Q: I am a 72 years old man suffering from chronic prostatitis for the last 15 years. Antibiotics, anti-inflammatory medicines (Nimulid) give relief but only for some time. I have undergone transuretheral prostatectomy (TURP) four times and every time the report says chronic prostatitis. How can this be treated? I have burning/pain in the urethra. The urine test says NAD. Please advise

A:Chronic prostatitis of bacterial origin is rare. Chronic bacterial prostatitis usually presents as recurrent urinary tract infections. Not all antibiotics reach prostate in sufficient concentration, and hence not very effective. Presence of stones and calcification in prostate makes eradicating infection even more difficult in these cases. However, more than 90 to 95% of cases labelled as chronic prostatitis are non-infective in origin. These cases have been rechristened as CPPS or chronic pelvic pain syndrome. Antibiotics in latter cases act by their anti-inflammatory property rather than by antibacterial effect. Antibiotics, anti-inflammatory drugs, alpha-blockers and surgical relief of obstruction may be effective only partly and temporarily. Alternative methods of medicine and pain experts may be put to excellent use in some refractory cases with CPPS.