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Medical Forum / Diseases and Disorders / Prostatitis / January 2005

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new to prostatitis--looking for positive reinforcement

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Brian B. - 16 Dec 2004 18:20 GMT
Hello everyone,

I thought I'd feel better posting a little bit about my own experiences
with prostatitis in the hopes of finding some comfort from other
sufferers' advice and experience.

I'm 28 years old and have been suffering from prostatitis for about a
month now.  I believe I may have contracted the condition from a bath
in not-so-clean water, but I'm honestly not sure.  I'm not a heavy
drinker, nor do I use recreational drugs or participate in anal sex.
My condition began roughly two days after the bath, and I felt that it
was the most likely cause.

My history:
I began urinating rather frequently one day, and attributed it to
coffee, which I'm a great fan of.  I would have to urinate a number of
times per hour, which, as you can imagine, was rather annoying.  I
didn't experience any pain or discomfort other than urgency (whether or
not I had a lot of urine to pass).  After a three days of this, I
decided to see my GP regarding the condition, because my wife and I
felt I might have a urinary tract infection.  The doctor took a urine
sample which came out negative and sent the specimen out for culture,
all of which turned out negative.  My step-father, who had experienced
a similar problem, recommended I take saw palmetto and zinc (which I
have taken since then, without fail).

After a week of the same symptoms, my GP recommended I see a urologist.
The urologist took another urine sample, gave me an ultrasound of the
bladder, and digitally examined my prostate.  Since my symptoms were
relatively painless (just constant urge to urinate) he prescribed that
I take advil and have sex on a regular basis.  "Easy!" I thought.

Happily, the problem subsided for a week, and I felt I was cured and
stopped taking Advil.  Unfortunately, I had a tragic death in my family
that caused me great stress, and involved plane flights.  My problem
returned as soon as I boarded the plane.  I began taking Advil again
and experienced relief for a few days until it was time to board the
plane again to go home.  The symptoms returned and have remained ever
since.

I still have to urinate rather frequently (though I can control it so
that I don't have to go as often) and I now experience an annoying
burning at the tip of my penis--not awful, but certainly distracting
and upsetting.  It never hurts to urinate, but I feel that I have to
constantly whether or not there's a trickle or a great stream.  Advil
and Alieve did not seem to help this condition.

I phoned the urologist to let him know my progress.  He said since
there was no bacteria or virus found in my sample they could only treat
the symptoms and he prescribed Celebrex for my "pains," since Advil was
ineffective.  I asked him if I would be stuck with this forever and he
honestly told me he couldn't say with any degree of certainty.
Comforting, no?  The Celebrex seems to deal with the pain fairly well,
but I do have bouts where I'm extremely uncomfortable.

I should add that I have abstained from both liquor and coffee/caffeine
(except a piece of chocolate now and again) since the second bout.  I'm
not overweight, nor do I have any other health problems.  I have been
avoiding spicy foods.  A heating pad and hot sitz baths (though never
at the same time ;)! ) seem to help for a period of time, and sex
alleviates the discomfort for a time, as well.

The idea of suffering from this potentially indefinitely has upset me a
great deal, which has, in turn, worsened my symptoms--not to mention
depressed me.  At this point, I'm unsure what to do next.  I note that
I tend to hold stress by tensing my pelvic area and I've made a
conscious attempt to relax this area, which has helped me deal with the
constant discomfort somewhat.  I have also purchased Dr. Wise's book "A
Headache in the Pelvis" to see if perhaps this is my issue.  I haven't
received it yet, though.

It upsets me to read about so many chronic cases and yet see few
success stories on the internet.  Must I worry about this discomfort (I
hesitate to call it pain) for years to come?  Any success stories or
helpful advice are appreciated.

Best, and thanks for reading,

Brian B.
Brian B. - 16 Dec 2004 18:33 GMT
I forgot to mention that I occasionally have a forked urine stream, and
have begun drinking a lot more water.

I have a desk job which keeps me in a seat for much of the day, which
hurts after a while, as you might imagine.

I have thought about broaching the topic of antibiotics with my
urologist, but I was unsure to proceed as both he and my GP seemed to
feel they were unneccessary.  I've read a ton of data on the internet
about the condition and I have to say I'm unsure whether or not they'll
work anyway.  The urologist mentioned that I have prostatitis, but made
it plain there was little in the way I could do about it other than
addressing the symptoms.

Brian B.
NorthernSpy1 - 17 Dec 2004 02:48 GMT
> was little in the way I could do about it other than
> addressing the symptoms

Yes, prostatitis is a big mystery, and sometimes docs find bacteria and kill it
and there's a cure; but sometimes killing the bacteria doesn't end the illness,
and sometimes (usally) no bacteria is detected.

But there *are* guidelines --- a list of what can be causing your condition,
and steps to try to identify the cause (and thereby hopefully the solution).  
Your doctor is not following them, and gave up wayyyyyyyyyyyyyy too soon.

Your big hope is you have an infection: something nice and treatable.  The
great majority of uros (in the USA, anyway) will automatically prescribe a
broad spectrum antibiotic (a quinolone like Tequin or Levaquin, sometimes
combined with Doxycycline) for at least a month, and then if there is
improvement for much longer (2 months or much more).

Then if those fail, many uros say "go home" which is terrible advice.  Levaquin
(etc.) does kill a lot of stuff, but it does NOT kill everything.  For example,
the drug of choice against enterococci  faecalis (which can cause your problem)
is Ampicillin, which may work when the others do not.

So here's what you do:

[1] Buck up.   The internet is populated by a lot of guys who never got
antibiotics or got the wrong ones -- unlike you they were not lucky enough to
learn the guidelines.   The success stories disappear.

[2] Another reason to buck up: there is a veiw that prostate problems
accompanied by urinary symptoms are almost always caused by infection.   I
question that wisdom, because my urinary problems took 10 months to arrive; but
in any event your odds of success start off really great.

[3] Check out the guidelines (see below).  They are not a complete statement
about the curable causes of your condition, but they provide useful places to
start.

[4] CHANGE YOUR URO NOW.  Most of them will at least give you some sort of
antibiotic; and look deeper into the possible causes than a simple urine test.

[5] Try to get a (A) urine culture (not test); and (B) semen culture which
often reveal infection when simpler tests do not.  Some docs do an "EPS" test
or culture.

[6] Check out this guy's website -- which will give you the idea that sometimes
there is not straight road out, but there is a road.

http://www.geocities.com/bill3320/

[7] If you are a distance bicyclist or avid weight lifter, consider stopping
for awhile.

[8] Get a better pain killer than Advil if pain is a problem for you.  Enduring
pain for long periods is not good, or necessary.

G'luck!

- Carlos

========= GUIDELINES ==================

http://herkules.oulu.fi/isbn9514265068/html/x552.html

=== OTHER LINKS =======================
http://www.drmirkin.com/men/M156.html

CDC GUIDELINES FOR EPIDIDYMITIS
http://www.epididymitisfoundation.org/cdcguidelines.php

http://www.prostatitis.org/itworksforme.html

=======================================
http://www.urologyhealth.org/adult/index.cfm?cat=09&topic=115

How is prostatitis diagnosed?

The correct diagnosis is very important because the treatment is different for
the different types of prostatitis syndromes. In addition, it is extremely
important to make sure that the symptoms are not caused by urethritis,
cystitis, an enlarged prostate or cancer. To help make an accurate diagnosis,
several types of examinations are useful.

To examine the prostate gland, the physician will perform a digital rectal
examination (DRE). This is a simple examination in which the doctor will pass a
lubricated, gloved finger into the rectum. Because the prostate is located just
in front of the rectum, it can be easily pressed. The physician will be able to
determine whether the prostate is enlarged or tender. Lumps or firm areas can
suggest the presence of prostate cancer. The physician will also assess the
degree of pain or discomfort the patient experiences as he presses the muscles
and ligaments of the pelvic floor and perineum. If a man has prostatitis, this
examination may produce momentary pain or discomfort but it causes neither
damage nor significant prolonged pain.

If the physician requires a closer look at the prostate gland or decides that a
biopsy is necessary, he may order a transrectal ultrasound, which allows him to
visualize the prostate gland. If you are at risk for cancer, your physician
will consider ordering a PSA test.

If your physician suspects that you have prostatitis or one of the other
prostate problems, he may refer you to a urologist, a doctor who specializes in
diseases of the urinary tract and male reproductive system, to confirm the
diagnosis.

The urologist will repeat some of the examinations already performed by the
first physician. The urologist will also assess the degree of pain or
discomfort the patient experiences as he presses the prostate as well as the
muscles and ligaments of the pelvic floor and perineum. The urologist may
analyze various urine specimens as well as a specimen of prostatic fluid
obtained by massaging the prostate gland during DRE. The various urine
specimens and prostatic fluid will be analyzed for signs of inflammation and
infection. These samples may help the urologist determine whether your problem
is inflammation or infection and whether the problem is in the urethra, bladder
or prostate.

Other tests the urologist may consider employing include cystoscopy in which a
small telescope is passed through the urethra into the bladder permitting
examination of the urethra, prostate and bladder. The urologist may also order
urine flow studies, which help measure the strength of your urine flow and any
obstruction caused by the prostate, urethra or pelvic muscles.
Brian B. - 17 Dec 2004 15:35 GMT
Carlos,

Thanks for your reply.

The Celebrex is working well to decrease my discomfort.  Of course, all
the stress that this condition has caused has probably made my symptoms
worse.  I'm trying to deal with it one day at a time and I'm thankful
that my symptoms don't seem to be severe when compared to most of the
discussions and experiences I've read about on the internet.

I will certainly talk with my doctor about having a test of semen or
prostatic fluid.  My urine was sent for culturing twice and came back
negative both times.  I'm guessing the uro felt that since no infection
was found, antibiotics were unnecessary.  I'm going to ask him to
consider doing more thorough tests--if he won't, I'll simply see
another doctor instead.

I do still have a question or two regarding the condition:

1. Are there some men who have irritated prostates which heal after a
time?

2. You said that success stories tend to disappear.  Can I take this to
mean that if a man is healed from his symptoms he tends not to bother
talking about it anymore?  Thus, on websites, etc, you tend to hear the
worst cases but not ones that gradually get better and go away?

It can be disheartening to read stories of many men getting life
sentences with this when there are no stories of "Yes, I suffered from
that, but I was able to be healed with the proper help and practices."
Thanks,

Brian B.
Jay - 17 Dec 2004 19:45 GMT
> I do still have a question or two regarding the condition:
>
[quoted text clipped - 6 lines]
> hear the worst cases but not ones that gradually get better and go
> away?

Hang in there Brian.

Chronic prostatis (CP) can go away, sometimes completely. But it often comes
back. My very first bout was 28 years ago at the age of 21. It was a full
blown case of bacterial prostatitis (urine and EPS were full of wbc's). An
antibiotic (abx) regimen of 10 days cleared it up.

About 2 years later, the prostatitis returned but this time all tests for
bacteria were negative. I still took abx and symptoms went away completely
within several weeks. Then a year or so later I was hit with non-bacterial
prostatitis again and abx cleared it within a few weeks. This cycle repeated
itself almost yearly until I was 45, at which time the abx treatment no
longer worked. My symptoms were/are voiding problems (urgency, can't empty
completely), pain in the perineum and lower back, and a burning sensation in
my penis. A digital rectal exam (DRE) and PSA test were all quite normal.

My uro recommended Flomax, an alpha blocker that relaxes smooth muscle in
the prostate and bladder neck to make it easier to urinate. I hated it
because it made my orgasms feel like non-events not to mention the
retrograde ejaculations. So I stopped taking it and my uro tried urethral
dilation under local anesthia in his office. Within a week, my symptoms
disappeared...for about a year. Another urethral dilation was then performed
and my CP symptoms vanished again. This cycle repeated itself until this
fall when the dilation no longer provided me, now 49 years old, any relief.
The symptoms were back with a vengeance. We tried abx (levaquin & then
cipro) at my request even though my EPS and urine cultures turned up
negative for infection. My uro then did a cystoscopy (it was a terrible
experience but more on that in another post) to see if there were any
problems in my urinary tract/bladder. He said everything looked normal
except for a somewhat narrow bladder neck.

My uro told me about a new alpha blocker that works better than Flomax with
minimal or no side effects: Uroxatral. I've been taking it for about 2 and
1/2 weeks and have seem definite improvement in my urinary symptoms and
moderate improvement in my pain (and no side effects!). He also suggested I
take Avodart which shrinks the prostate (it takes at least 3 months to start
working) and reduces irritative voiding symptoms even though my prostate is
of normal size. I'm taking that as well. Warm baths also help.

Bottom line is to find a uro that is knowledgeable and will work with you to
tackle your CP. What works for me may not work for another sufferer. You may
be lucky and go long periods where you are symptom free. Or you may have to
live with some minor discomfort. In my opinion, an important factor in
dealing with CP is relaxing both physically and emotionally. When symptoms
flare up and even when they don't, the worst thing you can do is worry and
get stressed out. Relaxation helps a great deal for many.

Good luck and keep the faith!

Signature

Jay

Gutbuster - 19 Dec 2004 20:51 GMT
> Carlos,
>
> Thanks for your reply.
>
> The Celebrex is working well to decrease my discomfort.

You may want to think twice on that. Reports have been coming out that
Celebrex is causing people to die of heart problems!
Spread deMocracy - 31 Dec 2004 14:30 GMT
Brian:  you might want to check out
http://bph-prostate-enlarged.blogspot.com/   and in particular the posting
there at the very bottom "Prostatitis--do I have it?"  If you don't think
your doctor has done enough, you might want to get a second opinion and
insist on some of the tests mentioned on that site?     Might give you some
ideas?  I don't think you can get prostatitis as quickly as you say you did
from a "bath" since it would take time for the infection to manifest itself
inside the prostate--circulation to the prostate is relatively poor, so,
that leads me to think that it was something that happened many months or
even a year or more ago.   Here's wishing you best and for a speedy
recovery.   You have a lot of fun ahead of you yet...I hope you get the
problem fixed soon so you can return to having a lot of "fun".

"Brian B." <bbieniowski@dellmagazines.net> wrote in ...[snip]...with
prostatitis in the hopes of finding some comfort from other sufferers'
advice and experience.  I'm 28 years old and have been suffering from
prostatitis for about a
> month now.
Unemployed - 01 Jan 2005 22:39 GMT
> Brian:  you might want to check out
> http://bph-prostate-enlarged.blogspot.com/   and in particular the posting
[quoted text clipped - 9 lines]
> hope you get the problem fixed soon so you can return to having a lot of
> "fun".

This only applies to Bacterial Prostatitis, which accounts for less than 10%
of all prostatitis cases.  Please stop spreading your medical disinformation
in this group!
Spread deMocracy - 02 Jan 2005 02:05 GMT
To "unemployed":   that's why I referred this chap to the link I mentioned
in my post...I made no claims to being an expert, nor to what percentage any
kind of source provides for prostatitis.   Obviously your knowledge is more
impressive than mine so maybe you can provide some of your wisdom to this
fellow to help him out?  I, too, would like to learn more...Your keyboard
awaits.

"Unemployed" <NoSpam@havenot.com> wrote  [snip]This only applies to
Bacterial Prostatitis, which accounts for less than 10% of all prostatitis
cases.[snip]

> "Spread deMocracy"  wrote  [snip].... Brian:  you might want to check out
> http://bph-prostate-enlarged.blogspot.com/   and in particular the posting
[quoted text clipped - 3 lines]
> some ideas?  I don't think you can get prostatitis as quickly as you say
> you did from a "bath" ...[snip]
Nomad9687 - 02 Jan 2005 17:30 GMT
> To "unemployed":   that's why I referred this chap to the link I mentioned
> in my post...I made no claims to being an expert, nor to what percentage any
> kind of source provides for prostatitis.   Obviously your knowledge is more
> impressive than mine so maybe you can provide some of your wisdom to this
> fellow to help him out?  I, too, would like to learn more...Your keyboard
> awaits.

You may want to stick to sci.med.prostate.bph, thanks.
Real information on prostatitis is at http://www.chronicpelvicpain.us
Elton Fan - 02 Jan 2005 21:50 GMT
Spread deMocracy,

As I stated earlier in this thread, prostatitis is a very poorly
understood condition.  Because of this, a lot of quacks have tried to
promote questionable methods and give incorrect generaliztions as to
the cause of the condition (do a google group search for Doctor Brad
Hennenfent).  Also, a lot of conflicting information is out there,  so
it is diificult for us to determine what to believe.  The best thing we
have right now are the expiriences shared on discussion forums like
this and looking at peer reviewed studies.

Many men with this condition have been throught the anti-biotic route
only to see them fail.  Some report temporary relief while on the
anti-biotic, but this may be due to the drugs anti-inflamatory and
analgesic effects rather than its bacteria killing effects (see first
paragraph at http://www.drzeitlin.com/conditions.htm).  The general
consensus is that prostatitis symptoms are most often not caused by
bacteria.

For more information, goto www.chronicprostatis.com or
www.chronicpevlicpain.us.

> To "unemployed":   that's why I referred this chap to the link I mentioned
> in my post...I made no claims to being an expert, nor to what percentage any
[quoted text clipped - 14 lines]
> > some ideas?  I don't think you can get prostatitis as quickly as you say
> > you did from a "bath" ...[snip]
Elton Fan - 02 Jan 2005 22:25 GMT
That should be  www.chronicprostatitis.com or
www.chronicpelvicpain.us.
Unemployed - 03 Jan 2005 09:46 GMT
Spread deMocracy,

Sorry if I overreacted.  We've had a lot of questionable articles posted in
this group.  The information Elton Fan has provided is worth reading.

> Spread deMocracy,
>
[quoted text clipped - 14 lines]
> consensus is that prostatitis symptoms are most often not caused by
> bacteria.

<CORRECTION>
That should be  www.chronicprostatitis.com or
www.chronicpelvicpain.us.
<>

>> To "unemployed":   that's why I referred this chap to the link I
> mentioned
[quoted text clipped - 26 lines]
> you say
>> > you did from a "bath" ...[snip]
Spread deMocracy - 06 Jan 2005 00:10 GMT
Unemployed...Appreciate your reply.   I don't have time now, but will
bookmark Elton Fan's sites and will promise to visit them within the next
week or two.   Though I don't need this info now, (PVP about 3 wks ago and
doing fine), there may be a time when I will need the info, so I like to
keep an open mind and to keep on top of the info.   Thanks.

"Unemployed" <NoSpam@havenot.com> wrote [snip]  The information Elton Fan
has provided is worth reading.  [SNIP]

...Elton Fan's links: [Snip] www.chronicprostatitis.com or
> www.chronicpelvicpain.us.
 
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