The pH of the Prostatic Fluid in Health and Disease:Implications of Treatment in Chronic Bacterial Prostatitis

Abstract

The pH of expressed prostatic secretion was measured in men with and without inflammatory prostatic disease. Whereas the pH of expressed prostatic secretion was acid with a mean of 6.7 in men without inflammatory prostatic disease, it reached a mean of 8.1 in those with chronic bacterial prostatitis. Return of expressed prostatic secretion to acid values after cure of the disease occurred after at least 2 yr. The implications are discussed of the elevation of the expressed prostatic secretion pH in chronic bacterial prostatitis on its effective treatment. The markedly alkaline pH of expressed prostatic secretion in chronic bacterial prostatitis is the probable cause of the ineffectiveness of the short-term co-trimoxazole treatment and the only partial success of the more effective long-term treatment in this disease. In the presence of such a pH the aminoglycosides are recommended as an additional effective antimicrobial drug in cases of chronic bacterial prostatitis not responding to co-trimoxazole therapy as supported by clinical experience. In view of the elevated pH of the prostatic fluid and the success of the lipid insoluble aminoglycosides in chronic bacterial prostatitis further antimicrobials, like the sulfonamides (lipid soluble acids), should be reconsidered in this treatment.