Subject: alt.support.prostate.prostatitis FAQ 3/5
Supersedes: <medicine/prostatitis-faq/part3_818363045@rtfm.mit.edu>
Date: 6 Jan 1996 23:45:53 GMT
References: <medicine/prostatitis-faq/part1_820971430@rtfm.mit.edu>
X-Last-Updated: 1995/10/16

Posting-Frequency: monthly

8. What causes prostatitis?

A leading research has called prostatitis has been called "a
wastebasket of clinical ignorance."  Its causes are not clearly
known.

The presence of disease-causing bacteria and response to antibiotic
treatment is strong evidence that many cases of prostatitis are
caused by bacterial infection.  Since antibiotics do not diffuse
readily into the prostate and since some bacteria appear to defend
themselves with slime coatings, the lack of success with
antibiotics does not necessarily mean that most cases of the
disease are not caused by infection.  The basic test for infective
organisms in the prostate is still the Meares and Stamey technique,
in which urine samples are taken before and after prostate massage;
the results of this test are often inconclusive.

Some researchers believe that many cases of prostatitis are caused
by autoimmune reactions, and autoimmune prostatitis has been
demonstrated in laboratory animals.  

Some doctors think that some cases are caused by a backflow of
urine into the prostate, caused by anatomical factors or overly
rushed urination.  Others believe that decreased sexual activity
can lead to prostatitis, as the prostate becomes "clogged up." 
Another theory is that some cases of prostatitis or prostatodynia
are caused by too much tension in the urinary sphincter.   

And it is possible that many cases diagnosed as prostatitis without
a full range of tests are caused by other conditions, such as
interstitial cystitis or ejaculatory duct obstruction.  

9.  Can prostatitis be cured?

(NOTE:  The following is not intended to recommend any specific
drug or regimen.  It is based on a review of the literature and the
reports of people in the newsgroup.  CONSULT YOUR PHYSICIAN BEFORE
UNDERTAKING ANY TREATMENT.)

Since physicians do not know the cause of prostatitis, they cannot
tell when you have been cured; scientists cannot objectively
measure pain.  Many people find that certain drugs reduce their
symptoms as long as they take the drug.  Other people find the
symptoms get better without treatment.  For still other people, no
drug helps.  And for some, the treatment will work and they will
never have symptoms again.  The following treatments have been used
for prostatitis. 

9A.  Noroxin (norfloxacin).  Noroxin is the brand name for
norfloxacin, a quinolone antibiotic.  DadOfSix@aol.com reports a
complete resolution of all his symptoms for over eighteen months. 
He was diagnosed with "non-bacterial" prostatitis.  He was placed
on two 400 mg. tabs of Noroxin a day, and responded immediately. 
He took Valium simultaneously during flare-ups.  As he got better
and flare-ups became less frequent he was tapered to one pill every
other day, then one pill every three days.  He and his physician
are afraid to take DadOfSix off antibiotics since he is symptom-
free.  

9B.  Other quinolones.  Other quinolone antibiotics are Cipro
(ciprofloxacin), Floxin (ofloxacin), Penetrex (enoxacin) and
Maxaquin (lomefloxacin).  All of the quinolones have had some
success in treating prostatitis, whether bacterial or "non-
bacterial."  These are new and therefore expensive drugs.  Some of
their success may be due to their newness; bacteria which have
developed resistance to other families of antibiotics may respond
to quinolones.

9C.  Transurethral resection of the prostate (TURP) or bladder neck
incision.  This surgery is often disappointing, and should only be
undertaken after seeking a second opinion.  (However, TURP is a
standard procedure in the treatment of benign prostatic
hypertrophy.)

9D.  Microwave hyperthermy or thermotherapy.  In these experimental
techniques, prostate tissue is heated by means of microwaves. 
There seem to be two different machines.  With the Prostatron, a
catheter is placed in the prostate; the catheter cools the urethra
while the surrounded tissue is heated.  With the Prostathermer, the
microwave device is inserted through the rectum.  With hyperthermy,
the prostate is heated to a level just below tissue destruction. 
Thermotherapy involves tissue restruction; it is being used as a
substitute for TURP surgery for BPH and prostatitis.  These
techniques are still in the experimental phase.  Side effects such
as temporary impotence or incontinence are possible.

9E.  Bactrim.  Bactrim (trimethaprim/sulfamethoxazole or TMP/SMZ)
is an antibiotic which has been used to treat prostatitis.  

9F.  Geocillin (carbenicillin) is another antibiotic that has been
used for prostatitis.  It a s member of the penicillin family.

9G.  Doxycycline or minocycline.  Yet more antibiotics used for
prostatitis.

9H.  Keflex (cephalexin)  Still another antibiotic. 

9I.  Hytrin.  This blood pressure medication is sometimes tried in
cases of prostatitis or prostatodynia.  It may work by reduce
urinary muscle tension.

9J.  Antifungals (Nystatin, ketoconazole, Diflucan).  Fungal
prostatitis has been reported in the literature, but is rare. 
However, Garst@sunchem.chem.uga.edu reports palliative effects from
these drugs in the absence of a diagnosis of prostatic fungal
infection. 

9K.  Herbal and alternative medications.  Saw palmetto capsules are
available in health food stores.  Domonkos@access.digex.net
reported a temporary improvement in urinary flow from drinking saw
palmetto tea, taking hot baths, and taking antibiotics.  A flower
pollen compound called Cernilton has been used experimentally in
Europe for prostatitis.  Experiences of newsgroup members with
Cernilton have been unsuccessful.

9L.  Zinc supplements.  The role of zinc in prostate health is
unclear.  Digmedia@nlnet.nf.ca reports that he was cured after
taking 50 mg of zinc for a month or so, and then switching to a
general multivitamin.
