Background: Many attempts have been made to improve the treatment success rate of chronic bacterial prostatitis (CBP). However, no treatment modality has achieved complete cure. The growth and development of the prostate is under direct hormonal control, and it is possible that prostatitis may be directly influenced by its hormonal milieu in a similar fashion to benign prostatic hyperplasia and prostate cancer. Therefore, the effects of androgen deprivation on the treatment of CBP were investigated in rats.
Methods: Experimental CBP was induced in one hundred, male Wistar rats by instillation of bacterial suspension (Escherichia coli Z17, O2: K1: H-) containing 1 x 10(8) CFU/ microL into the prostatic urethra. Microbiologically and histologically proven CBP was demonstrated in 62% (62 of 100) of the rats after 4 weeks of bacterial instillation. The 62 rats demonstrating CBP were randomly divided into five groups: control; castration; finasteride; estrogen; and levofloxacin groups. All drug treatments were conducted over a period of 4 weeks.
Results: Microbiological cultures and histological findings of the prostate and urine samples demonstrated reduced bacterial growth and improved inflammatory responses in all four experimental groups compared with the control group. The castration and estrogen groups showed coherent trends of decrease in bacterial growth and improvements in prostatic inflammation compared with the control group, but not to a statistically significant degree (P > 0.05). However, the finasteride and levofloxacin groups did show statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (P < 0.05).
Conclusion: These results suggest that androgen deprivation is an effective modality in CBP treatment. In particular, the finasteride treatment reduced the severity of CBP in the animal model without reducing the systemic testosterone level. The combination of finasteride and levofloxacin maybe one of the effective treatment modalities for CBP.