What to do with prostatitis

Prostatitis is mostly a male disease that often occurs in middle-aged and elderly male friends. It requires a very long time to treat after it occurs. It is not a disease that can be completely cured overnight. At the beginning, patients must adopt antibacterial treatment according to their symptoms. There are many antibacterial drugs that can be used to treat prostatitis. The effects are very significant and will not bring many complications.

1. Antimicrobial therapy

The detection of pathogenic pathogens in prostatic fluid culture is the basis for selecting antibacterial drug treatment. If patients with non-bacterial prostatitis have signs of bacterial infection and general treatment is ineffective, they can also be appropriately treated with antibacterial drugs. When choosing antibacterial drugs, it is necessary to pay attention to the presence of a prostate-blood barrier composed of lipid membranes between the prostate acini and the microcirculation. The barrier prevents the passage of water-soluble antibiotics, greatly reducing the treatment effect. When prostate stones are present, the stones can become a shelter for bacteria. The above factors constitute the difficulty in the treatment of chronic bacterial prostatitis, which requires a longer course of treatment and is prone to recurrence.

Currently, quinolone drugs such as ofloxacin or levofloxacin are recommended. If ineffective, continue to use for 8 weeks. If recurrence occurs and the strain remains unchanged, switch to preventive doses to reduce acute attacks and relieve symptoms. If long-term use of antibiotics induces severe side effects such as pseudomembranous colitis, diarrhea, and the growth of drug-resistant strains in the intestine, the treatment plan needs to be changed.

Whether nonbacterial prostatitis is suitable for treatment with antibiotics is still a clinical debate. Patients with "sterile" prostatitis can also use drugs that are effective against bacteria and mycoplasmas, such as quinolones, SMZ-TMP or TMP alone, used in combination with tetracycline and quinolones or used intermittently. If antibiotic treatment is ineffective and it is confirmed to be sterile prostatitis, antibiotic treatment should be discontinued. In addition, using a double balloon catheter to block the prostatic urethra and injecting an antibiotic solution from the urethral cavity into the prostatic duct can also achieve the treatment goal.

Type I is mainly treated with broad-spectrum antibiotics, symptomatic treatment and supportive treatment. Type II is recommended to be treated with oral antibiotics, and sensitive drugs are selected. The course of treatment is 4 to 6 weeks, during which the patient should be evaluated for the efficacy. Type III can first take oral antibiotics for 2 to 4 weeks and then evaluate the efficacy. At the same time, non-steroidal anti-inflammatory drugs, α receptor antagonists, M receptor antagonists, etc. are used to improve urination symptoms and pain. Type IV does not require treatment.

2. Anti-inflammatory and analgesic drugs

Nonsteroidal anti-inflammatory drugs can improve symptoms. Generally, indomethacin is taken orally or in suppositories. Chinese medicines that use anti-inflammatory, heat-clearing, detoxifying, and hardness-softening drugs also have certain effects. Allopurinol can reduce the concentration of uric acid in the whole body and prostatic fluid. In theory, it can be used as a free radical scavenger, and it can also remove active oxygen components, reduce inflammation, and relieve pain. It is an optional auxiliary treatment method.