Jiménez-Cruz J F, Tormo F B, Gómez J G
Service of Urology, La Fe Hospital, Valencia, Spain.
J Urol. 1988 May;139(5):967-70. doi: 10.1016/s0022-5347(17)42733-9.
We treated 51 patients diagnosed as having chronic bacterial prostatitis (gram-negative) with 2 ml. intraprostatic amikacin (500 mg.) or tobramycin (100 mg.) weekly for 2 to 4 weeks. Administration was perineal with echographic control and injection was done in the echogenic zone or external gland. In each case the diagnosis was obtained by fractioned microbiological study via the method of Meares and Stamey. This test was repeated 4, 12 and 24 weeks after the end of treatment. Of the patients 25 (49 per cent) were cured microbiologically, 11 (21.5 per cent) were cured after a second cycle of treatment and the remaining 15 (29.4 per cent) failed to respond. The clinical cure rate was 43.1 per cent and 41.1 per cent of the patients were improved. After 6 months 5 patients had relapse and 1 had reinfection. No differences were observed with both antimicrobials. The microbiological cure indexes of 70.5 and 58.8 per cent after 3 and 6 months, respectively, compared favorably with that obtained by oral therapy with antimicrobials that reach effective levels in the prostatic fluid. Transitory post-injection hemospermia was observed in 11 patients. Together with pain during or after injection (8 and 5 patients, respectively), these were the sole adverse effects observed with this therapy.
我们对51例诊断为慢性细菌性前列腺炎（革兰氏阴性）的患者，每周经会阴给予2ml前列腺内阿米卡星（500mg）或妥布霉素（100mg），持续2至4周，注射过程采用超声引导，药物注射至前列腺强回声区或外腺区。每例患者均通过Meares和Stamey方法进行分段微生物学研究以明确诊断。治疗结束后4周、12周和24周重复此项检查。结果显示，25例（49%）患者微生物学治愈，11例（21.5%）患者在第二个疗程后治愈，其余15例（29.4%）治疗无效。临床治愈率为43.1%，41.1%的患者病情改善。6个月后，5例患者复发，1例再次感染。两种抗菌药物治疗效果无差异。3个月和6个月时微生物学治愈率分别为70.5%和58.8%，与口服能在前列腺液中达到有效浓度的抗菌药物治疗效果相比更优。11例患者出现注射后短暂血精。此外，分别有8例和5例患者出现注射时或注射后疼痛，这些是该治疗仅观察到的不良反应。
