Patient's question:
Doctor, hello: I have had infections of chlamydia and mycoplasma. After treatment, I developed chronic prostatitis. The current symptoms are a constant feeling of discomfort in the right thigh and buttock, sometimes pain in the urethra and base of the penis, and frequent flatulence (needing to pass dozens of times a day). Currently, I am taking Norfloxacin and Yandu. Before this, I used 10 days of Mi Lin capsules and Prostatic Suppositories. Could you please recommend other medications for me? Additionally, what condition must the treatment for prostatitis reach to be considered cured? Thank you.First follow-up question: Please take a careful look at my question and answer accordingly, thank you. I look forward to your correct guidance.
Doctor's answer:
Hello:1. General treatment: Boost confidence, eliminate mental concerns, moderate sexual desire, but avoid forced abstinence. Avoid alcohol and stimulating foods. Take warm Sitz baths once daily, undergo local therapy, and modify obvious lifestyle triggers, such as avoiding prolonged cycling.
2. Prostate massage: Regular prostate massage can promote the discharge of prostatic inflammatory secretions. Perform once weekly, and concurrently conduct routine prostatic fluid tests to evaluate treatment effectiveness.
3. Drug instillation: 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. Perform once weekly.
4. Urethral dilation: For patients with urethral stricture or obstruction, regular dilation facilitates excretion. Additionally, when a probe passes through the urethra, it can stretch the prostate orifice, promoting glandular drainage.
5. Prostatic perineural block: 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 drugs: 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:
Trimethoprim-sulfamethoxazole 1.0 g twice daily
Doxycycline 0.1 g