Chronic prostatitis: Comments on infectious etiologies and antimicrobial treatment

Abstract

Twenty-three males with the clinical diagnosis of chronic prostatitis were evaluated for a bacterial etiology by the Stamey and Meares method. In addition, 16 patients, regardless of culture results, were placed on either cefadroxil or oral carbenicillin antimicrobial therapy. Culture results identified only four (17%) of 23 patients with bacterial prostatitis: coagulase-negative Staphylococcus (2), Enterobacter agglomerans (1), and Haemophilus parainfluenzae, and coagulase-negative Staphylococcus (1). Four of seven patients who received oral carbenicillin and three of nine patients who received cefadroxil reported symptomatic relief. This study did not identify a common etiology for chronic prostatitis or a consistently effective antimicrobial treatment. Rather, we observed that the etiologic agent in most cases of chronic prostatitis (83%) could not be identified by routine bacteriologic culture. Future research efforts in chronic prostatitis must address not only treatment regimens but expand the search for etiologic agents.

Research in 'Prostatitis Syndromes': The Use of Alfuzosin (a New α(1)-Receptor-Blocking Agent) in Patients Mainly Presenting with Micturition Complaints of an Irritative Nature and Confirmed Urodynamic Abnormalities

“…Research concerning the origin of these disorders has been directed towards the illumination of extra-prostatic etiologies. Uroflowmetry abnormalities are reported in 30% of the cases [2], Urodynamic testing in these patients has frequently shown functional disorders of the lower urinary tract: disorders of the bladder outlet [3]; detrusor hyperreflexia, and detrusor areflexia with nonre laxing pelvic floor striated musculature [4]. Pelvic floor tension myalgia due to habitual contraction and spasm has also been suggested as a possible cause [5,6].…”

Advanced therapy for prostatitis: Minimally invasive and invasive therapies

“…Anatomic or neurophysiologic obstruction resulting in highpressure dysfunctional flow patterns has been implicated in the pathogenesis of this syndrome [9]. Uroflow abnormalities (eg, poor flow) were reported in 30% of the patients with Category III prostatitis [10]. Many investigators have suggested extraprostatic causes, such as pelvic floor tension myalgia or bladder outlet obstruction, as reasons for the voiding dysfunction in patients with prostatitis syndrome [11,12].…”

Pelvic Pain — ein neurourologisches Konzept

“…Beckens werden im Rahmen verschiedener Krankheiten beschrieben oder als ein Symptom angegeben [1±3, 5,6,12,18,19,20, 25±27] (Tabelle 1). Der Schmerz wird nach Ausschluû pathologisch-anatomischer Veränderungen (Karzinom, Entzündung etc.)…”

“…B. Antibiose für die abakterielle chronische Prostatitis; Hysterektomie oder laparoskopische Koagulationen für Endometriose) [12].…”