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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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This is very exciting!!
This is great!!!
This is fantastic news and very exiting. I also find it frightening that 4 out of 5 showed cancer undetected previously-certainly gives me pause for thought. It would be interesting to know there ages & symptom duration in relationship to the cancer. Although early days yet it would certainly seem that prostatitis could well be a precursor to cancer in many cases as suspected by many urologists globally.
If my time comes to have an LRP it would almost certainly be with a surgeon of similar experience and skills to Christopher or Arnon. I am saving to make sure I have the money to go private if I need to, as I would not want to rely on the NHS choice of surgeon for such an intricate operation..!!!

Christopher Eden said:
I have done 5 radical prostatectomies for 'chronic prostatitis' to date, all of which have cured their patients of intractable perineal pain. Four patients had immediate relief and one patient waited 6 months before his symptoms disappeared. Interestingly, four out of the five men had prostate cancer present on their final histology, which was undiagnosed prior to surgery and all currently have unrecordable PSA levels.
Although it is anecdotal evidence, I think that what has been written in this discussion is important as the overwhelming majority of men with chronic pain are unaware of surgery as an option and would welcome the opportunity to at least discuss it. But caveat emptor - for it to be reasonable to treat a benign condition by radical prostatectomy patient morbidity (complications) would have to be minimal so the surgery should only be done by experienced surgeons. I would be delighted to collaborate in a study to look at the efficacy of radical prostatectomy in treating chronic prostatitis.
Can some body tell me how can i contact with t doctor Christopher Eden? Any telephon, mail, whatever. Thanks in advance. German
German,

Christopher Eden has two practices, both of which I have listed for you below.

Consultant Urologist
The Royal Surrey County Hospital
Egerton Road
Guildford
Surrey
GU2 7XX

Honorary Consultant Urologist
The North Hampshire Hospital
Aldermaston Road
Basingstoke
Hampshire
RG24 9NA

Good luck
Chris thanks a lot for your answer, im not living in England, besides t address that u gave me i found an e-mail adress to put me in contact with t doctor.

I had been reading t interesting discussion about t issue, but i have some questions (for any body with t enough experience to answer them) that already mades to my urologist without a properly answer, let get introduce my situation before:

33 years old, 2 years now with prostatitis, which one?.. thats t question, the esential one.

All t test negatives, any doctor takes a sample of my prostatical fluids.. even i didnt know that can makes a difference in t diagnosis, my urologists (a couple of them) told me that this test is irrelevant because reports poor accuracy.... and is enough with a sample of semen; but even that's not reliable because the bacterias some times are not so easy to discover in such a young people (i had chlamydia 5 years before).

Well in general Perineal pain, urinary congestion, discomfort after or before the sexual intercourses and the cold literally kills me (winter is a nightmare), i cannot seat (anywhere) and in the job im using somekind of 'donut' to works more or less comfortable.

- Rectal tacts shows that i have a tender prostate.
- Negative urine and semen cultives.
- PSA in the norm.
- USG transrectal: Prostate gland a little enlarged, smooth, very painful during examination with some calcifications around the urethra.

Prescribed with antibiotics CIPRONEX several times (the longest period 90 days) they were working well enough, but when finished the pain strikes back again, with t urinary congestion not always work, then i had been using alfa blockers and pain killers (aspirin, ibuprofen forte) and of course herbs (cat claw, saw palmito, sabalis serrulatae/ betasistosterol, polen)... that gaves me a little of relief... but temporary and really small; actually its getting worse.


Diagnosis....NONE!! (or yeah FRUSTRATED and DEPRESSED) One doctor say Non bacterial prostatitis, the other one Prostatodynia, the third one doesnt know... in the index of prostate i have 35 points (thats mean really F...!) then t questions are:

1.What is it, none bacterial prostatitis or prostatidynia? ....if its prostatodynia why the antibiotics help me? (less with t time, obviously for t resistance developed).

2. Why i cannot sit?, Why the cold affect me so much? ...can the prostate removal helps me with that ? (Of course i know t risks.)

3. Even in the case of prostatodynia or pelvic pain syndrom (...whatever), can the surgery helps me or can happens that t pain remains? (or its no evidence at all?)

Well, thanks in advance to every body here, waiting for some of help (in special from the especialists or the specialy affected.)

Good energy, German
1.What is it, none bacterial prostatitis or prostatidynia? This may not matter. The issue is which treatment will work for your symptoms, no matter what we call them.

2. Why i cannot sit?, Why the cold affect me so much? ...can the prostate removal helps me with that ? This was Radford's problem. It became a major problem because he is a drummer and needed to sit. Just like you describe. His problem was completely solved.

3. Even in the case of prostatodynia or pelvic pain syndrome (...whatever), can the surgery helps me or can happens that t pain remains? Surgery has helped some men. I recently did a lap prostatectomy for a man who had two (2) previous partial prostatectomies: transurethral and retro-pubic. Neither of the partial prostatectomies reduced his symptoms. Finally, after a 20-year history of pain, the lap radical prostatectomy, eliminated the pain, the chills, and what he called the "funiness."
Doctor Arnold what is sex like after the operation. I know its a dry climax but is everything else ok, are the guys telling you they are happy with the results?
German,

If you are saying your urologist is refusing to do the prostate EPS test on you, then I would dump him immediately and find one that will. To get a clearer picture of the obstacles you face in being correctly diagnosed, have a read of the "Diagnosis of Prostatits Accurate??????" thread below this which Dr Feliciano posted.

I don't know where you live, but you are going to have to get busy and find a competent urologist. Somebody who is willing to carry out the tedious and unpleasant tests which will lead to a more precise diagnosis of your condition, and then hopefully the correct treatment protocols that will bring some much needed relief to your systems. Unfortunately, this will not be easy. Finding a competent urologist is like finding buried treasure.

Good luck.
Doctor Arnon What is sex like after the operation. I know its a dry climax but is everything else ok, are the guys telling you they are happy with the results?

Climax is relatively dry, yes. I understand that climax feels the same. If you are asking about functional outcomes, that is a complicated question that depends on many, many factors, including age, baseline function, smoking history, illness, obesity, depression ... I can talk about it but prefer to discuss a specific case than a general abstraction.
Chris im living in Poland and this is the sixth urologist that refuse to do it allegating that is not a definitive evidence, an a semen cultive is more than enough (one of the bests in the city, surgeon by the way).
The next week a nurse that works in a hospital gonna practice me the first prostatical massage in my life :/ to collect the EPS and be checked in a laboratorium for bacteries, mushs?, and chlamydia.
What are the rest of the unpleasant tests that are you talking about? can you give me more details, you know just for help me to save time and money. Now im going by private (and in some way by myself) and any guide is more than welcome.

Nik thanks to you too for send me the wall post comments with the adress from the Dr Eden, (im new here and already learning about how the place works.) i will try to put me in contact with him soon.

Dr Krongrad thanks for answer my questions again, we already had the pleasure to talk by telephone in a couple of ocassions, if i still have some is because i want to be totally sure about the all the alternatives before to take the radical one (even if it is the definitive one).

At least here in Poland no body is totaly cured from the illness,its a lot of young people suffering from prostatitis, some of them reports some temporaly reliefs but the illness always, ALWAYS!! strikes back again (in winter with minus 20 degrees its really terrible); and of course all the urologists are against that kind of surgery.. arguing the typical reasons (that such a young man; you even doesnt looks ill; patience, patience; no, no, no forget about it; you have to learn to live with that; bla, bla, bla..) and of course none of them offers you any single solution besides the standar and evidently ineffective treatment (antibiotics + antyinflamatories + painkillers) that taked for long time hurts you another organs in your body... and the worse, they say (thats true) that nobody around the world really knows so much about the prostatitis and being realistics they dont care.

Of course the people is looking around for another possibilities.. massage, acupuntura, miraculous herbs, exotical treatments, etc.. to fight against the symptoms, (mainly the pain) just like me.. after two years trying everything, i dont know what to do, im feeling completely helpless, alone and lost.. but still fighting, sounds dramatic but is just like that even trying to keep the good mood.

Im afraid of the surgery for the same reason that the doctor kongrad expose me once, "its no guarantee about the results"; and my main fear is that the pain would remains after the operation, i.e, (check the link):

http://groups.google.com/group/sci.med.prostate.prostatitis/browse_...

For that im so interested in the differentiation between the prostatitis, maybe thats the key to have a successfull intervention or a properly treatment; because im still trapped in the vicious circle that how you can obtain a properly diagnosis it is not a clear defnition of the illnes itself and viceversa.

Trying to be reasonable, and abussing from your time; my new questions are (i guess the questions that many of us have):

1.What are the procediments to obtain a properly diagnosis, its possible describe them step by step?

2. After a properly diagnosis can the typical treatment cure the illness or only bring you a temporaly relief? (any cases?)

3. In Case of prostatodynia, or non bacterial chronical prostatitis, or bacterial chronic prostatitis, can every single ill person be benefitiated with the radical prostate extraction or exist some specifical conditions for each type of the illness? ( I still dont know what i have, PROSTATITIS or PELVIC PAIN SYNDROM.. whatever; then can im my personal case be obtained good results?)

3. Why the pain can remains after the extraction, wich is the reason.. and in that case what are the plan B for this such of patients? ( Did the specialists know any case like that?)

4. And the last one (for the doctors specially):
Dr Krongrad if you still keep the contact with the the case Radford, can you described wich can of prostatititis he had, even the second case that you refer us...i mean the history of their illness.

Dr Eden can you bring us more information about the five cases of prostatitis that you succesfully operated?, maybe comparing their stories with our ones can be possible stablish some parameters to compare.

Well, thats all for now, one thousand of thanks for your patience to read that, and one million more for your inapreciable help.

Good energy. German
The six urologists who refused to massage your prostate, saying the EPS is not definitive evidence, and that a semen culture is enough, are all wrong. All six of them. Because my semen was tested recently, along with my prostatic fluid, and my semen came back from the microbioliogist "clean", but my EPS was infected with multi-resistant stapholoccuccus Aureaus, along with E.Coli.

You worry me when you say that a nurse at the hospital is, " gonna practice me the first prostatical massage in my life :/ to collect the EPS and be checked in a laboratorium for bacteries,"

Has the nurse done this procedure before? You better ask him or her. Because you don't want somebody practicing such a delicate medical procedure on you without any experience, they can easily make your condition worse if they're not skilled practicioners. If they are, then fine, go right ahead, because it's one of the most important tests available for an accurate diagnosis of your condition. While your at the hospital, I would also recommend that you get tested for any fungal infection you may have. This can be done by having an urethral swab.

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