Treatments for Chronic nonbacterial prostatitis
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The following are some of the latest treatments for Chronic nonbacterial prostatitis:
Hospital statistics for Chronic nonbacterial prostatitis:
These medical statistics relate to hospitals, hospitalization and Chronic nonbacterial prostatitis:
- 0.023% (2,982) of hospital consultant episodes were for inflammatory diseases of prostate in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 95% of hospital consultant episodes for inflammatory diseases of prostate required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 100% of hospital consultant episodes for inflammatory diseases of prostate were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 14% of hospital consultant episodes for inflammatory diseases of prostate required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 4.7 days was the mean length of stay in hospitals for inflammatory diseases of prostate in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Pelvic Pain - Female:
Treatment
(In a Page: Signs and Symptoms)
-
Primary dysmenorrhea: NSAIDs; consider oral contraceptives to suppress ovulation in severe disease
-
Positive pregnancy test: Determine last menstrual period; obtain quantitative β-hCG; confirm intrauterine pregnancy
-
In patients at high risk for STDs, treat empirically for PID (to cover gonorrhea and Chlamydia)
–Ofloxacin 400 mg PO BID for 14 days plus metronidazole 500 mg PO BID for 14 days, or
–Ceftriaxone 250 mg IM single dose plus doxycycline 100 mg PO BID for 14 days
-
Endometriosis: Treat with hormonal medications or surgical
laparoscopy
–Oral contraceptives for 3–4 months, or
–Provera 39 mg QD for 2 months, or
–Danazol 200–800 mg QD for 6 months, or
–GnRH agonist (e.g., leuprolide)
'>>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Benign prostatic hyperplasia:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Conservative therapy includes prostate massages, sitz baths, fluid restriction for bladder distention, and antimicrobials for infection. If symptoms are mild, methods for relief may include avoiding alcohol and caffeine, especially after dinner; urinating when the urge is initially felt; avoiding over-the-counter cold and sinus medications that contain decongestants or antihistamines because they can increase BPH symptoms; keeping warm and exercising regularly as cold weather and lack of physical activity may worsen symptoms; performing pelvic strengthening exercises (Kegel exercises); reducing stress because nervousness and tension can lead to more frequent urination. Some males have had success taking extracts of saw palmetto berries, an herb that has been used to ease prostate symptoms. Fat-soluble saw palmetto extract that has been standardized to contain 85% to 95% fatty acids and sterols is more effective. Regular ejaculation may help relieve prostatic congestion.
Urine flow rates can be improved with alpha1-adrenergic blockers, which relieve bladder outlet obstruction by preventing contractions of the prostatic capsule and bladder neck. Finasteride lowers levels of hormones produced by the prostate, reduces the size of the prostate gland, increases urine flow rate, and decreases symptoms of BPH. It may take 3 to 6 months before a significant improvement in symptoms occurs. Potential adverse effects related to finasteride include decreased sex drive and impotence.
Surgery is the only effective therapy to relieve acute urine retention, hydronephrosis, severe hematuria, recurrent UTIs, and other intolerable symptoms. A transurethral resection may be performed if the prostate weighs less than 2 oz (56.7 g). In this procedure, a resectoscope removes tissue with a wire loop and electric current. In high-risk patients, continuous drainage with an indwelling urinary catheter alleviates urine retention. Transurethral needle ablation may be used to heat and destroy prostate tissue by radiofrequency; this helps spare surrounding tissue.
The following procedures involve open surgical removal:
❑ suprapubic (transvesical) resection: most common and useful when prostatic enlargement remains within the bladder
❑ retropubic (extravesical) resection: allows direct visualization; potency and continence are usually maintained.
Balloon dilatation of the prostate is still being investigated. Balloon dilatation or balloon urethroplasty involves passing a flexible balloon catheter through the urethra at the level of the prostate while being guided by fluoroscope. The balloon is inflated for a short time to distend the prostatic urethra.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Prostatic cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Management of prostatic cancer depends on clinical assessment, tolerance of therapy, expected life span, and the stage of the disease. Treatment must be chosen carefully, because prostatic cancer usually affects older men, who commonly have coexisting disorders, such as hypertension, diabetes, or cardiac disease.
Therapy varies with each stage of the disease and generally includes radiation, prostatectomy, orchiectomy to reduce androgen production, and hormone therapy with synthetic estrogen (diethylstilbestrol [DES]) and antiandrogens, such as cyproterone, megestrol, and flutamide. Radical prostatectomy is usually effective for localized lesions.
Radiation therapy is used to cure some locally invasive lesions and to relieve pain from metastatic bone involvement. A single injection of the radionuclide strontium 89 is also used to treat pain caused by bone metastasis.
If hormone therapy, surgery, and radiation therapy aren't feasible or successful, chemotherapy (using combinations of mitoxantrone with prednisone, estramustine, docetaxel, and paclitaxel) may be tried. However, current drug therapy offers limited benefit. Combining several treatment methods may be most effective.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Prostatitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Systemic antibiotic therapy chosen according to the infecting organism is the treatment of choice for acute prostatitis. If sepsis is likely, I.V. antibiotics may be given until sensitivity test results are known. If test results and clinical response are favorable, parenteral therapy continues for 48 hours to 1 week, after which an oral agent is substituted for 30 days. For infections caused by a sexually transmitted disease, injection of ceftriaxone followed by a 10-day course of doxycycline or floxacin is effective.
Supportive therapy includes bed rest, adequate hydration, and administration of analgesics, antipyretics, sitz baths, and stool softeners as necessary. Diet therapy includes avoiding substances that irritate the bladder, such as alcohol, caffeinated food and beverages, citrus juices, and hot or spicy foods. Increasing the intake of fluids (1,893 to 3,785 ml/day) encourages frequent urination that will help flush the bacteria from the bladder. In symptomatic chronic prostatitis, regular massage of the prostate is most effective. Regular ejaculation may help promote drainage of prostatic secretions. Anticholinergics and analgesics may help relieve nonbacterial prostatitis symptoms.
If drug therapy is unsuccessful, treatment may include transurethral resection of the prostate, which requires removal of all infected tissue. However, this procedure usually isn’t performed on young adults because it may cause retrograde ejaculation and sterility. Total prostatectomy is curative but may cause impotence and incontinence.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Benign prostatic hyperplasia:
Treatment
(Handbook of Diseases)
Treatment depends on the cause, severity of the obstruction and the status of the patient. Conservative therapy includes prostate massages, sitz baths, fluid restriction for bladder distention, and an antimicrobial for infection. Regular ejaculation may help relieve prostatic congestion.
Urine flow rates can be improved with alpha-adrenergic blockers, such as terazosin, tamsulosin, and prazosin. These drugs relieve bladder outlet obstruction by preventing contractions of the prostatic capsule and bladder neck. Finasteride may also reduce the size of the prostate in some patients.
Surgery is the only effective therapy to relieve acute urine retention, hydronephrosis, severe hematuria, recurrent urinary tract infections, and other intolerable signs and symptoms. (See Combating septic shock after prostate surgery.)
A transurethral resection may be performed if the prostate weighs less than 2 oz (57.2 g). In this procedure, a resectoscope removes tissue with a wire loop and electric current. In high-risk patients, continuous drainage with an indwelling urinary catheter alleviates urine retention.
Alternatively, large prostates can be removed by one of two surgical approaches:
❑ suprapubic (transvesical) resection: most common and useful when prostatic enlargement remains within the bladder
❑ retropubic (extravesical) resection: allows direct visualization; potency and continence are usually maintained.
Balloon dilatation of the prostate is ineffective. Transurethral microwaves (heat therapy) are now being used in some patients. Their efficacy lies between that of the use of an alpha1-adrenergic blocker and surgery.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Prostatic cancer:
Treatment
(Handbook of Diseases)
Management of prostatic cancer depends on clinical assessment, tolerance of therapy, expected life span, and the stage of the disease. Treatment must be chosen carefully because prostatic cancer usually affects older men, who commonly have coexisting disorders, such as hypertension, diabetes, or cardiac disease. If the patient is younger than age 70, a radical prostatectomy is commonly performed. If the patient is age 70 or older, radiation (including implants) or cryosurgery may be performed to ablate the cancer.
Therapy varies with each stage of the disease and generally includes radiation, prostatectomy, orchiectomy to reduce androgen production, and hormone therapy with synthetic estrogen (diethylstilbestrol [DES]) and antiandrogens, such as cyproterone, meges-trol, and flutamide. Radical prostatectomy is usually effective for localized lesions.
Radiation therapy is used to cure some locally invasive lesions and to relieve pain from metastatic bone involvement. A single injection of the radionuclide strontium-89 is also used to treat pain caused by bone metastasis.
If hormone therapy, surgery, and radiation therapy aren’t feasible or successful, chemotherapy (using combinations of cyclophosphamide, doxorubicin, fluorouracil, cisplatin, etoposide, and vindesine) may be tried. However, current drug therapy offers little benefit. Combining several treatment methods may be most effective.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Prostatitis:
Treatment
(Handbook of Diseases)
Appropriate treatment includes drug therapy and supportive measures. Surgery may be necessary if drug therapy is unsuccessful.
Drug therapy
Systemic antibiotic therapy is the treatment of choice for acute prostatitis. Trimethoprim-sulfamethoxazole, fluoroquinolones, and tetracycline derivatives are used most commonly. If prostatitis is due to a sexually transmitted disease, ceftriaxone and doxycycline or floxacin are used.
If test results and clinical response are favorable, parenteral therapy continues for 48 hours to 1 week; then an oral agent is substituted for 30 more days.
Support measures
Supportive therapy includes bed rest, adequate hydration, and administration of analgesics, antipyretics, sitz baths, and stool softeners as necessary. In symptomatic chronic prostatitis, regular massage of the prostate is most effective. Regular ejaculation may help promote drainage of prostatic secretions. Anticholinergics and analgesics may help relieve nonbacterial prostatitis symptoms. Alpha-adrenergic blockers and muscle relaxants may relieve prostatodynia. Antispasmolytics may be administered for bladder spasms.
Surgery
If drug therapy is unsuccessful, treatment may include transurethral resection of the prostate, which requires removal of all infected tissue. However, this procedure usually isn’t performed on young adults, because it may cause retrograde ejaculation and sterility. Total prostatectomy is curative but may cause impotence and incontinence.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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