Prostatitis - treatment

Two weeks ago, I was having the sensation that I needed to urinate constantly. I often didn't actually urinate much at all. I saw a DR (not my regular DR who was on holidays). Assuming it was a UTI, she gave me three days treatment of antibiotics (ciproxin 250).

At the end of the 3 days I felt somewhat better. The day after having sex with my wife, she developed a bad UTI and we both went back to the DR and had urine tests as I was still having to urinate very frequently. She had an obvious UTI but my urine test came back with no problems.  

Even though my urine analysis showed no infection, I was still having the sensation to urinate all the time and while having a bowel movement I discharged semen-like fluid.  I went back to the DR who performed a prostate exam. This was very painful and sore. She therefore concluded that I had prostatitis and prescribed the following:

Ofloxacin 200 mg (2 x per day for 10 days)
then
Doxyclycline 100mg (2 x per for 11 days)

She also gave me Detrusitol SR 4 mg (tolterodin; 1 x per day) for the urge to urinate.

The medication to help me not have the urge to urinate constantly worked very quickly. However, since the prostate exam, I have had fairly serious pain in my lower back and bum muscles. I have been on the antibiotics for 4 days now with no change in this pain. I can't sit down for more than an hour without being very sore.

I am wondering how long it will take for the antibiotics to work (thereby decreasing my pain) and whether more aggresive (aggressive) or different treatment is needed.

[Kevin Pho, MD]

Prostatitis can be difficult to treat - and may require longer courses of antibiotics.  You may need to be on these medications for longer than 4 days to notice an effect.  

If the pain continues, I would consider a transrectal ultrasound to image the prostate.  If an abscess is present, antibiotics won't be helpful and a procedure would be needed to drain the abscess.  

These options can be discussed with your personal physician, or in conjunction with a urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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