Chronic Bacterial Prostatitis

Chronic bacterial prostatitis may manifest with irritative voiding symptoms, prostatitic obstruction, or recurrent UTIs (Lipsky, 1999). Patients may have microscopic pyuria but negative cultures. Other symptoms include hemospermia, penile discharge, and systemic symptoms.

Longer courses of antibiotics are generally considered standard practice. Options include TMP-SMX and fluoroquinolones for 4 to 6 weeks (Lipsky, 1999). Alpha-adren-ergic blockers have limited evidence of benefit when added to antimicrobials for category II prostatitis (Erickson et al., 2008). Patients with recurrent symptoms may need longer antibiotic courses, urologic consultation, or reconsideration of their diagnosis.

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