Johns Hopkins Health Alert
Options for Treating Chronic Prostatitis
The formal term for chronic prostatitis is chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The condition is generally defined as chronic pelvic pain lasting more than three months, with no signs of bacterial infection.
Like other forms of chronic pain, chronic prostatitis/chronic pelvic pain syndrome is a complex condition with no simple solutions. Successful management depends on treating the original source of the pain as well as the neurological and psychosocial problems that often accompany it. As a result, your doctor may prescribe several different types of medication.
- Antibiotics. Even in men who have no evidence of a bacterial infection, one round of antibiotic therapy -- for example ciprofloxacin (Cipro) or levofloxacin (Levaquin) -- may be tried early in the course of chronic prostatitis/chronic pelvic pain syndrome. About 75% of these men who have not previously been treated with an antibiotic will improve.
- Alpha-blockers. As with antibiotics, alpha-blockers like tamsulosin (Flomax) or alfuzosin (Uroxatral) may be given early in the course of chronic prostatitis/chronic pelvic pain syndrome to men who have not been heavily treated with alpha-blockers previously. Researchers theorize that these drugs might be effective because they relax smooth muscle in the prostate and may reduce nerve inflammation in the lower urinary tract.
- Finasteride. Only a few studies of the 5-alpha-reductase inhibitor finasteride (Proscar) for chronic prostatitis/chronic pelvic pain syndrome have been done, and results show it's not significantly better than placebo. Nevertheless, some men report improvement in symptoms, especially if they also have BPH.
- Herbal therapy. Some herbal therapies may have an anti-inflammatory effect. While several small studies suggest that quercetin, saw palmetto, or Cernilton N (a pollen extract) may improve symptoms of chronic prostatitis/chronic pelvic pain syndrome, there is no strong evidence demonstrating effectiveness.
- Anticonvulsants. Although gabapentin (Neurontin) and pregabalin (Lyrica) were originally approved by the U.S. Food and Drug Administration (FDA) to treat epilepsy, both show promise in treating nerve-related pain, including that from diabetes and shingles. Use of Lyrica to treat chronic prostatitis/chronic pelvic pain syndrome is being studied in a randomized, controlled trial.
- Antidepressants. These drugs, in particular tricyclic antidepressants, are sometimes prescribed to help with chronic prostatitis/chronic pelvic pain syndrome-associated depression.
Posted in Enlarged Prostate on February 9, 2010
Reviewed September 2011
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No comments to report. Stanley C. Ellefson Sr.
Posted by: SCEllefson | April 14, 2010 12:13 PM
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I don't understand why you limit the effectiveness of antibiotic therapy to "these men who have not previously been treated with an antibiotic." In my case sulfatrim DS has been totally effective in ameliorating occasional recurrences for at least twenty years.
Posted by: fredhep | February 14, 2010 12:50 AM