Untreatable prostatitis?

[Luepe]

I have diagnosis of chronic prostatitis.  The symptoms, which are mild and include painful erection, ejaculation and tenderness in the prostate and penus, started in late December 2007.  I began treatment in early January.  My primary care physician put me on doxycycline (twice a day) until late February 2008.  Because my condition did not improve, I was referred to a urologist.  The urologist put me on bactrim (twice a day) until late May 2008.  My condition did not improve, but did not get worse.  Thus, I was put on Cipro (twice a day).  After two days of treatment, I developed side effects to the Cipro (muscle and joint pain).  I was taken off the Cipro and was put on Augmentin (twice a day) for 21 days, which I began taking today.  My urologist advised me that if the Augmentin does not work, then there is not a whole lot he can do to improve my condition given that there are no other antibiotics that could be helpful.  I just got a PSA done, and I am awaiting the results.  A UA was done back in February, but no bacteria was found.  

If the Augmentin does not help, should I continue with Augmentin or go back to the bactrim for a longer period of time?  
Could this be NBP?  
Should I get more labs done?  
Should I consult another urologist?
If I do have bacterial prostatitis, could it be untreatable since nothing seems to be working?

Thank you

[Stephen Liroff, MD]

I do not think that your situation is untreatable, just that the proper treatment has not been identified in your case, yet. Since your symptoms persist in spite of treatment with antibiotics, I do not see pursuing treatment with further antibiotics without finding urine or semen  that is infected. A second opinion from a urologist with a particular interest in chronic pelvic pain syndrome would be my recommendation. You may find such an individual most easily by contacting one of the urology residency programs near you.
S.A.Liroff, M.D.

"This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.”

[Wildcatman]

I have had bouts the prostatitis.  It is not true that only two antibiotics are effective.  In both cases I have had, Bactrim has been very effective in treating my condition.  My urologist gave me a very simple treatment plan.  Bactrim 2x a day and Advil 4 times per day.  The Bactrim took out the infection, while the Advil helped with the pain and the inflammation that brought on urinary symptoms.  I tried Cipro and Levaquin in the past and they did not work.  Your doc has to isolate the type of infection and then treat it. I would bet that Bactrim will work if the Cipro/Levaquin class of drugs do not.