How to treat prostatitis

For most of our male friends, prostatitis should be relatively familiar, because prostatitis is a disease exclusive to men, and the incidence of this disease is generally relatively high. Many middle-aged and elderly people are often troubled by this disease. So, how to treat prostatitis? This is a very serious problem, and it is very important for men to understand.

Prostatitis is a common inflammation among men, and it is more common among middle-aged and elderly people. This is actually related to their living habits and physical fitness. Of course, prostatitis is relatively rare among teenagers. So, let’s take a closer look at the treatment of prostatitis.

First, a clinical assessment should be conducted to determine the type of disease and select a treatment method based on the cause. Psychological therapy and regulation of sexual life should be carried out throughout the entire treatment process. A misunderstanding of the disease, unnecessary anxiety, and excessive abstinence can make symptoms worse. Prostatitis may be a disease with mild or no symptoms, a self-limiting disease that can resolve on its own, or a disease with complex symptoms that leads to urinary tract infection, sexual dysfunction, infertility, and greatly reduced quality of life. The treatment of patients should avoid exaggerating the harmfulness of the disease to the patients, and should also avoid taking a simple, negative, and blind attitude towards antibiotic treatment. We should start with the cause of the disease and carry out comprehensive treatment.

Antimicrobial therapy

The identification of known urinary tract pathogens in prostatic fluid culture is the basis for selecting antimicrobial therapy. If rare pathogens or commensal bacteria are found in the urogenital tract, they cannot be confirmed as the causative pathogen. Patients with nonbacterial prostatitis who show signs of bacterial infection and who are unresponsive to general treatment may also be suitable for treatment with antibacterial drugs. When choosing antimicrobial drugs, it is necessary to pay attention to the existence of a prostate-blood barrier composed of lipid membranes between the prostate acini and the microcirculation, which hinders the passage of water-soluble antibiotics and greatly reduces the therapeutic effect. Some bacteria secrete glycoprotein matrices that prevent antibiotics from reaching the bacteria. When prostate stones are present, they can serve as harborages for bacteria. The above factors make chronic bacterial prostatitis difficult to treat, requiring a long course of treatment and prone to relapse.

In the past, commonly used drugs such as trimethoprim-sulfamethoxazole (SMZ-TMP) have a broad antibacterial spectrum, but cannot be concentrated in the prostate, and the therapeutic effect is still unsatisfactory after two months of continuous use. Currently, it is recommended to take quinolone drugs such as ofloxacin or levofloxacin orally. If ineffective, continue for 8 weeks. If the disease relapses and the bacterial species remains unchanged, switch to a preventive dose to reduce acute attacks and alleviate symptoms. If long-term use of antibiotics induces serious side effects, such as pseudomembranous colitis, diarrhea, and the growth of drug-resistant intestinal strains, the treatment plan needs to be changed. Another option is to use tetracycline first, and if symptoms are relieved, extend the treatment to 28 days. If symptoms do not improve, switch to quinolones.

There is still controversy in clinical practice as to whether nonbacterial prostatitis is suitable for treatment with antibiotics. There is evidence that patients who have used quinolones in the past may have false-negative results in urine cultures of prostatic fluid or after prostate massage. Chlamydia trachomatis and mycoplasma can cause prostatitis, while ordinary culture will not have positive results. Moreover, for patients with prostate symptoms, about 40% of them can achieve therapeutic effects through a course of antibiotic treatment. Therefore, patients with "bacterial" prostatitis are also suitable for using drugs that are effective against bacteria and mycoplasmas, such as quinolones, SMZ-TMP or TMP alone, and used in combination with tetracyclines and quinolones or at intervals. If antibiotic treatment is ineffective and it is confirmed to be aseptic prostatitis, antibiotic treatment should be discontinued.

There are actually quite a lot of treatments for prostatitis. The most targeted treatment is antibacterial treatment, and the general approach of antibacterial treatment still needs to rely on drugs for treatment, so our patients with prostatitis need to take medicine for treatment. Due to the particularity of prostatitis, those of us suffering from prostatitis must seek timely treatment, otherwise it will have adverse effects on our lives.