New to the site and Prostatitis. Questions for Dr Eden and Dr Krongrad

[DJ]

Dear Dr Eden & Krongrad

Firstly I would like to give you a brief history and then ask a few questions, I hope this is OK.

5 months ago I contracted non specific urethritis and was treated within 2 weeks of infection with 1g Azithromycin and 250mg Ceftriaxone to cover possible causes

This cleared the discharge I had but I was left with a slight burning on urination. Over the next 5 weeks my symptoms developed to the following:

Perenial pain/discomfort when sitting
Bilateral Testicular/scrotal pain after sitting for long periods (testicles are not particularly tender or sore on examination, the pain seems referred)
Occasional stabbing pains in the penis tip
Pins and needles in the buttocks and left hamstring!
Very slight urine flow reduction and frequency

I saw my GP and was prescribed 4 weeks of Cipro for suspected Prostatitis, I had to stop this on day 8 due to a bad reaction to the drug

A few weeks further on I had a slight case of epididymis swelling on the right testicle which went down with a 2 week course of doxycyline prescribed by my GP (the pain did not subside however)

I have since seen a Urologist and had the following tests:

1st void urinalysis (no EPS or post massage urine) - clear
Bladder, Kidney and Testicle ultrasound - normal
Flow test was 26ml per second with post void residual volume of 27mls.
My prostate was not excessively tender on DRE and according to the Urologist felt normal.
I also tested negative for all STDs (tested at GUM clinic)

The Urologist diagnosed me with non-bacterial prostatitis/pelvic pain syndrome and gave me a prescription for Tamsulosin (despite me voiding fairly well) and Amitriptyline. I have been taking both for 2 weeks now with no change to the pain symptoms shown above!

My questions are:

1) have you seen cases of prostatitis/cpps before that have developed from urethritis?

2) which tests/treatments would you like to see a patient go through before being considered for LRP?

3) is there a minimum length of time a patient would need to have prostatitis before being considered for LRP?

4) is it common for patients with prostatitis to have pain as the primary symptom?

Thank you very much Dr Krongrad for providing this forum as it has been very informative!

If anyone else has any input on my situation I would welcome your comments.

Best Regards
David
UK