Arnon Krongrad, MD's Comments

Hi Dr Krongrad,

Thank you for this site and the information about prostatitis. 

You kindly asked me if I had PSA checked and whether I had trauma, history of cancer or vasectomy. I have had PSA checked many times - always it being in normal values. I have not had a vasectomy and I don't know of any history of cancer in my family.

When I got prostatitis 20 years ago for the first time, it began with blood in semen. My symptoms have always been gnawing pain in the perineum area and the feeling like a lump in the rectum. My first bout took about a year to get rid of with many different antibiotics used. I was then living in England and was being treated by a research urologist at Oxford University (attached to the John Radcliffe Infirmary).

I've lived in Calgary Canada for 18 years and my urologist gives me flomax (useless) and he just shrugs saying that there isn't a cure for this problem. He referred me to a physio who does pelvic floor massage and told me to take quercertin. I have not had the PF massage yet.

My symptoms generally go away after a few weeks of levaquin and diclonefec. The problem for me is that bouts of pain etc are always caused by ejaculation. This of course means I rarely engage in this practise. I get temped once in a while when my wife says "maybe it's okay now" but truth is, whatever is broken seems to stay broken.

When I do ejaculate, the pumping action behind the mechanism (maybe it has a name) is very weak and so it sort of feels like there is a constriction. The liquid does not exit like it used to when I was younger - it just flows out gently.

Here is another strange behaviour. The last time I went to the ER for a very acute bout (two years ago), the ER doc gave me percocet (cetaminophen and oxycodone). Taking these and anything with codeine (tylenol 3) makes the pain increase. My urologist is stumped - I can tell he thinks I have lost the plot. I had sinus surgery two years ago and had no prostate issues at the time. After surgery, I was given percocet and the prostate pain started to present itself about one day later. I stopped taking them - the pain subsided.

I have no trouble with urinating. I don't have to urinate frequently at night and have no pain in the tip of the penis. Usually at the beginning of a bout (like I have this week), I get chills and sweats - kind of like flu for a two or three days.

You asked about trauma. When I was 18 I had a motorcycle accident. The result was some internal injuries and so I had my spleen removed and my left kidney is smaller as it was torn and was sewn back together. Today it functions perfectly as far as they can tell. I have a mid-line incision from just below left lower rib to one inch below the naval. 

Thank you for asking about my story. Again, thanks for your site and the information here.

Robert

My urologist mentioned that it might originate from my spine, but no tests were done.  I don't recall any injury or funny movements.  I don't really have any spinal pain.  My pain is all in my lower pelvic area.  I feel pressure against my rectum and bladder feeling a painful urge to urinate all the time.   Would welcome any suggestions.

Hello Dr. Krongard,

I had a TURP 16 days ago and overall it went really well.  My only concern, and it's a substantial one, is  regarding my orgasms.  I've had two orgasms since the TURP (on days 14 and 16 after the surgery) and the sensation I experienced during orgasm was a "2" whereas before surgery it was a "10."  My urologist said that it was highly unlikely that the orgasm sensation would change as a result of the TURP and all the literature I've read says the same.  Is it maybe because I'm having orgasms too soon after surgery?   I'm in overall great health and just 51 years old so the thought of living the rest of my life without at least decent orgasms is very depressing.  Any info you can provide would be very much appreciated.  Thank you.

There is a general tendency, and maybe it applies to you, too, to rush and prove "manhood" in all its facets after prostate surgery. This reflects anxiety in most cases. And anxiety in itself can negatively affect orgasm, as well as many other functions and pleasures. I'd be interested to hear how you do not 2 weeks after surgery but 6 months after surgery.

Went back to my PC a week & a half ago, the only antibiotic i was on was levofloxacin for 10 days by my urologist so my PC put me on sulfameth after 2 days bad reaction (light headed, cold sweat, burning urine, in frequent urination) stopped, switched to cipro 500mg 2x a day for a month,  taking a few vitamins and supliment super beta prostate.Been on a low acid ic diet since before the new year,spring water, not much change,very down. See my PC in a week or so,dont know whats next, hope he does

Hi Dr Krongard.

When you do LRP for prostatitis do you spare the internal sphincter and what effect this has to incontinence?

Thanks for answering!

Do you know any data about how pre opt chronic prostatitis effects incontinece after LRP?