QUESTION: Well assuming it is prostatitis why do I still suffer from pain after two different antibiotics? Should it typically just heal after all bacterial issues have been cleaned out?

ANSWER: James:

Prostatitis can be difficult to completely eradicate.  Maybe the medications weren't taken for long enough; maybe you continued with a diet that contained prostate irritants (smoking, caffeine, potassium, alcohol, hot spices) and maybe your prostatitis was the non-bacterial type.

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QUESTION: How does one address the non bacterial type and assuming I avoid unhealthy or spicy foods are there certain things I should add to  my diet that could help?  something with anti inflammatory properties? Does prostatitis typely turn into anything health threatening or  largely just quite uncomfortable? From my last appointment I was prescribed hyophen which actually has been helpful towards reducing pain unlike the phenazopyridine from before which almost seemed to  sensitize the pain. What type of drug is Hyophen? the urologists helper (female strangely enough) who I assume prescribed it seemed reluctant to refer to it as simply being a "pain killer". what exactly is it?

ANSWER: James:

Hyophen is a combination product that includes small amounts of several drugs.  Its effectiveness is considered relatively low but its one of the few analgesic agents that can be used when phenazopyridine is not working.  You can look it up on GOOGLE if you want more info on it.

There is little you can add to your diet that would help much.

Typical treatment for prostatitis includes the following:  

Avoid caffeine which irritates the prostate and bladder.
Hot sitz baths.  Sitting in a very hot tub for 10 minutes really seems to reduce pelvic pain, inflammation and discomfort.  We recommend twice or even three times a day for severe cases or flare-ups, but at least once a day for most prostatitis patients.
Avoid hot spices which tend to irritate the prostate.
Avoid sitting on hard surface; use an inflatable donut to spread the pressure away from the prostate.
Use NSAIDs like ibuprofen (Motrin, Advil) or naprosyn (Aleve) to help reduce discomfort and inflammation.
Antibiotics as prescribed by your physician.
Alpha blocker medications such as tamsulosin and alfuzosin will help relax muscle tension in the prostate.
Avoid high potassium foods that some people are sensitive to and which can be irritating.
Less alcohol and smoking.
Use quercetin which is a natural anti-inflammatory herbal supplement that has been shown to help reduce inflammation in the prostate.

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QUESTION: How is  nonbacterial version treated differently? if no bacteria what causes inflamation? does prostatitis lead to much else of a more severe natures? I have three months till my next appointment and I'm not sure how proactive I need to be when it comes to insisting that there is something wrong.  I don't think he plans on giving me more antibiotics so I  would hope  change in diet and exercise can make the best  difference.


Non-bacterial prostatitis is treated pretty much the same as the bacterial version.  Inflammation is not always from infection.  You bruise your hand, it may get red and swollen with pain but there are no bacteria.  Arthritis is another form of inflammation without bacteria.  The exact cause of inflammation in prostatitis is not well understood.

Good luck.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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