Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.
I have been living with what I recognize as chronic non-bacterial prostatitis since January 2011. Early on, I had slight discomfort urinating, slight dribbling, and pain at the base and bottom of the penis. From the very beginning, my urine tests always came back negative for STIs or bacteria. They did appear to show signs of inflammation such as the presence of white blood cells. Throughout 2011, I was put on the following antibiotics:
…and many others...
None proved effective.
That year, I also had a cystoscopy which showed urethral irritation, and I was diagnosed with non-specific urethritis.
I received relief through ibuprofen and quercetin.
During the winter of 2012, my symptoms took a turn for the worse. It became so debilitating that I had to take time off work. At this point, I called Dr. Toth in NYC and flew down to see him the very next week. I spent 5 weeks there and had 10 Injections, hoping that would clear it up. He commented that my left prostate showed significantly more scarring than my right. The injections were relatively pain free and I was getting the results I was seeking. The perineum pain disappeared, but I was left with this lingering pain that originated in around the location of my left seminal vesicle and radiated down my left leg to my heel. The pain was definitely more tolerable than what I had been experiencing before seeing Dr. Toth. Now for the life of me, I could not figure out if this pain had been with me previously and I had just not noticed it due to the severity of the perineum symptoms, or if it had originated in New York. The pain was exacerbated by orgasm, wearing shoes (aggravated the nerve in the heel it seemed), any exposure to heat (e.g. hot tub), exercising or working out my legs in any way (esp. biking), and sitting for long periods of time on a hard surface.
I received 2 booster shots, one from Dr. Toth in November 2012, and one from my own doc in February of 2013 due to recurring perineum symptoms.
During the summer of 2013, the pain that was occurring solely on my left side began happening on my right but to a much lesser extent.
In September 2013, I thought the pain in my legs might be due to an old skiing accident I had as a kid. I went on a campaign to solve it by seeing chiropractors, osteopaths, acupuncturists, physiotherapists, and rehab specialists. I had CAT scans and three MRIs targeting the pelvic and lumbar areas, all of which turned up normal.
Stretching exercises, particularly those targeting the piriformis muscle seemed to be helping. It seemed my symptoms had all but disappeared for about a week. I continued them, but then I relapsed which put me back to square one.
In January 2014, I started getting mostly left-side pain at the base of the penis at the pubic bone, but on the top and to the left this time. I chalked it up to referred pain from my legs. This however continued and is occurring today. Some old urinary symptoms have also been appearing which makes me think I am having another bout with prostatitis.
Today, I nevertheless continue to see all of the natural doctors I have previously listed, but nothing has seemed to make a significant difference to date.
The items in bold underline are what I will be asking you about. By scanning these forums, it is easy to see that I am not the only person with these sciatica-like symptoms. Strangely, this is the first place I have come across people who report similar symptoms. Every doctor I have seen to date has stated they have never seen anyone display these symptoms.
I am curious to know what event (if any) brought about your neuropathic pain symptoms?
And Dr. Krongrad, how frequently have you encountered patients with similar/ identical symptoms and are you able to provide any insight as to a link between the two?
My doctors still believe that this is not related to my prostatitis, but deep down, I strongly feel that it is. It is very difficult to make progress when you and your care providers are not on the same page.
Thank you for any insight!
Sorry to hear. I've had burning pain in my thighs for about the last 7 years out of 13 yrs of prostatitis. It's been pretty consistent, worse with flare ups of prostatitis, less when not having flare up. Sitting pain, groin pain, urinary symptoms, etc. No problem with shoes and hot baths are very good for me. Exercise ok when not flaring, but I don't ride bicycles since many bikers get pudendal nerve entrapment (PNE) with symptoms like prostatitis and for a while I thought that was my problem. Steroid shots along the pudendal nerve even helped for 6 to 10 months at a time. I later had PNE surgery to free-up the nerve and thought it was helping, but last Dec, I got one of my worse flare-ups. Injections only helped for about a month at a time. Finally, about 8 months later, the prostatitis seemed to ease off on its own. Pain from about a 5 down to about a 2. If you've been a bike rider for a long time, maybe you should look into this. Good luck. I am considering prostectomy, but man is it scary.
I believe, from my experience with chronic non-bacterial prostatitis that symptoms can evolve. I'm not saying that there is a clear progression towards the condition worsening but, for me, each flare-up I suffer produces a range, and divergence of symptoms. The last really bad bout I had to deal with was over three years ago, and I'm still living with the symptoms today. I, like you, was struggling with a shooting pain that radiated down the back of my left leg and into the sole of my foot. This sort of referred pain is a common symptom of prostatitis and is not so unusual given the parallels that can be observed when a person's sciatic nerve becomes inflamed.
I'm sorry you've encountered a Dr. who seems unable to accept the obvious logic behind this type of nerve-based, referred pain, as in other conditions people seem more than happy to accept the association with little scepticism.
How to get rid of it is another matter. I benefitted from a walking regime, that, over time, I was able to develop into something more akin to hiking. I used to cycle for a club in Manchester (UK) but I wouldn't advise that type of exercise any more due to the pressure that can be applied to the perineal area.
Sorry I can't give a definitive answer to the problem of how to remedy this type of pain, but with sort of condition you've got to be patient ( I've had it for eleven years ) and try and wait for your body to heal.
Good luck, James