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Suggest Treatment For Chronic Bacterial Prostatitis

Posted on Sat, 2 May 2015

Question: Have been diagnosed with chronic bacterial prostatitis ( entrecoccus faecalia) after almost 3 months of trial and error. The semen analysis finally provided the diagnosis. Based on the culture analysis I was put Linezolid for 10 days then changed to Levofloxacin. However faced a lot of stomach related issuesc with levoflox. Now doctor has moved me to Doxy for next 10 days and then ciproflox for 10 more days. My doctor has told me that I need to have lot of patience as this is not an easy treatment. While there has been some marginal improvement wrt frequency of urination and reduction in burning sensation there is still lot of pain and stinging sensation in the anus especially post urination.

Is this normal and is my treatment on course?

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Chronic Prostatitis takes long time to get cured.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have been diagnosed to have Chronic Prostatitis due to Enterococcus Faecalis .

Your treating physician has prescribed antibiotics as per culture report .

Chronic Prostatitis is a notorious disease and embarrasing for patient and treating physician too.

Please continue taking appropriate antibiotics as per culture report .Please note that Chr.Prostatitis takes very long time to get cured completely hence one has to take medications for long time.

I have been practicing daily prostatic massage for my patients of Chronic prostatitis since last 4o years of my practice and getting good results .

You can also discuss this modality of treatment with your treating physician (Doing prostatic massage every day).

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Dr. P. T. Patil (1 hour later)

Dear Doc. Thanks. I will check with my doc on massage. few more questions:
1. How long does it take to cure fully. There are 3/4 days when everything is fine but then again 3/4 bad dys. You are not sure whether you are getting cured
2. Can anything be done for increased urine frequency when it happens. Big problem while traveling to office.
3.Is sleep dis order normal. Have to get up in the night to pass urine. unable to sleep post that.

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
It may take 6-8 months for cure

Detailed Answer:
Hello
Thanks for follow up.

What is your age?
It is really difficult to predict time frame for complete cure.Relapses are very common.

You can take Tomsulosin once daily along with Flavoxate twice daily. to reduce the frequency of urination .

Sleep disorder is associated with nocturnal frequency.Empty your bladder before going to bed and avoid drinking water .This will help to some extent to reduce nocturia.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Dr. P. T. Patil (3 days later)

Hi Doctor my age is 45. Also is it normal that the pain flares up badly during the treatment. Since starting doxy the stinging anus pain has increased and sitting in office chair is painful. burning/stinging of penis has stopped. 3 weeks into antibiotics but unable to know whether I am getting cured. Thanks

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
It takes long time for Chr.Prostatitis to get cured.

Detailed Answer:
Hello

Symptoms that you have are primarily due to Prostatitis itself .

Thanks for follow up .It takes long time for Chronic Non bacterial Prostatitis to get cured .You need to have patience .

Start prostate massage daily I am sure it will work for you.
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (13 minutes later)

Thanks doctor. Actually the diagnosis is bacterial prostatitis and not non bacterial. The semen culture showed enterecoccus faecalis. Anyway understand this will take time. Many thanks for your assistance.

Answered by Dr. Dr. P. T. Patil (8 hours later)

Brief Answer:
You need to take antibiotics for a period of 2-3 months.

Detailed Answer:
Hello
Thanks for follow up.

Enterococcus Faecalis infection takes long time to get cured moreover the organisms change their sensitivity pattern very frequently hence one needs to do urine and semen culture frequently so that you can take appropriate antibiotics as per culture report.

Enterococcus faecalis is highly sensitive to Ampicillin check your culture report and take appropriate antibiotics .

Relapses are common in Chr.Bacterial Prostatitis hence nothing to be worried about it.You are bound to have symptom free period followed by relapses.

As far as frequency for urination is concerned you may take Tomsulosin once daily along with urinary antispasmodics like Flavoxate twice daily.

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar