The treatment of chronic bacterial prostatitis.

Chronic bacterial prostatitis, the most common cause of recurrent urinary tract infections in the male patient, is a clinical entity accurately defined by two essential features: (1) recurrent urinary tract infections and (2) persistence of gram-negative bacteria in the prostatic secretion. Chronic bacterial prostatitis is mainly a bacteriologic diagnosis and, therefore, sequential bacteriologic localization cultures are the only way to correct diagnosis. Thirty-five of 39 patients (90%) with chronic bacterial prostatitis were cured of their disease either by a short-term (14-day) intramuscular kanamycin treatment or a long-term (average of five months) oral co-trimoxazole, pure trimethoprim or ciprofloxacin treatment; selected patients suffering from chronic bacterial prostatitis with an associated pathology such as benign enlargement of the prostate, associated occasionally with infected prostatic calculi, who did not respond to medical therapy alone, were cured by a combined adequate antibacterial and surgical (a modified retropubic prostatectomy) treatment. All the patients were followed up for at least one year and most patients several years following treatment.