What is included in long-term monitoring following treatment for prostatitis?

Updated: Dec 06, 2018
  • Author: Paul J Turek, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

After initial improvement with parental antibiotics, acute bacterial prostatitis may be managed with outpatient care with a 2- to 4-week course of oral antibiotics and urologic follow-up. Management strategies for category II prostatitis, chronic bacterial prostatitis, include intraprostatic antibiotic injection, alpha-blocker therapy, transurethral resection of the prostate (TURP), and long-term antimicrobial suppression.

Additional therapeutic modalities studied for category III prostatitis include anti-inflammatories, phytotherapy, biofeedback, thermal therapy, and pelvic floor exercises.

Prostate-specific antigen (PSA) levels may be elevated with both prostatitis and prostate cancer. However, PSA levels typically fall after resolution of prostatitis but do not fall with prostate cancer. Patients found to have elevated PSA levels should have follow-up by their primary care physicians, urologists, or both.

PSA levels may increase with acute prostatitis; with appropriate antibiotic treatment, levels usually return to normal within 1-3 months. [32] In some studies, a longer course of antibiotics has been shown to result in a decrease in PSA values in patients with category IV prostatitis.


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