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.
