This study was undertaken to evaluate the influence of treatment with rifaximin followed by the probiotic VSL#3 versus no treatment on the progression of chronic prostatitis toward chronic microbial prostate‑vesiculitis (PV) or prostate‑vesiculo‑epididymitis (PVE). A total of 106 selected infertile male patients with bacteriologically cured chronic bacterial prostatitis (CBP) and irritable bowel syndrome (IBS) were randomly prescribed rifaximin (200 mg, 2 tablets bid, for 7 days monthly for 12 months) and probiotic containing multiple strains VSL#3 (450 × 109 CFU per day) or no treatment. Ninety‑five of them (89.6%) complied with the therapeutic plan and were included in this study. Group A = “6Tx/6‑”: treatment for the initial 6 and no treatment for the following 6 months (n = 26); Group B = “12Tx”: 12 months of treatment ( 22); Group C = “6‑/6Tx”: no treatment for the initial 6 months and treatment in the last 6 months ( 23); Group D = “12‑”: no treatment ( 24). The patients of Groups A = “6Tx/6‑” and B = “12Tx” had the highest frequency of chronic prostatitis (88.5% and 86.4%, respectively). In contrast, group “12‑”: patients had the lowest frequency of prostatitis (33.4%). The progression of prostatitis into PV in groups “6Tx/6‑” (15.5%) and “6‑/6Tx” (13.6%) was lower than that found in the patients of group “12‑” (45.8%). Finally, no patient of groups “6Tx/6‑” and “6‑/6Tx” had PVE, whereas it was diagnosed in 20.8% of group “12‑” patients. Long‑term treatment with rifaximin and the probiotic VSL#3 is effective in lowering the progression of prostatitis into more complicated forms of male accessory gland infections in infertile patients with bacteriologically cured CBP plus IBS.

Keywords: chronic bacterial prostatitis; irritable bowel syndrome; probiotic VSL#3; prostate‑vesiculitis; prostate‑vesiculo‑epididymitis; rifaximin

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