Summary
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.
Zusammenfassung
Die chronische bakterielle Prostatitis ist die häufigste Ursache rezidivierender Harnwegsinfektionen bei männlichen Patienten. Das klinische Bild wird im wesentlichen durch zwei Charakteristika geprägt: 1. rezidivierende Harnwegsinfektionen, 2. Persistenz gramnegativer Bakterien im Prostatasekret. Die Diagnose chronische bakterielle Prostatitis beruht im wesentlichen auf bakteriologischen Untersuchungen, und kann folglich nur durch sequentiell entnommene Kulturen, die eine Lokalisation zulassen, gestellt werden. Von 39 Patienten mit chronischer bakterieller Prostatitis wurden 35 (90%) durch antimikrobielle Therapie geheilt. Verabreicht wurde entweder eine Kurzzeit (14-Tage-)Therapie mit Kanamycin i. m. oder eine Langzeit (durchschnittlich 5-Monate-)Therapie mit oralem Cotrimoxazol, Trimethoprim allein oder mit Ciprofloxacin. Einzelne Patienten, die neben der chronischen bakteriellen Prostatitis andere Veränderungen wie eine benigne Prostatahypertrophie aufwiesen und gelegentlich auch infizierte Prostatasteine hatten und auf die medikamentöse Therapie allein nicht ansprachen, wurden durch kombiniertes Vorgehen mit adäquater antibakterieller und chirurgischer Therapie geheilt. Dabei wurde eine modifizierte Methode zur retropubischen Prostatektomie eingesetzt. Alle Patienten wurden mindestens ein Jahr, einige mehrere Jahre lang nachbeobachtet.
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Pfau, A. The treatment of chronic bacterial prostatitis. Infection 19 (Suppl 3), S160–S164 (1991). https://doi.org/10.1007/BF01643689
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DOI: https://doi.org/10.1007/BF01643689