I'm a 68 year old guy, currently being treated by Dr. Irwin Goldstein of the
Center for Sexual Medicine at Boston University Medical School (a marvelous
physician and first-rate scientist whom I recommend strongly).  My primary
symptom is a gradual decrease of semen flow and ejaculatory force, to the
point now where I can barely ejaculate at all, even with a vibrator, and
get only a little bit of semen oozing out.  I also had low free
testosterone, though that's been remedied with testosterone replacement
therapy plus DHEA.  And I've had BPH for about 15 years, needing to urinate
about 4 times a night.  But -- unlike most of the prostatitis sufferers
here -- I have no pain at all.  In fact, I have radically decreased
sensitivity in my penis (Dr. Goldstein measured it).

After determining that fixing my hormone levels wasn't helping (though I
think it prevented the problem from getting worse even faster), Dr.
Goldstein finally did a TRUS (transrectal ultrasound scan) and was
astonished to discover that my ejaculatory ducts were almost completely
blocked by calcified stones.  This was a problem he had not seen before and
had no experience with, so he suggested that I see for myself what I could
find out about it.

That led me to Google and, right off, to Dr. Federico Guercini at the
University of Rome, whom others here have heard of.  Dr. Guercini's
description of prostatitis and its symptoms fitted very well with what I
had experienced, including the "rosary bead" formation of stones and the
compression of the erigens nerve that can cause loss of sensitivity.  Dr.
Guercini is convinced that the cause of the calcification is bacterial, and
his recommended treatment is direct injection of a large dose of
antibiotics into the prostate.

I asked Dr. Goldstein to read Dr. Guercini's famous discussion of
prostatitis (http://www.prostatitis2000.org/eng/intro.htm).  Dr. Goldstein
found it interesting but was unable to draw a conclusion as to how sound
Dr. Guercini's approach is.  Nevertheless, at my request he's planning to
do the antibiotic infusion that Dr. Guercini recommends, though doing the
injection transrectally rather than through the perinium as Dr. Guercini
does.

All this leads to a number of questions I have for this group:

1. Has anyone been treated by Dr. Guercini?  How successful was the
treatment?

2. Does anyone else have the same symptoms that I do (loss of ability to
ejaculate but no pain)?

3. Assuming that the stones are indeed caused by bacteria (which some
urologists question) and that the antibiotics get rid of the bacteria, what
then has to be done, if anything, to get rid of the stones?

4. Why would Dr. Guercini recommend injection through the perinium (where
it's much harder to aim the needle accurately) than through the rectum?

5. Has anyone had a transrectal injection of antibiotics?  How painful was
it?

All feedback is appreciated.

Paul A.