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Urology/young doctor with prostatitis

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Question
hi sir

am a doctor myself,34 years  , am suffering from prostatitis since 10 days.

my only presenting complaint is increased frequency(only urge but i am able to hold and space out micturition) and a vague senastion in uerthra and a feeling of incomplete emptying..., and minimal testicular pain

urine routine had 3-4 pus cells,otherwise normal. c/s showed no growth. usg abdomen and pelvis was normal.

took  nitrofurantoin initially for 1 week, now put on levoflox since yesterday.

tried tolterotidine and tryptomer for control of symptoms last week but didnt work out so has been prescribed with tamsulosin 0.4 mg since yesterday.

i had very similar symptoms last year in september which went away in 10 days(that episode i took a contrast ct   KUB which was also normal)

what should i keep in mind or do anything different

please advise sirr

thanking you very much

Answer
Sriram:

We don't typically use nitrofurantoin for prostatitis as it doesn't penetrate prostate tissue well.l  Levoflox is fine.  Only 1 week of tolterodine is usually not sufficient.  Most anticholinergics for bladder control require 3-4 weeks.  Plain oxybutynin works quickly so you may want to try that if you are still having frequency/urgency.  Dose is 5 mg TID.

Here is my general guide to prostatitis.

Typical Treatments for Prostatitis Include:
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.  Typically, at least 4-6 weeks minimum is required.
Alpha blocker medications such as tamsulosin and alfuzosin will help relax muscle tension in the prostate and improve urinary flow.
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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Stephen W. Leslie, MD

Expertise

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

Experience

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.

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

Publications
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.

Education/Credentials
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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