What is the role of prostatectomy in the treatment of chronic bacterial prostatitis (CBP)?

Updated: Jan 15, 2019
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Prostatectomy is rarely indicated in the treatment of chronic bacterial prostatitis (CBP). When used, radical transurethral prostatectomy is suggested. This procedure may be more effective in men with prostatic calculi. Because most of the inflammation is located in the peripheral zone of the gland, an extensive resection of the gland is required to remove all infected and potentially infected tissue down to the level of the true prostatic capsule.

Only a single series of 10 patients, most with prostatic calculi, has been reported, but all 10 were considered cured. [58]  These authors concluded that the procedure is indicated, although only rarely, in men with well-documented bacterial infections in whom medical pharmacotherapy fails for 1 year.

For refractory cases, other authorities have suggested that transurethral microwave therapy to ablate prostate tissue has shown some benefit. [59]  At this time, this intervention should be considered only in patients in whom less-invasive therapies have failed but who do not desire radical transurethral prostatectomy. Larger series would be helpful to define the benefit of this procedure.


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