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

Dr. Krongrad, is there a difference in bi lateral nerve sparing with no cancer (ie prostatitis) and those who have cancer? What I mean is, can you leave a larger prostate facia behind when cancer is not a risk, meaning less heat damage to nerves as more space between cautery and nerves, ie less thermal transfer?

Please correct me if my question doesnt make sense.

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Thanks for the details of this case Dr Krongrad. It helps me understand how easily this condition is mis-diagnosed. I have been on Lyrica (Progabelin) for the past 2 weeks and have experienced a lot of relief (at times total). I am begining to realise that the inflamation in my prostate is compressing nerves, and that Lyrica seems to be the only "very effective" pain control for my particular case. My GP was willing to try it with me, after I showed him evidence of some others having success with it (he said it was "not in the prostatitis box" however). My prostatitis seems to be a type of neuropathic pain that Lyrica seems to make quite a large dent in. Having thought about how this guys case ended up with spine surgery, now does not seem so outrageous.
I am thinking this is where I am... It is so frustrating to have Medical professionals look at my lean body and overall good physical condition at 49, and always comment on how healthy I am and then seem to disregard any symptom I describe.. My prostate has passed all tests so far (still waiting on PSA), and even though the latest Uro has stated he thinks I have Chronic Non-Bacterial Prostatitis, he is treating me with Cipro and pain meds. This, in spite of having to quit work for a month now, total weight loss of 22 lbs (part I attribute to "the season", no lunches for months) from 147 to 125 and I am 5'10 1/2"... I have had probable prostatitis several times in my years, but never so bad that it was debilitating like the last few months.. Until reading all of this, I never knew it could be that bad, yet everything be so normal. Seems like all they screen for or take seriously is cancer...
I am hoping I can see Dr Krongrad and finally get back my life and the activities I enjoy so much...

mike said:
Very interesting Dr Krongrad. You, mention the patient had a normal small prostate yet the surgery cured him. This goes to show a normal looking prostate with no inflammation detected can still cause miserable prostatitis. Pelvic floor disorder would have been this guy’s diagnosis in the current leading authority for prostatitis. Years of painfull pt would have been his prescription.I doubt a pt would have cured this guy. Hopefully this man will post after he recovers. Thanks for the interesting post Dr K. So the lesson here is a normal appearing prostate can indeed cause prostatitis symptoms. This is big news and helps me understand my condition.

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