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The most appropriate antibiotics, based on pharmacokinetic data, are trimethoprim, trimethoprim/sulfamethoxazole, or a fluoroquinolone. Others have advocated erythromycin, the tetracyclines, and carbenicillin, but these really should be second-line antimicrobials for category II prostatitis. If the patient relapses, continuous suppressive antibiotics are indicated.If prostatitis recurs (with or without a different organism), low dose prophylaxis may be necessary. If the patient’s symptoms remain refractory, an attempt at repetitive prostatic massage (at least twice weekly) combined with antibiotics for a 6-week period may be beneficial in draining some of the obstructed prostatic ducts and allowing better antibiotic penetration.This historic and theoretical treatment has started to receive widespread general popularity again. Surgery is a very last resort and should be restricted to patients in whom the bacterium is identified in the prostate gland on biopsy. If a patient has prostatic calculi associated with bacteria, there is a greater chance that he may benefit from surgery. Patients should be willing to accept the morbidity of possible incontinence, impotence, and the fact that pain may continue despite removal of the infected prostate gland.A number of exciting developments over the last several years are changing the realities of prostatitis research: The formation of a very strong patient advocacy group (the Prostatitis Foundation), a reappraisal of the epidemiologic scope of the problem, significant new funding initiatives by sponsoring agencies, and an awakening of interest by industry with the realization that prostatitis may truly be the largest, untapped disease in urology. But most of all, it is the renewed interest in an old prostate disease by a new generation of urologic researchers that will change the face of prostatitis as we enter the new millennium.This simple-to-administer prostatitis specific questionnaire has been modified from the original SSI from data obtained from testing the original (or similar) questions during validation studies for the new NIH Chronic Prostatitis Symptom Index.The SSI (used together with the Symptom Frequency Questionnaire [SFQ]) has proven useful in both clinical studies and clinical practice. It has also proven more sensitive than the SFQ to follow patient response to therapy.This simple-to-administer prostatitis specific questionnaire (formatted very closely to the American Urological Association BPH Symptom Index) has been modified from the original Symptom Frequency Questionnaire (SFQ), from data obtained from testing the original (or similar) questions during the validation studies for the new NIH Chronic Prostatitis Symptom Index. The SFQ (used together with the Symptom Severity Index [SSI]) has proven useful in both clinical studies and clinical practice. Although not as sensitive as the SSI to measure effects of therapy, this questionnaire provides important baseline history information for the practicing clinician when first evaluating a difficult patient with chronic prostatitis.Keep Prostate Healthy - Click here to read

When you see ‘Fraser Institute” on a report you must, must, must read the methodology section.The data for this issue of Waiting Your Turn were collected between January 4 and April 28, 2017. Survey questionnaires [4] were sent to practitioners in 12 medical specialties: plastic surgery, gynaecology, ophthalmology, otolaryngology, general surgery, neurosurgery, orthopaedic surgery, cardiovascular surgery, urology, internal medicine, radiation oncology, and medical oncology. This year, the overall response rate was 21% (table 1).This is not ‘wait times for medical care’. This is ‘wait times for specialist visits as estimated by 21% of specialists using “weeks” as the scale of measurement.’ When evaluating this I’d want to see a far more granular breakdown in the response rate by specialty and analysis done within each province (and within the health regions in each province), instead of nationally.Here’s the specific question used in the questionnaire1. From today, how long (in weeks) would a new patient have to wait for a routine office consultation with you? ____________ week(s)You MUST read a Fraser Institute report methodology section.You’ll notice as you read the report that there are significant regional disparities in wait times as well as significant disparities between specialties.As is normal, the Fraser Institute is taking noisy data, creating a convenience sample based on estimates and then making broad proscriptions for health policy.

Viagra is an effective treatment for impotency in men who have their prostate removed. For men whose nerves have been spared, the drug improves the ability to have an erection by nearly 60%, but the effectiveness drops to 20% in those with no nerves spared."Incontinence and impotence are the two most common [prostatectomy] side effects. A large number of patients, even with nerve-sparing techniques, end up with erectile dysfunction," Milton Lakin, MD, who leads the medical urology section at Cleveland Clinic Foundation, tells WebMD. "The first thing [doctors] want to do is a very good cancer operation. Cancers are being discovered early enough that in many cases it is possible to spare both nerves, or at least one."The new study, which appears in the November Journal of Urology, was completed by physicians at Baylor College of Medicine in Houston. It involved about 80 men who ranged in age from 47 to 76 years old. All were prescribed Viagra following prostate removal surgery. Based on their responses to a series of questionnaires, 53% had improved erections and 40% had improved ability to have intercourse.Source :[1]The prostate’s most important function - Clik Here to readFootnotes[1] Viagra Useful for Impotence after Prostate Surgery