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

Dr Eden,
Of the five radical prostate removals you have successfully carried out for chronic prostastitis sufferers, you say four were found to be cancerous. Were any further tests carried out to discover whether these prostates were infected with bacteria?

Dr. Krongrad,
Same question


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No further tests. Remember that prostates go in formaldehyde, which kills bacteria, which means culture would be useless. You could stain I suppose. However, the prevalence of bacteria in prostates, including benign prostates, is very high (source is a 1980s paper by a Dr. Gorelick). We would surely find bacteria if we looked for them.
Yes, Dr Krongrad, I am aware that bacteria is found in healthy prostates. But a healthy prostate can deal with bacteria on a daily basis, keeping it in check without symptoms.

Whereas an unhealthy prostate, one which has been chronically inflamed over a number of years due to improper treatment, or one which has been damaged because of fibrosis--again due to improper treatment, cannot deal with this bacteria and so symptoms continue to rage. On a recent trip to China, I was told by a professor of urology, that the prostate has its OWN immune system, completely seperate from the body's immune system. This was news to me. He went on to say, that this is the reason why so many sufferers feel improvement in their symptoms once they improve their diet--cutting out spicy foods, fizzy drinks, coffee, and eating a more bland diet--because you are assisting the prostate's immune system in dealing with the bacteria. I have no idea whether this is true or not, and can cite no medical papers, but there are many c.p.sufferers who will testify that an improved diet has improved their symptoms markedly.

The argument about what causes chronic prostatis has been a point of controversy for many years. So I think it will be fascinating that during your upcoming study programne, the removed prostates could be taken straight to the path lab and analyzed for significant amounts of bacteria and fungi before they are immersed in formaldehyde. If significant amounts are found, then much new knowledge is gained; and the people who charge $4,000 for a weekend of yoga exercise at Standard University, the very same people who advocate that bacteria has nothing to do with chronic prostatitis, can be finally exposed as frauds and charlatans.
very well put chris.
A good question but the answer was 'no'. The whole prostate was fixed in formalin (which would destroy any bacteria) in each patient in preparation for pathological processing and analysis. Granted, a sample could have been taken for culture but the result would have been academic as the decision to perform prostatectomy had already been taken and acted upon. However, all four prostates demonstrated chronic prostatitis on analysis, but this is such a common finding in prostate pathology, even in patients with no symptoms of prostatitis, that it is impossible to know what significance to attribute to it.
Dr Eden and Dr Krongrad,

Is the reason you seal the prostate in formalin before removal, to stop any possible cancerous cells spreading to other tissue? If the answer is yes, is there any way a small section of the chronic prostatitis sufferer's prostate could be saved for a more comprehensive analysis of what's inside, and therefore what's been causing the patient so much distress?

It's possible that you're not really interested in finding out the root cause of chronic prostatitis; after all, you're both surgeons, so your expertise is in a different field, not etiology; and that's fine. I'm sure I speak for everyone on this forum, in saying that we're all lucky to have you contribute.

But to me, it seems such a shame that a diseased prostate which has caused so much suffering, is going to be rendered useless for analysis once it's been sealed in formaldehyde. You are supposed to be embarking upon a study programne, so the etiology of the illness is fundamental to finding a cure, and you could be missing out on a huge opportunity to gain added insight and knowledge into this awful disease which afflicts tens of thousands of men around the world.

What's wrong with both of you? Don't you want the Nobel Prize for Medicine?
Chris Wrote
tens of thousands of men around the world.

What's wrong with both of you? Don't you want the Nobel Prize for Medicine? >>>>

Hello Chris,

This was already done by Dr.Polacheck and pathologist Dr. L. Eduardo Vega. Dr. Polacheck has a book on how the prostate is made up and how the bacteria gets in the prostate from dissecting freshly removed prostates from people that have died with prostate problems.
he has a lot of information on this that's not on his website. His conclusion is it's very difficult to eradicate bacteria if not impossible because in the prostate there are natural wool like fibers in the acni-tubes and the bacteria also forms a shell around the bacteria (bio-films) with in this wool so it’s hard for antibiotics to penetrate in these bio-films. If the antibiotics even get in the acni tubes with in the prostate the chances of it getting in all of them I think are impossible.

I see the problem is that it's almost impossible to penetrate the well armored elusive bacteria within the prostate!! Even if these great surgeons did find bacteria the problem would be the same as the other doctor’s findings. And yes I totally believe that 90% of prostatitis is caused by bacteria and I see your point about let the research show this to be true.
I think these Doctors should get a noble prize for even answering our questions. I'm sure they will come to the same conclusion as these other doctors did that have done this by looking for bacteria. I think saving the prostate is like trying to save your bad appendix or bad gallbladder. I don't think there is a cure for a bad prostate just like there's no cure for a bad appendix. Maybe they should get a noble prize because they already found the cure..Laparoscopic surgery!!
I agree with ya soso.

Prostates always have bacteria inside them, its normal. There is no doubt that cultures on removed prostate with prostatitis will show some sort of bacteria present. Studys have all ready been done with this. Dr Alexander did a study a few years ago showing more Bacteria in non prostatitis patients. I think everyone just handles the bacteria differently. Or maybe the bacteria is not the cause. Could be a candida yeast issue/fungus or even a virus that cant be cultured. Autoimmune problems also come to mind.

Dr toth, guercini, polacheck have been studding this issue for years. They seem pretty clueless and like to blame chlamydia. If that is true, chlamydia, is almost imposable to get rid of according to dr toth
Mike wrote
Dr toth, guercini, polacheck have been studding this issue for years. They seem pretty clueless and like to blame chlamydia. If that is true, chlamydia, is almost imposable to get rid of according to dr toth>>>>

So true Mike..So they just keep making money on an organ that there is no cure for (Big Cash Cow)..My first urologist that I went to said that there is no cure for this and I thought he was crazy and he was the only one that said it the way it is..Good for him. He told me he could put me on antibiotics but it would be a waste and that in time it will calm down with out drugs just be patient. Why didn't I listen to him?..ERRRR
Maybe because there is no cure the other root to take or study is something like botox injections. I am on the list in Canada for a trial study. The idea is to just mask the syptoms and it can work for up to one year and be close to 100% syptom free.

Even if it comes back maybe it won't be so bad as the first onset. My uro says for most men it will burn itself out, just takes some guys 20 years or so, he says as a joke, some joke!
Another question for our two eminent surgeons:

Of all the prostate removals you have performed, what percentage of cases has incontinence proved to be permanent?

The reason I ask, is because this might be an acceptable trade-off for a patient with prostate cancer, a disease which will kill him. But for someone with chronic prostatitis, a non-lethal disease, the trade-off might not be acceptable if the percentage is high.

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