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Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.

Hello everyone,

I just wanted to update my experience with radical prostatectomy for prostatitis. I had LRP last July (2012) & I'm worse now than before the surgery. The pain directly after the surgery (gas and incision directly over previous scar tissue) & from the procedure itself was almost unbearable. I kept the catheter in for 10 days & for several months things finally started to calm down somewhat until about the 6 month mark. Keep in mind that my erections were still non-existent at this time, as they still pretty much are now at 14 months post LRP. I'm also an otherwise healthy male that just turned 40 with really good erections before the surgery.

At 5-6 months I noticed that my flow was getting weaker so I asked Dr. Krongrad about it & he said it sounded like a bladder neck contracture from the scar tissue building up around the bladder neck (casused from lrp) So, I went to my local urologist & he had to perform a Bladder Neck Incision in order to open up the scar. Well, since the BNI everything has been even worse with bad urgency, frequency (10-12 times day) urge/stress incontinence & more pain. I'm about to see another urologist in Florida to have a series of mapped nerve blocks to see if I can finally get some relief from this hell.

So, as it stands now post LRP: (1) Worse pain (2) Urgency (3) Frequency (4) Incontinence (5) ED                    Before LRP: I had no urgency, no frequency, no incontince & good erections but lots of pain & discomfort.

PLEASE think twice about having this surgery if you have prostatitis as you may end up worse off like me. I was only 38 years old before the surgery & relatively healthy, so don't let the age & health spill fool you. I did have a minor transurethral incision of my prostate several years ago but I don't think that had anything to do with the failure.

This is just my experience & I know others have gotten relief but you don't really hear from the ones that had negative experiences/outcomes. All I ask is that you make sure that you exhaust ALL efforts before you try LRP for prostatitis. I know everyone wants to believe that it can help them & for some it can but you also run a huge risk off making things worse.

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Hunter why do u think it didnt work for you? I read ur three month update an things were getting better it sounded like.

Really sorry to hear about this Hunter, my thoughts go out to you. I guess it does not work for everyone.

I really believe it's neuromuscular in nature since a urodynamic test & 2 cystoscopies were basically normal. I just started a pelvic floor myofascial release program with a physical therapist in the hopes that it will release some tension & get the blood flowing again. Only time will tell, as it can take several sessions to see good results. I'm sick of living with this hell & I'm determined to find out what's wrong, no matter what. I've also got plans to see a prominent urologist in Florida who is going to perform a series of mapped nerve blocks under anesthesia to try& help with the pain. I've had a couple of nerve blocks in the past (while awake) & they essentially knocked out all of the pain for several hours, although they hurt pretty bad at the time. I believe that between the nerve blocks & the pelvic floor therapy I can get my symptoms under control once & for all.

I had worse pain post-op, too. My quality of life b4 the surgery was a 5 or 6. It was about a 1 after. I also had a bleeding episode after 3 weeks and wound up in the hospital. I kept track of my pain and I was even worse after the complication. So was it the  LRP or the complication? I'll never know. 2-1/2 years since the surgery and I am just getting the pain under control, seeing a pain specialist. I was pretty well fully continent a couple of weeks after getting the catheter removed and have yet to get my erections back. I'm using a pump and a Viberect device. Oral ED drugs don't work but I get a very hard erection with Trimix. If I could do it over, I wouldn't have gotten the surgery. I had CP back in the mid-90's and it went away by itself. I should have waited to see if it would happen again.

Dennis how is ur pain now? Better or worse before surgery

I think I've crossed a threshold. I was almost praying for it to be as good as b4 surgery. But, I think considering everything, it's better than b4 now. It's funny, the guys who have had this operation for cancer seem to recover more quickly. They're almost back to normal after a couple of weeks. The guys I know who have had this for CP were all in worse pain after the surgery. I've also heard of guys being better after 2 or 3 years. I can see that is probably about right.

Is the testosterone therapy raising ur testosterone levels? Also what was ur number when diagnosed?

I was like a bioavailability of 5. It's raised my levels to normal, whatever that is, but no change in my sex drive and I have really bad acne on my chest and shoulders. So, I'm weaning my way off of them.

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