Treatment of chronic prostatitis: intraprostatic antibiotic injections under echography control

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.