Patient's question:
I have chronic prostatitis. Are there any medications that are effective and affordable?Doctor's answer:
Hello:1. General treatment: Boost confidence, eliminate mental worries, moderate sexual desire, but avoid forced abstinence. Avoid alcohol and stimulating foods. Take warm sitz baths once daily, local physiotherapy, 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 simultaneously conduct routine prostatic fluid tests to evaluate treatment effectiveness.
3. Drug instillation: Insert a specially designed balloon catheter through the urethra, inject sterile normal saline into the prostatic urethra, and aspirate several times to remove purulent secretions. Then, inject antibiotics. Perform once weekly.
4. Urethral dilation: For urethral stricture or obstruction, regular dilation facilitates excretion. Additionally, when a probe passes through the urethra, it can stretch the prostate opening, promoting glandular drainage.
5. Prostatic perineural block: Gentamicin 80,000 units plus 1% novocaine 1–2 mL, once daily, for 7–10 sessions per course. Alternatively, penicillin 800,000 units, streptomycin 0.5 g, plus 1% novocaine 2–4 mL, once or twice weekly.
6. Antibacterial drugs: General antibacterial drugs are difficult to penetrate prostate tissue, which is one reason 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. Currently, commonly used drugs include:
Trimethoprim-sulfamethoxazole 1.0 g twice daily
Doxycycline 0.1 g