allopurinol--a drug normally used to prevent conditions such as gout that are caused by the overproduction of uric acid--may be effective in treating some men with chronic prostatitis.
Surgery
Rarely, some men with chronic nonbacterial prostatitis may require surgical removal of all or part of the prostate gland. Because surgery can cause complications such as sterility, erectile dysfunction, retrograde ejaculation (a backflow of semen during ejaculation into the bladder as opposed to out of the urethra) and incontinence, doctors usually only recommend surgery when other treatment options have failed to improve symptoms, according to MedlinePlus.
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