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QUESTION: Hi doctor
previously i contact you about my problem (prostatities) and know i whould like to useful from your experiance
racently, i visted doctor about the case and he give me the followibg program
1- the first month, i take levofloxacin 500 mg once aday
2- the second month, i take ciprofloxacin 500 mg twice aday
3- the third month, i take doxycyclin 100 mg once aday
during these periode, i take complementery treatment like pumpkin seed capsule and saw palmetto capsule also the doctore made massage for prostate ten time untile know one every week
the symptoms sometime disapper and sometimes i suffer alot fron burining and slow motion of urine and pelvic pain in general
finally, could you please give me your adivce espically about the massage
my eage is 39 years married, i suffer from this problem from 10 years ago

ANSWER: Mahmoud

I am not a big fan of prostatic massage. Proponents suggest improved drainage from the ducts but this votes at the expense of traumatizing an inflamed organ. I usually prefer prolonged antibiotics, anti-inflammatories, hot sitz baths and avoidance of dietary irritants like caffeine.
It makes no sense to me to go from Levaquin to cipro since the are essentially equivalent. Doxycycline is an effective agent. Quercetin is a natural supplement that can be helpful. Saw palmetto has yet to show any real actvity when properly tested.

---------- FOLLOW-UP ----------

QUESTION: thank doctor for your response, as following of your answer, my question is why i don not be good and get rid the harmful symptoms after long period of treating by antibiotic. it is chronic disease!!!!!!!.
do you have suggest programs for treating


Prostatitis can often be difficult to get rid of especially if the main cause is not known.  As far as treatment programs, they were outlined in my prior answer. Treatment us usually given in 4-6 week periods. My policy is to continue treatment until no further benefit is apparent, then go to another antibiotic until the prostatitis is eliminated. Hot sitz baths and anti-indlammatories can be increased on "bad" days. 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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