Acute and chronic prostatitis discussion. Arnon Krongrad, MD, moderator.
Hi everyone! I'll start with a brief introduction to my case, before the part on antibiotic injections which I do believe interest alot of people.
I am a 24 year old male from Sweden, and I got my first prostate infection at about 21. Realizing afterwards that I've had it for a while, I started to seek medical care once the symtoms started to get unbearable, but Swedish healthcare is extremly restrictive with antibiotics and I was denied it for months despite several visits to different doctors, and an extremly symptomatic situation. At last, almost begging on my knees, I got two weeks of cipro, and bought another 4 weeks of cipro on the black market (..).
This cleared my infection up and restored me 100% - with one exception. I seem to always get re-infected when having unprotected sex, with otherwise non-pathogenic bacteria naturally found in the vagina, as do many prostatitis patients. I cleared up another infection a year later with 10 days of antibiotics, luckily - but another year later, never failing with antibiotics - I took several too short courses with ciprofloxacine and doxycykline, making the bacteria resistant to various levels to those two precious prostatitis agents.
I tried many other antibiotics on the market, and responded to all of them targeting gram-negatives, but nothing eradicated the infection completely, probably because the infection also had spread and severly affected my right seminal vesicle. Despite living in the capital of Stockholm, there is no medical attention to prostatitis at all, and all of the 10-15 doctors I visited, including a few urologists, kept sending me home claiming I did not have an infection as "antibiotics didn't help", also telling me I should "go home and learn to live with it".
A year later of failed oral antibiotics (mostly bought on the black market) even when overdosing and combining them, I decided upon going to Italy for injections, and let me start by saying this;
Injections DO work. It is a valid treatment option for bacterial prostatitis, and should probably be done in all severe, treatment-resistent cases, before the bacteria causes irreversible damage or fails to respond even to injections.
Wheter massage or injection protocols, there seems to be massive critic to these methods, as they don't cure everyone (in opposite to what other prostatitis treatment?). People seem to say that it either "does work" or "doesn't work", but there is probably a big gray zone inbetween where many patients including myself are.
I underwent a prodecure of three injections with 10 days inbetween. At my first visit, no bacterial testing had been done but the doctor claimed I had chlamydia judging by the pattern of my calcifications. I know for sure, 100% that my infection is not chlamydial and started dropping many strong arguments for it, but the doctor wouldn't listen and still gave me an injection with the old chlamydia-agent rifampicin, with a little mix of cipro (resistance!) into it.
I got slow response and started to relapse at about day 6-7. At my second visit, the PCR-tests for chlamydia was negative (no cultures on gram- was done!), but the doctor would still want to use rifampicin. However, it was out of stock and I got amikacin + cipro instead. This improved me GREATLY, the result was INSTANT and my symptomps were 95% down for a full 7 days, until I once again started to relapse from my right seminal vesicle.
At my last visit, I suggested that we continue the treatment with a forth injection after 6 days instead, with the same antibiotics, but I was denied this. The rifampicin was in stock again and he used it, despite the poor results. I have no explanation for this behavior, other than that the antibiotic is old, out of demand and probably extremly cheap. Needless to say, the results from the third injection were once again poor and I relapsed. Also, unlike the first two injections - the third was painful and today, a week later, I still have pain from it.
So, statistically - I am one of those who were not helped by the injections, I only got worse from them. Does this mean that they don't work? Doe's it mean that I have non-bacterial prostatitis? That it is treatment resistent and that I should stop pursuing the antibiotic way?
No. It means that the protocol was performed poorly. The injections have great potential but needs to have some adjustment. First of all, 10 days inbetween is too much. Secondly, my case shows the importance of choosing correct antibiotics even at these concentrations. Thirdly, I couldn't help noticing the needle is awfully thick. This probably allows for a quick injection, but could cause damage. The Chinese claim to have longer and much thinner needles for this reason, and it might be true as their injections lasts for 1-2 minutes while those are done in ~15 seconds including both seminal vesicles.
The temporary relief but fast relapsing we hear about could maybe be attributed to failure of the doctor rather than the method itself, or patients ejakulating the treatment out too close to the injection. Relapsing in months or years could depend on sexual contact, and not treatment failure.
I do believe this method works, but that sometimes questionable results are a result from poor performance of the treatment. My recommendation to chronic sufferers thinking about undergoing the procedure, is to go on with it, but not in Italy. I hope my experience and thoughts provide helpful to someone out there, as there is little information on the internet on this from a patients perspective.
Are there patients benefited from treatment in Rome ؟ for me i can only get this kind of treatment from guercini china it's very far and more expensive .
I had injections done by Dr Toth, a New York doctor specializing in Fertility solutions. He also never tested and claimed it to be caused by Chlamydia even though I have tested repeatedly negative prior for Chlamydia and other infections. I took 2 shots of a combination antibiotics, therapy was suppose to be for 10 shots, but the I stopped on the second shot because the shot almost took my life. I had serious pains 5 -10 mins after the injection , my heart almost stopped. It didn't work for me and I will advise anyone to be very careful going with this treatment protocol.
I myself moved on to Dr Toth in NY, where I stayed for 45 days of treatment.
Dr Toth, just like Guercini, suspected chlamydia judgning by the shape of the calcifications at one spot in my prostate. I knew for sure that my bacterial prostatitis at this point was not a chlamydial one - but I became open to that my first episode of prostatitis might have been chlamydial, leaving those traces that confused us all.
No testing was done and I got a mix of many different antibiotics and also a steroid to accelerate bacterial activicy, thus making them easier to kill. I was skeptical to this mix as I could identify only gentamicin as active against my infection, but we carried on with two injections with two days apart. The first injection did maybe help a little, but caused bleeding, but the day after the second injection - all hell broke loose. My prostate got extremely inflammed to the extent that I almost called an ambulance. The pain was out of this world, and if there was a surgeon beside me offering to take the prostate out, I would not hesitate to do so. At this point, I almost flew back to Sweden 'til I figured out what to do next.
I attribute this to the steroid and the needle trauma itself - where we put stress on an already sick body part, without the sufficent antibiotic to deal with the core of the problem.
Unlike Guercini - Toth was communicative and at my third visit - he put all his antibiotics in front of me and said - pick whichever you like for your next shot. Confident that my infection was caused by gram-negatives, I choose a high concentration of gentamicin and cipro (despite quinolone resistance at orally achieved concentrations). After that third injection, my symptoms subsided rapidly and I felt better than I've done in quite a while.
However, as I mentioned in my earlier post - my issue was also a severely infected seminal vesicle. We were injecting it too, but progress was slow and I asked Dr Toth to take a closer look at it. He found that the very tip of the seminal vesicle was scarred in a big lump, with no communication with the rest of the vesicle, nor with any fluid production. Toth switched to injecting this part of the SV, and immidiately as the needle went throught - I could feel (from the pain) that he found the right spot. I was in such a severe pain during and after the injection, that they had to calm me down with dermarol (morphine-like substance).
Does this mean that there's something wrong with this treatment method? No, it means that I was very sick. The condition of my seminal vesicle was so bad that even Toth was not sure if it could be saved, and I was even in contact with Swedish surgeons regarding a removal of it. However, the seminal vesicle pain started to subside aswell after injections at this spot - and the ultrasound also showed that the SV started to regain it's structure. Each injection was painful but less for each time.
A month in into the treatment or so, I started to feel close to completely cured. By this point, I had abandoned oral antibiotics since a few weeks aswell. On my initiative, we did once-weekly injections instead of twice weekly. At this point, I started feeling somewhat symptomatic again and by the time I flew back, I had relapsed fully - but only from the prostate - the seminal vesicle was much less inflammed compared to baseline. It should also be noted, that the injections were not painful at all the end of the treatment. I went from litteraly rolling on the floor from pain, to not feel it at all.
After misuse of the trimethoprim antibiotic - I was afraid that it too wouldnt work for me now like the previous antibiotics that's been inactivated by my bacteria. To my surprise however, it worked better than ever before. I recalled the numerous particles I discharged during the treatment - in different sizes, shapes and colors. This was probably blockages that now were reduced, and made it easier for the antibiotic to do it's job. This also made me switch strategy from adding more antibiotics, to deal with blocking of the prostate and enhancing the effect of the antibiotic.
I did this by antibiotics (trimethoprim), daily self massage (by pressing hard on the infected and voided part of the prostate), allicin, EDTA suppositories and L-arginin. Two months into this treatment, I'm more or less symptom free. My everyday symptoms are mostly gone - and by now, I can't even produce pain from palpating the infected spots, neither on the prostate or seminal vesicle. I had more pelvic floor tensions than I was aware of - all caused by the inflammed seminal vesicle. I even give it a chance of me being cured now, but I'm not taking chances and I'll sustain on this regimen for another month of two. I can't tell which of the compounds did the most good, but I'd guess antibiotics and massage alone.
I have no side effects from the total of 12 or so injections I had as far as symptoms go, but there might be some scarring or whatever from them.
So, to summarize - injections are a very effective treatment method. Not only does it achieve high antibiotic concentrations, but there's also a possibity to add antibiotics that cannot penetrate the prostate with oral or IV delivery - such as the aminoglycosides, rifampicin etc. It also seems to render some mechanical de-blocking of the prostate, and its probably the only effective way of treating a severly infected and blocked seminal vesicle.
However, my experience is that oral treatment should be added to the regimen aswell, especially after finding out afterwards that the high concentrations from an injection is only sustained for 24h or so. Dr Toth treats many patiens with simultaneous intraveneous antibiotics. To many people, injections is a black or white-dilemma, but in reality it's like any other treatment - a poor performance of it may only be harmful, but carried out well - it's probably the last non-invasive option for many patients. I'm disappointed that there is not a new generation of doctors anywhere in the world willing to pick up this treatment and further enhance it to achieve a cure rather than improvment - or, I'm disappointed that I'm not in the position to do this myself.
The literature does not support the notion that "injections are a very effective treatment method," as shown by the data in the links above. This does not mean that injections have not worked and will not worked in individual cases.
One must carefully distinguish individual reports of success and failure from the observations made in a population of patients, from which one infers probabilities of success, which are useful in counseling the next individual.
The only reasons an injection would show poor results would be from
1. Performed on a non-bacterial issue
2. Injecting wrong medicines
3. Hitting the wrong point
4. Introducing treatment at a stage with chronically damaged tissues, even outside the injectable organs with symptoms originating from ie testicles, urethra, bladder, pelvic muscles etc.
What I'm trying to say with my detailed writings, is that I could have stayed in the group who did not benefit from injections but even got worse, discouraging other people to try them. But by altering the treatment both chemically and mechanically, I improved more than with any other antibiotic therapy. For example, when nothing else could penetrate my severly infected seminal vesicle - and the injections more or less cured it - the direct definition must be that it is a very effecctive treatment method, regardless of it not being effective for someone else with different pathology.
Yes. In an individual case it may be effective. Or ineffective. A new patient cannot know what will happen to him by looking at any other specific individual case, be it a success or a failure. The only reasonable choice for him is to look at population data, which in the case of injections are not very encouraging. In general, it's not a good idea to encourage or discourage based upon an individual case. It would be much more reasonable to encourage or discourage based upon clinical studies done with populations of patients, as linked above.
We have a very poor understanding of the causes of the symptoms we call "prostatitis." So yes, the failures of injections may very well be because they are used in patients whose symptoms actually have nothing to do with bacteria. This would include patients in whom there are bacteria cultured but in whom this is merely an irrelevant distraction having nothing to do with the symptoms. This may be a dominant explanation for the failure of antibiotics, be they orally, intravenously, or directly administered. We just don't know.
I am getting alot of relieve from Azithromycin antibiotics. I can say that I am 99.8% cured. Just having very mild discomfort in rectal area, i guess from antibiotics killing off the good bacteria.
"discomfort in the rectal area is a true sign of prostatitis my friend."
Unless it's a sign of hemorrhoids, fissures, fistulas, abcess, pilonidal cyst, constipation, appendicitis ....
@Blake, i cannot describe my discomfort as pain, I have never had pain in my rectal area but mild burning sensation in my rectal area that comes and goes.
@Goran.You said you relapsed(in prostate) at the end of injections treatment,so prostate was treated with injections,or not?What time has passed since injections therapy,and are you still feeling better?And what your thoughts on this ,would you need another trip to see Dr Toth,and feel there is a chance get cured?Thanks
Yes, we treated both prostate and my very infected seminal vesicle with injections. They more or less cured the infected seminal vesicle, but something survived in the prostate and I relapsed. Since then, I've been on oral antibiotics, self-massage and EDT (dissolving calcifications). A, and I feel very good by now. It's been 3 months since my last injection, and I'm more or less symptom free. I seem to relapse a little however once I stop the daily massage, but for each time, the flare-up is less severe.
I attribute much of the success to the EDTA, to the extent that I at this point am working with a biotech company to develop an EDTA product for prostatitis patients only. At this point, we are testing different kinds of EDTA to see which chelates the calcifications most effectivly and which cause the least reactions in the human body. The current EDTA products cost a fortune, and we prostatitis patients need plenty of it. We plan to offer our product at about a third of that price, making this treatment option available for other sufferers than well-capitalized westerners.
At this point, I feel so good that I don't think I would need another trip to Toth for treatment. Whatever is left in my prostate is located to a small spot that's probably blocked with calcifications/plaque, and I believe these has to be dissolved to achieve a full bacterial eradication. However, a blockage of the seminal vesicle does not consist of material, but rather swelling of the tissue itself. Oral antibiotics would just not clear this part during all my courses, but repeated injections did - not only improvning me to a great extent, but also allowing oral antibiotics to affect whatever was left of the seminal vesicle inflammation.
For those who decide to undergo the injection treatment, I also recommend staying on oral antibiotics. I have no pain symptoms whatsoever after the injections themselves, allthough they might be some scarring that I'm unaware of.