Patient's question:
Detailed medical condition and consultation purpose: Prostatitis and Mycoplasma and Chlamydia infection. Received injections for twelve days, with the following medication regimen: The first five days involved ciprofloxacin injections. The next seven days involved levofloxacin and azithromycin injections. The final two days added two tinidazole injections. Five days later, a prostate fluid and blood test was conducted. The results showed 1-2 white blood cells in the prostate fluid, 65% of which were lecithin bodies. The Mycoplasma and Chlamydia test was weakly positive! After a seven-day interval, another five-day course of injections was administered, combining azithromycin and levofloxacin! Now, the symptoms of prostatitis feel more severe than before! Could you please advise when I can start taking medication for prostatitis, and what medication should I use?Duration of the current illness and persistence: The second treatment started with the onset of symptoms!
Doctor's answer:
Hello: Based on your condition, you can continue using anti-inflammatory medications and pay attention to rest.Treatment for Chronic Prostatitis:
1. General Treatment:
- Boost confidence and eliminate mental concerns.
- Moderate sexual activity, but avoid forced abstinence.
- Refrain from alcohol and irritating foods.
- Take warm sitz baths once a night.
- Undergo local physical therapy.
- Modify obvious lifestyle triggers, such as avoiding long-distance cycling.
2. Prostate Massage:
- Regular prostate massage can promote the discharge of prostatitic secretions. Perform it once a week, and simultaneously conduct routine prostatic fluid tests to evaluate treatment effectiveness.
3. Drug Infusion:
- Insert a specially designed balloon catheter through the urethra, inject sterile physiological saline into the prostatic urethra, and aspirate several times to remove purulent secretions. Then, inject antibiotics. Repeat weekly.
4. Urethral Dilation:
- For patients with urethral stenosis or obstruction, regular dilation facilitates excretion. Additionally, as the probe passes through the urethra, it can stretch the prostate orifice, promoting better glandular drainage.
5. Prostatic Periurethral Blockade:
- Gentamicin 80,000 units plus 1% procaine 1–2 mL, administered once daily, with 7–10 sessions constituting one course. Alternatively, penicillin 800,000 units, streptomycin 0.5 g, plus 1% procaine 2–4 mL, administered 1–2 times weekly.
6. Antibacterial Medications:
- General antibacterial drugs are difficult to penetrate prostate tissue, which is one of the reasons for the challenges in clinical treatment. An ideal antibacterial drug should meet three conditions: ① Lipophilic alkaline drugs; ② Low binding to plasma proteins; ③ High dissociation degree. Currently, commonly used drugs include: