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

Can prostate removal for prostatitis really offer a cure for suffering men?

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Hi -

I've considered prostate removeal for chronic bacterial prostatitis.  I'm saving up the cash to have it done.  I've spoken to Dr. Krongrad, who seems like a good resource, but I wondered if anyone knows of a Doctor in the NYC, where I live, that performs this?  The thought of traveling 1000 miles when there are thousands of urologists within 5 miles of me, forces me to ask that question.  No disrespect to Dr. Krongrad, but for follow-ups and other stuff, it would be good to have a local physician.  Does anyone know of one?  I'm guessing "no", or I would have discovered already, but I thought I'd give it a shot. 

To my knowledge Dr. Krongrad is the only MD who has pioneered in prostatectomy for treatment of chronic prostatitis.  I'm so thankful he did, I thought I would never find relief.

 

Nick

Hi Doctor - I saw your video and could relate on many levels.  Yours was the video that make me seriously consider this step.  I'm scared about losing the ability to have an erection, but at 47, I figure sex should be mostly behind me.   I also recently found a physician in NYC that does injections which I'm exploring.  Based on your video though, I'm slightly less optimistic. 

At 47 you are still in the age group for a high chance of erections returning. I also tried having the injections before removing my prostate and they just made me worse. I was able to achieve a good erection with levitra within a month after surgery at 40 years old. Now at 9 months post surgery I no longer need pills to get a good erection (haven't done for a while), it just takes a little longer without, and a little more foreplay-my wife doesn't complain as I always used to rush her too much before anyway LOL..!! The only times I still use a pill are if I am really exhausted after a long day, but to be honest most people wouldn't want sex then anyway. Mornings are the best and erections are normal as before the surgery then.

Erections usually improve for up to 2-3 years after surgery so if this is how I am at 9 months then I have no concerns whatsoever.

Hi Nik - Thanks for the good news.  I also heard Dr. Muff say the same thing about the injections.  Did your prostatitis come back, post-injections, with a vengeance after a while? 

Also, did was it a problem for either of you that the physician was not local, after you returned home? 

Yes it did. I was in agony after the injections.

My surgery was carried out in the UK only an hour and a half drive from my house, so I had no issues with follow-up.

No problem that the physician was not local either with the injections or the surgury.

Steven,

Dr. David B. Samadi is one of the best surgeons in your area, probably in the world but I'm not sure if he would perform LRP for prostatitis. Check out roboticoncology.com for more information.

 

 


 

Hi Nik -

I spoke to a physician today about injections.  I was curious about the agony you experienced.  do you think the pain was from the injection itself or from the antibiotic?   did you have any relief at all from the infection?  the injections will be expensive, and I'm not sure i want to throw it down the drain when I could apply the money to a prostatectomy.  Thanks in advance. 

Nik said:

Yes it did. I was in agony after the injections.

My surgery was carried out in the UK only an hour and a half drive from my house, so I had no issues with follow-up.

Hi Dr. Muff & Nik -

I'm sorry to bother you.  As I mentioned in an earlier post, I saw a doctor yesterday to discuss injections.  As part of my work-up, he did an ultra-sound and showed me where some of the damage to my prostate is and some narrowing of the seminal vesicles.  I was awake all last night thinking about those images.  Now that I've seen the actual damage (which he says isn't dramatic/huge), I'm leaning to toward removal...I want this damaged piece of goods out of me.  Dr. Krongrad seems to be the best option.  

Please forgive me if you've already recounted this (I looked at your other posts but didn't see anything), but I'm not clear on what the expect afterwards.  Is there any activity post-operation that remains particularly painful, e.g. like sitting through a movie? 

1.  Was there a lot of pain after the surgery?  did it keep you from work?  I can't take anything type of addictive painkillers, so I'd be relegated to strong doses of anti-inflammatories, etc.  Another reason I ask about the duration, is that I'm a salesman with a lot of sales quota to achieve....I can't take weeks and weeks off from work. 

2.  My biggest concern is about incontinence.  I'm beyond caring about orgasms, but don't want to wear a diaper for the rest of my life.  I noted Nik mentioned a little bit of a problem during masturbation, but not more.  Did either of you find this to a big problem?

thanks!

Steve

Hi Steve;

    After prostatectomy you'llprobably be sitting gently on a "doughnut" cushion for 2-3 weeks. My surgery was on Thursday, I flew Miami to Seattle on Sunday and returned to work on Monday. I was very apprehensive about the flight but it went ok. It was a really tough week at work but I had to do it. If you could fly home a week later and return to work in 2 wks that would be better.

   I did use Tylenol and an occasional Vicodin for pain. I am the poster boy for relief of all the pain, burning, urgency, fever chills etc. However I am at the bottom of my class a regards continence. I am totally incontinent. Thats to bad but is unusal. It was a fair trade to get rid of the all the other disabling symptoms. It is not like wearing a "diaper". Now days Depends offers a "True Fit" brief. It fits snug and comforatably like cotton briefs. In it I wear a day time pad which I change every three hours. The True Fit briefs are susally still dry by evening and I wear the same briefts through the night starting again in the AM. So even the worst possible downside is not as bad as it sounds.

   Like one gentleman said, I used to worry all the time about having to pee with all the urgency and burning. Now that I am incontinent I don't have to worry about going pee at all! In fact I can pee anytime and no one even knows!

 

   So I am being really up front and frank about my experience with the incontinece. If I had known I would suffer this side effect in advance I still would have had the surgery in a heart beat. Hey, I fell alive and well again and can enjoy life.

 

Nick

 

   

Thanks Dr. Muff - I really appreciate your candor and honesty.  I can't believe you went to work 4 days after surgery!  Wow!  You are a strong man. 

The incontenency thing is something I'll have to consider.  I appreciate your description.  I'm sure it's better than your pre-op experience...  I feel my energy and life draining slowly away.  All I want to do is rest in a comfortable position while life passes me by.  So the trade-off, even if I'm at the bottom of the class, too, is probably a no-brainer. 

Again, I truly appreciate the time you took to provide this info.  I could relate to your video on many levels and am glad that you've done so well. 

Best regards - Steve

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