Treatment of Chronic Prostatitis Syndromes: Evaluation of Combining Antibiotics with a-Blockers

GA Barbalias, G Nikiforidis, EN Liatsikos

Departments of Urology and Medical Physics, University of Patras, School of Medicine, Patras, Greece

Purpose This study was undertaken to evaluate the immediate and long-term effects of the combination of a- blockers and antibiotics in the treatment of chronic prostatitis.

Materials and Methods The patients eligible for study were assigned to three groups: group 1-prostatodynia, abacterial prostatitis (134), group 2-prostatodynia (72), and group 3-chronic bacterial prostatitis (64). a-Blockers were administered to all patients of groups 1 and 2 with demonstrable high maximal urethral closure pressure and typical clinical secretion. a-Blockers were given to 50% of patients with bacterial prostatitis. Antibiotics were administered to all patients with positive expressed prostatic secretion cultures and in half of those with abacterial prostatitis and inflammatory expressed prostatic secretion. Mean followup was 22 months (range 6 months to 3 years). The sign 1-tailed test was used for statistical analysis of data.

Results The recurrence rate of bacterial prostatitis was significantly reduced by a-blockade (expressed prostatic secretion culture negative), and symptom relief was achieved for many months. For abacterial prostatitis, statistical analysis revealed a lower symptom recurrence rate in patients receiving only a-blockers in comparison with those treated with a combination of a-blockers and antibiotics.

Conclusions The use of a-blockers is justified, not only for prostatodynia, but also for abacterial and bacterial prostatitis. In the latter case, a-blockade not only caused enhanced clinical improvement but also reduced the recurrences as defined by expressed prostatic secretion positive segmental cultures.