Antibiotic Treatment for Chronic Prostatitis: Key Questions Answered - Urology

Hello, I would like to inquire about the use of antibiotics for prostatitis?

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Hello Dr.
Lai, I previously suffered from chronic bacterial prostatitis and underwent treatment at Hospital A for over five months before it was resolved.
Ultimately, I was treated successfully with ciprofloxacin.
The doctor mentioned that due to the massage of my prostate, the initial urine sample did not show significant white blood cells.
However, for safety reasons, I sought a second opinion at Hospital B.
During the examination at Hospital B, after directly massaging the prostate and collecting prostatic fluid, the results showed 2-4 white blood cells and two plus signs for bacteria.
The doctor prescribed an antibiotic called Baccidal.
I believed that, according to many doctors, the white blood cell count is the most accurate indicator and that the number of bacteria is not as critical (as many doctors from various hospitals have told me).
However, after being declared cured at Hospital A, I still experienced prostate pain, especially during prostate massage and prolonged sitting.
Therefore, I decided to follow the advice of the doctor at Hospital B and took the medication for nine days.
After nine days, I returned to Hospital B for another prostate fluid examination, which showed 6-10 white blood cells and two plus signs for bacteria.
I began to wonder if the medication prescribed by the doctor at Hospital B was ineffective (since I had already taken many types of antibiotics, both first-line and second-line).
It seemed that the bacteria, which had been reduced to a minimal level, became active again.
However, the doctor kept attributing the cause to my engaging in risky behaviors or drinking alcohol.
Am I not aware of my own actions? The doctor at Hospital B insisted on prescribing other medications, claiming they would be more effective, but I firmly refused.
After seven days, I returned to Hospital A to consult the physician who had successfully treated me.
He stated that after examining my urine sample taken after prostate massage, there were no white blood cells or red blood cells present.
This led me to another suspicion: how could there be 6-10 white blood cells just seven days ago, and now none at all after not taking any medication? Therefore, my questions are as follows:
1.
Is the method of examining the prostate by massaging it and collecting the initial urine sample at Hospital A really less accurate than directly collecting prostatic fluid at Hospital B? Which method is more reliable in terms of accuracy? (The massage at Hospital A was sufficient for me to feel prostatic fluid reaching the penis.)

2.
Is it possible that my immune system could have eliminated the inflammatory symptoms, given that the white blood cell count was 6-10 at Hospital B, but none were detected at Hospital A seven days later?
3.
According to the physician at Hospital A, I am considered cured.
If I were to take an antibiotic that I had previously taken, which was later proven to be ineffective against the bacteria (like the Baccidal prescribed by the doctor at Hospital B), could this potentially stimulate the previously controlled bacteria in my prostate to proliferate? This question is very important to me because I have taken too many antibiotics.
If the answer is affirmative, does this mean that in the future, if I need antibiotics for other medical issues, I must inform the respective specialists about my history with antibiotics from hospitals A and B to avoid prescribing medications that could irritate my prostate?
I appreciate your time in addressing these lengthy questions.
Thank you very much for your assistance.
I am currently studying in Wisconsin, where medical resources are scarce, making it difficult to consult doctors as easily as in Taiwan.
Thank you again for your help.

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Xiao Ming, 20~29 year old female. Ask Date: 2009/01/28