Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.
Im a 58 year old male, fairly good health except for my pacemaker but im used to that now..
my problems started about6 a mont ago which is probably a lifetime ago to many here but here is my story.
On March 21st I woke up with a slight fever didn't think much of it thought was a bug or soemtign so I started to take tylenols. I also must say I travel alot that evening I headed to Hamburg ,Germany for work, I arrived in London thrrsday mornign and started to feel worse trouble urinating but again didnt think much of it work up friday went to airport and visited the bathroom many times .... still I sadi I will be home in two days tuff it out.. got to Hamburg and the pain started by friday night I was crying in orsder to urinate it was extremely painfull I kept going to the BR and just dribbled I manage to work Friday Night .. wenty back to the hotel and realized that someign was very wriong still fever 102 and just unbearable pain urinating. I canceled the rest of my trip and booked a flight back to New Jersey where I live
UIpon arrivel I went righ tto the Veterans Hospital... now my body was revoltiong.besides the bad pain and fever , I went into Atrial fibrulation...
They took all kinda test and admitted me and said I had an infection in my urine but wouldnt know till the culture retuened.. a few days later the said it came back as a UTI - E-coli.. infection and I had an enlarged prostate.. the gove me Cipro for a few dayays and sent me home with a 10 supply of cipro ... after aboutt a week I was feeling really good and thoguth im out of the woods well... last Thursday May 17th the symptoms started top come back the worse of it being the Anal pressure ... I waited and went to the hospital on Monday to seen my Primaary Care Dr and he gave me Bactin,,,
Yesterday I went to see the Urologist and hes said didn't they tell you you had Prostatits I said not he said it will take about 3 months for the Gland to heal and gave me Flomax and an apt for 3 months I must say I was shocked. he said thats how it is.. can't examin the prostate for thress moths becasue they dont want to bother it..
Anyway im looking for a litel help and advice on how to deal with the Rectal pain and desire to constantly go this at this point is my biggest problem is there anytign that can help reduce this need..
Thansk in advance sorry for the long post probably alot of un-necessare info also sorry for the spelling just trying to type to fast.
my urinating is ok now just getting up every 2 hrs instave of ever 30 min ... so as a newbgee I would apprecuiate any advice ..
John in New Jersey
Alan thank you for replying doesn't seam to be much participation here sad for those who come here looking for help ....the rectal pressure has mostly subsided but now every littel pain I worry, work up with a touch of feaver similkar to how this all started so of courtse I get worriesd moving on in life sucks... yea the Dr I was assigned was terrible i had about 25 dyas of antibioatics. and he was very rude and short so ill see how it goes. where in the UK are you I visit frequently .
PS thanks for replying
Hey John, glad things are subsiding a bit. Yes the worry of a flare up is something we probably all share... the hint of urinary urge or twinges down there can make us worry that things are about to go pear shaped, and sometimes they do. For some they never go away.
If you get flare ups, do not underestimate the benefit of hot baths.... they do bring relief to an extent. One of the reasons you may have got few replies to start with is that no one really knows what to do when this thing strikes - some people don't respond to antibiotics and there is a whole school of thought that this is not infection. However I think it is probably the right thing to use them to see if they help - they certainly help me - and I can't believe that infection is not involved, as either primary cause or a side effect.
The usual candidates are Cipro and Bactrim though I think here in the UK the first choice is Ofloxacin. The main problem is often the length of treatment .... the prostate is difficult for medicines to get into and hence many abx have low penetration rates e.g. <25%. This is why Cipro, Bactrim etc. are used as they get in there more easily. However it may still takes weeks and weeks .... some say 6 weeks is the absolute minimum. The UK NHS says 4 weeks but then see what the situation is and continue if deemed beneficial. One of the main problems is that most doctors don't like using abx because they know they are generally overused and so some default to 10 days, which tbh is possibly insufficient if you have prostatitis.
Ultimately, a proportion of people who get this will find that the abx nukes it but then after a while it comes back.... that is most of us here. At that stage it is a case of trying to find pain killers and other medications that improve life, with intermittant abx. Others eventually opt for surgery.... this is a last resort and is still to be well evaluated but has been beneficial to some. Some people find diet changes beneficial. The problem is there are many conditions that may cause similar discomfort and sensitivities.
I really cross my fingers that yours clears up, and if you are getting benefit from the abx then discuss with a doctor as to how long this should be used for beyond the point where all symptoms subside. Find guidelines/recommendations online and take them with you if it helps. By the way, some people say that the problems are mostly due to the inflammation and even after the infection has gone, the inflammation can take a while to subside... hence use of NSAIDs. That may also be why your doc didn't want to upset things, though I would have thought most would at least have prodded the prostate to check sensitivity.
But if this continues, then you need to get proper cultures done - urine, prostatic secretion plus semen ideally by a urologist who vaguely knows what he is doing (they often use a 3 glass test where they take urine then massage the prostate and then take more urine etc.) but if it is here longer you need to a) try to work out what makes it worse, what triggers it, etc. (e.g. does ejaculation make it worse? does lack of sleep cause it to restart?) and b) what treatment regimen helps you (what abx, what pain killers etc.)