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Chronic Prostatitis and treatment

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I have been getting conflicting information from my family doctor and my urologist. My doctor says that I could well have bacterial prostatitis even if my urine and semen samples come back clean and therefore I should take Cipro . My urologist says not and that one of the tests will show it if it is bacterial and therefore he wants me to hold off any antibiotics for about 10 days to get these tests done. Any opinion on this? My urine came back negative but I am still waiting on the semen test.

Also if one seems to be getting prostatitis numerous times (third or fourth for me) should any changes be made to ones sex life.

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replied April 4th, 2008
Prostate Answer A3865
According to your symptoms (“bladder feels constantly full”), cystoscopy report and data about repeating prostatitis, you could be experiencing chronic prostate inflammation (prostatitis chronica).

Basic rules for treating the chronic prostatitis are: to inform the patient better, to avoid unnecessary antibiotics and if the condition often repeats itself, to do fractional microbiological examination of the urine.

Symptoms of chronic prostatitis are similar to those in acute prostatitis but weaker and chronic:

1. Uften urination;

2. Painful urination;

3. Burning sensations in the lower abdomen, scrotum, perineum, penis’s head and inner sides of the legs;

4. Feeling of incomplete bladder emptying;

5. Feeling of pressure in the perineum and anal opening;

6. Disturbed seating;

7. Painful ejaculation and bloody sperm, and

8. Decreased libido with erectile dysfunction.

Treatment of chronic prostatitis includes:

1. Warm clothes;

2. Warm bath;

3. Medications: Painkillers (non-opiate), alpha-blockers, 5-alpha-reductasa inhibitors;

4. Prostate massage can help in some cases;

5. Doctor should convince the patient that the condition is harmless in order to prevent depression;

6. Antibiotics are indicated only if bacterial infection is proved. Fluoried chinolones (ciprofloxacin , norflohacin) or combination trimetoprim+sulfonamide are usually used. Antibiotic therapy lasts 1-2 months. If antibiotics do not help they should be aborted.

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