Charles Patrick Davis, MD, PhD
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Doctor's View on Prostatitis Treatment
Comment by Charles P. Davis, MD, PhD
What is prostatitis?
Prostatitis is an inflammation of the prostate gland. There are four different types of prostatitis -- acute and chronic bacterial prostatitis, chronic prostatitis (also termed chronic pelvic pain syndrome, nonbacterial prostatitis or prostatodynia) and asymptomatic inflammatory prostatitis. The first two are caused by bacteria. The third, chronic prostatitis, does not have a defined cause. The fourth, asymptomatic inflammatory prostatitis, also does not have a defined cause and is usually found incidentally when examining other tissues or fluids.
Prostatitis treatment depends on the diagnosis of what is causing the inflammation of the prostate. If it is acute bacterial prostatitis, the patient will need antibiotics for at least 14 days (some clinicians recommend even longer times for treatment). The longer term of antibiotics is used because most antibiotics reach prostatic tissues in low amounts and need to be present for longer times to damage or kill bacteria. If chronic bacterial prostatitis is diagnosed, treatment with antibiotics is prolonged further to about 4 to 12 weeks, depending on the patient's condition and the doctor's assessment of their chronic condition. Even with this prolonged treatment, chronic bacterial prostatitis may reoccur in about 25% of patients.
Patients diagnosed with chronic (nonbacterial) prostatitis and asymptomatic inflammatory prostatitis may not need any antibiotics. However, many clinicians may administer them for a while because the tests to find bacteria are not always 100% diagnostic and some antibiotics have anti-inflammatory effects. Most patients are treated with muscle relaxants, anti-inflammatory drugs, and pain medications and in some patients, repetitive prostate massages to drain prostatic ducts to reduce prostatic pressure. Some individuals may use plant extracts, heat therapy (warm sitz baths), and biofeedback to reduce discomfort. Some clinicians advise to stop eating spicy foods and quit drinking caffeinated and acidic drinks that may increase symptoms of prostatitis. Finally, in rare cases, surgery on the prostate and/or adjacent structures may be done to reduce prostatic symptoms.
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Last Editorial Review: 7/29/2013 2:08:08 PM