ALPHA-BLOCKERS FOR THE TREATMENT OF CHRONIC PROSTATITIS IN COMBINATION WITH ANTIBIOTICS

Purpose: This study was undertaken to evaluate the immediate and long- term effects of the combination of alpha-blockers and antibiotics in t he treatment of chronic prostatitis. Materials and Methods: The patien ts eligible for study were assigned to 3 groups: group 1-nonprostatody nia, abacterial prostatitis (134), group 2-prostatodynia (72) and grou p 3-chronic bacterial prostatitis (64). alpha-Blockers were administer ed to all patients of groups 1 and 2 with demonstrable high maximal ur ethral closure pressure and typical clinical complaints irrespective o f the presence of inflammatory findings in expressed prostatic secreti on. alpha-Blockers were given to 50% of patients with bacterial prosta titis. Antibiotics were administered to all patients with positive exp ressed prostatic secretion cultures, and in half of those with abacter ial prostatitis and inflammatory expressed prostatic secretion. Mean f ollowup was 22 months (range 6 months to 3 years). The sign 1-tailed t est was used for statistical analysis of data. Results: The recurrence rate of bacterial prostatitis was significantly reduced by alpha-bloc kade (expressed prostatic secretion culture negative) and symptom reli ef was achieved for many months. For abacterial prostatitis statistica l analysis revealed a lower symptom recurrence rate in patients receiv ing only alpha-blockers in comparison with those treated with a combin ation of alpha-blockers and antibiotics. Conclusions: The use of alpha -blockers is justified, not only for prostatodynia, but also for abact erial and bacterial prostatitis. In the latter case alpha-blockade not only caused enhanced clinical improvement but also reduced the recurr ences as defined by expressed prostatic secretion positive segmental c ultures.