Patient's question:
I have a swollen and painful penis, lower abdominal pain after sexual activity, testicular pain, frequent urination and urgency, short sexual intercourse duration, etc. It has been going on for several years. Usually, I have some lower abdominal discomfort.Doctor's answer:
Currently, many advocate the use of quinolone drugs such as ofloxacin or levofloxacin. If ineffective, continue for 8 weeks. If recurrence occurs with the same bacterial strain, switch to a preventive dose to reduce acute episodes and alleviate symptoms. If long-term antibiotic use induces severe side effects, such as pseudomembranous colitis, diarrhea, or the proliferation of intestinal drug-resistant strains, the treatment plan should be changed. The appropriateness of using antimicrobial drugs to treat non-bacterial prostatitis remains debated in clinical practice. "Aseptic" prostatitis patients can also use drugs effective against bacteria and mycoplasma, such as quinolones, SMZ-TMP, or TMP alone, combined with tetracyclines or quinolones, or used alternately. If antibiotic treatment is ineffective and confirmed as aseptic prostatitis, antibiotic therapy should be discontinued. Additionally, using a double-balloon catheter to close the prostatic urethra and injecting antibiotic solution into the urethral cavity to reflux into the prostatic ducts can also achieve therapeutic goals.Type I primarily involves broad-spectrum antibiotics, symptomatic treatment, and supportive care. Type II is recommended to be treated mainly with oral antibiotics, selecting sensitive drugs, with a course of 4-6 weeks, during which the patient should be evaluated for treatment efficacy in stages. Type III can begin with oral antibiotics for 2-4 weeks, followed by an evaluation of efficacy. Simultaneously, non-steroidal anti-inflammatory drugs, α-receptor antagonists, and M-receptor antagonists can be used to improve urinary symptoms and pain. Type IV does not require treatment.