Hi All,

Some of this info maybe useful for some of you, especially the
bacterial portion, thats from all sort of research articles ive read.

I liked seeing Dr.Kaplan, i recommend him for others, he seems very
knowledgable and willing to listen, and helps out financially to. Last
time I saw him he said I seemed fine, but I dunno, And I saw another
URO. He asked me to return in a few weeks again, which i am now about
to do. Below is some info I would like to share with him, and kind of
lead him to a problem if there is one.

ONE other GOOD point is, that they do urine/semen cultures right there
at their lab, so it does not have to be shipped out to what some of
you may call a bullshit Lab with a bunch of TECHs. The URO does it
him/herself and can look at the sample under the microscope right that
instant.

Pricing is: $100-150 first visit, $100 visits after
Culture: $15-50 (i believe)

I think they are a good batch of UROs. I guess I will see Monday. Keep
you guys posted. SORRY FOR LONG POSSSSSSSSSSSSSSSSSSSST.

This basically summarizes all of my problems (?).

Commentary is welcomed.

Summary:

Too much protein from protein shakes, high RBC in blood – prostate
stones?
Took SAW PALMETTO????? Had some abdominal pain, then stopped, pain
left.
November 2003 – Fast from sunrise to sunset, dehydration = UTI?
December 2003 – slight warm sensation on initial urination (on/off)
           Urinalysis/culture negative
               Urethra seemed swollen (1 day) (??)
January 2004  - New Years, sexual intercourse, condom used, but popped
at end.
Mid Jan 2004  - IVP. Noticed Bactrim (?) taken through rectum as part
of KIT.
               Warm feeling gone.
           Feel like something deep inside rectum was swollen, feel
           Uncomfortable when sitting.
           Saw URO (Cosgrove), he said was fine.
           PCP said to ejaculate more. (1-2 day was what I was doing)

February 2004 – clear drop of fluid at end of urinary stream. Saw URO
(Cosgrove), he did Urethra Swab, Semen Analysis/Culture, Urine
Culture. Results all negative. (I was constantly squeezing urethra,
and folding legs to squeeze fluid out, noticed a lot coming out at
this time)

Mid February 2004 –  Test came back negative. Prescribed Doxy(200 mg?)
10 days.
(Noticed clear fluid subsided greatly by this time)Also taking some
IBUPROFEN.

March 2004 -      Rarely saw clear fluid. More obsessed with symptoms.
  Very               depressed. Took more and more tests urinalysis/cultures.
              Noticed a period from March 17-April 2, no clear fluid.              
   Then ejaculated, and the day saw some clear fluid.

April 2004        - Saw E.Coli in Urine culture. Repeated 2 times
after, both              negative. Took 7 days of Cipro 500 mg.

Mid  April 2004   - Saw URO (Cosgrove), he could not explain it. He
says he     doesn't see anything wrong. Symptoms don't bother him. DRE
showed prostate normal size, Ultrasound of bladder & prostate, showed
bladder retaining negligible amount, and prostate of normal size.

May 3, 2004        - Saw URO (Kaplan), DRE seemed normal. Ultrasound of
bladder & prostate showed bladder retaining 1cc (?). Said to come back
in 1 month.

May 10, 2004     - Saw URO (Bejjani), DRE seemed normal. Listened to
story. Said everything is normal. Clear fluid is due to muscles bring
pressure around prostate. He said TRUS, cystoscopy was not necessary.
Said to go home. Everything was fine. He said urine retention due to
psychologically thinking bout it? Too much.

My Current Symptoms:

On/Off – rarely, slight warm feeling on initial stream. Right when the
urine starts to exit the Urethra, feeling is gone.

Clear fluid – usually day or 2 after ejaculation, it is present at the
end or
Urinary stream. More rarely, is seen after bowel movement.

Incomplete emptying of bladder – usually this is the case the morning
after ejaculation. Almost seems as if prostate discharges this into
urethra, and therefore makes it harder to get out initial urine???
Rarely, I feel like I don't completely empty, while sitting on the
toilet, and having bowel movement.

Muscle twitching – from pelvic bone or waist area to knees and at
times butt area. This occurs usually in the evening, not sure if it is
stress related, but occurs when I am thinking too much possibly bout
the problem?

Last drop- sometimes there is like a drop that comes out later on,
after the face of urination.

Common Prostatitis Bacteria: (Have researched)

Chlamydia trachomatis
Escherichia coli
Klebsiella pneumoniae
Pseudomonas aeruginosa
Proteus species
Staphylococcus species
Enterobacteriaceae (80%)
Enterococcus (15%)
mycoplasma ????
ureaplasma ????
Staphylococcus aureus????
Streptococcus faecalis????
Neisseria gonorrhoeae?????
Trichomoniasis

Questions
Have you seen patients with similar symptoms? If so, what was the
outcome?
What do you feel the potential problem (s) is ?
What tests can help you determine what the problem(s) is?

Tests I think might help? (test for bacterias listed above)
-Urinalysis/culture before & after ejaculation (5 day culture)
-Semen analysis/culture (5 day culture)
-PCR Testing (?)
-TRUS Before & After ejaculation (check retention of prostate fluid,
for probable cause) (Evaluate muscles in that area)
-Ultrasound of abdominal area (pain from before)