I have come to believe through all my reading in forums and my own personal experience that there are 2 main categories of CPPS. These are true prostatitis, and pelvic floor muscular problems.
I have mentioned to many UK urologists the possibility of prostate removal for severe chronic prostatitis. They all say that they are not certain that the pain is coming from the prostate so it would be crazy to remove it on that basis.
I do not understand why this is so difficult to ascertain. Myself & many other prostatitis sufferers have the following symptoms, which I find difficult to understand how pelvic floor problems could be the cause of:
1.Slightly off colour/light yellow ejaculate, more obvious the longer time between ejaculations. Ejaculate was always white before suffering from prostatitis.
2.Low sperm counts. (Is the sperm dying quickly in the abnormal prostate fluid?)
3.Burning feeling in urethra.
4.Pain/swelling after ejaculation.
5.Pain when doctor pushes prostate during DRE.
6.Stool size varying depending on amount of inflammation in prostate area, i.e. stools generally larger during times of reduced symptoms/inflammation & smaller during flare up's. (OK I guess you could attribute this to a muscular problem possibly?)
7.Much more calcification of prostate than normal for age shown on TRUS.
In David Radford's case I believe it was more straight forward to define him in the true prostatitis category due to his fevers he would get after sitting playing the drums. After all how could fevers after sitting & compressing the prostate be attributed to a pelvic floor muscular problem?
I believe from David's outcome (and Chris Eden's yet unpublicised CPPS patients), that in time, nerve sparing LRP will be shown to be highly effective in the majority of true prostatitis sufferers. I really think the pelvic floor type CPPS is another problem which shares many symptoms with prostatitis, making diagnosis very difficult.
Oh, I forgot to mention an anecdotal case I know about. A friends father came home from work in the 60's in massive pain in the prostate area. He was on the floor curled up, so they called an ambulance. He was taken away and had his prostate removed by open surgery. The pain was gone when he woke up, replaced by post op pain which was considerably less and went in the next few weeks during recovery. CPPS was not even a recognised phrase back then. Coincidently (or not-genetic perhaps-who knows?) my friend now suffers from chronic prostatitis too.
Anybody have any thoughts about this?