Is Chronic Bacterial Prostatitis 100% curable? How & which is the best therapy?
April 5, 2010 by Prostate Dr.
It's widely believed that Chronic Bacterial Prostatitis can't be cured 100% and that the symptoms arise after a period once the therapy is completed.
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chronic means uncurable
any chronic infection does not respond well to treatment or it would not have become chronic. Flare ups can be expected.
Therapy
Antibiotics are the first line of treatment in acute prostatitis, which is classified as a medical emergency. In chronic bacterial prostatitis, prolonged high-dose courses of antimicrobials, typically Ciprofloxacin, are often attempted to eradicate infection.
For chronic nonbacterial prostatitis (pelvic myoneuropathy or CP/CPPS), which makes up the vast majority of men diagnosed with “prostatitis”, a treatment called “the Stanford Protocol”, developed by Stanford Professor of Urology Rodney Anderson and psychologist David Wise around the year 2000, has become prominent. This is a combination of medication (using tricyclic antidepressant and benzodiazepines), psychological therapy (paradoxical relaxation, a type of progressive relaxation technique developed by Edmund Jacobson during the early 20th century), and physical therapy (Myofascial Trigger Point Therapy on Pelvic Floor and Abdominal muscles, and also yoga type exercises with the aim of relaxing pelvic floor and abdominal muscles). [6]
Some patients report that the use of a biofeedback machine to relearn how to control pelvic floor muscles is useful, although the Stanford Protocol does not specifically recommend this.
The current line of thinking is that antibiotics resolve acute prostatitis infections in a very short period of time. The rather rare entity (<5% of patients with prostate-related non-BPH LUTS) of chronic bacterial prostatitis usually yields to long and repeated courses of antimicrobials, but there is often a structural abnormality that acts as a reservoir for infection in these cases.
The bulk of prostatitis patients fall into the Chronic Pelvic Pain Syndrome or Pelvic Myoneuropathy category, where there is no initial trigger other than anxiety (often with an element of Obsessive Compulsive Disorder or other anxiety-spectrum problem). This leaves the balance of the pelvic area in a sensitized condition resulting in a loop of muscle tension and heightened neurological feedback (neural wind-up). Current protocols largely focus on stretches to release overtensed muscles in the pelvic or anal area (commonly referred to as Trigger Points), physical therapy to the area, and progressive relaxation therapy to reduce causative stress.
Anecdotal evidence suggests that food allergies and intolerances may have a role in exacerbating CP/CPPS, perhaps through mast cell mediated mechanisms. Specifically patents with gluten intolerance or celiac disease report severe symptom flares after sustained gluten ingestion. Patients may therefore find an exclusion diet helpful in lessening symptoms by identifying problem foods.
A Japanese immunomodulator called suplatast tosilate has been studied in open pilot studies in CPPS and has been found to be effective.Double-blind placebo controlled studies are needed.Suplatast tosilate is currently approved in Japan for the treatment of allergies and asthma.
Alpha blockers (tamsulosin, alfuzosin) have been shown in randomized placebo controlled trials to be marginally helpful for many men with CPPS. Duration of therapy needs to be at least 3 months.
Quercetin has shown effective in a randomized placebo controlled trial in chronic prostatitis but the study has been criticized because of small numbers. Subsequent studies showed that quercetin reduces inflammation and oxidative stress in the prostate. Bee Pollen (Cernilton) has also been shown effective in small studies but the active therapeutic constituent has not been isolated.
Prostatitis is mst of the times infectious..whosoevr hs it go to find for infections espacialy if semen shows pus cells…go for semen culture nd othr necesary tests.hit the bug..bigest mistake is to mis infectious for noninfectious causes.