Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.
its been a while since i have been on here. my life is pretty much back to normal .THANK GOD!
but i would like to hear from the guys who have had the surgery and give us some updates.
i dont see anything current or detailed . thank you.
i pray for us all every day! GOD BLESS!!
The desire for knowledge is obvious. The question is how to get it, amidst all the noise and distraction.
The essential point we've defined is: Knowledge comes only with specific methods. There is absolutely NO substitute for properly designed clinical trials as one step to knowledge. And there is no substitute for seeing that a scientific observation is reproducible as the ultimate step to universal truth. With prostatitis, we are far from knowledge and universal truth.
To this point ...
You did a lot of research before having injections. Implicit is that this research consisted in talking after-the-fact with other men. The finding was that "most have been helped." Men call me routinely from the US and abroad who report severe decline in function after injections. None has produced and I have not found a prospective study of the association of injection with symptom relief. So we have contradictory observations, perhaps partly explained by selection bias. The only remedy, the only way to a valid clarification, is a clinical trial.
Relating to your findings: What proportion of the total treated, i.e. the denominator, do the "helped" represent? How many of the treated were lost to followup and were they accounted for in the summation of the total treated? How much were the men who were helped helped? Was a standard index, such as the CPSI, used to measure their symptomatic improvement: Are we comparing apples to apples? How did those who were not helped fare? Were they worse? If worse, how much worse? Are there any published data on the magnitude, speed, and durability of symptom change after injections? If so, can somebody please post it? As a patient considering injections and wanting knowlege, these are questions I'd want answered.
There are in fact prospective studies of specific treatments for prostatitis. A few are posted on the home page (see left column). These studies illustrate scientifically and convincingly that specific treatments, including antibiotics and alpha-blockers, do not work for prostatitis. One might say we have knowledge about these specific treatments. Is there such knowledge about other specific treatments: Massage, injections, herbs?
You are asking all the questions any man would ask. Understood. The answers you are getting -- "John Doe" got better -- are inadequate. They are perhaps all one has in the absence of knowledge, but one should not confuse them for knowledge. Happily, all my patients seem to understand this point and are thoughtful. All are agreeing to enrolling in the clinical trial, so that today's data can inform tomorrow's decisions.
One reason there is such poor knowledge about prostatitis: The affected community is disorganized and inactive. Compare to breast cancer and HIV activism and you see the point instantly. Enlightened activism would help.
We must raise the level of knowlege about prostatitis treatments. The only road to this knowledge is science.