Hello Dr. Krongrad,

What's the cost of laparoscopic radical prostatectomy including the hospital and anasthelogist or just a approx total on everthing? And how do you get your insurance to pay for it if you have prostatitis?

Thanks for all your help.

Hi Soso,

The out-of-pocket cost to the patient varies by insurance policy. Having said that, for patients paying without insurance, the "retail" cost varies depending upon which facility we use. I can offer two facilities in Miami and one and perhaps soon two abroad that will be less costly.

To investigate something like this we need to go through two steps:

1) review of the medical situation
2) review of the insurance policy

This is best handled in direct coordination with our medical concierge, Hope, and our finance coordinator, Ruth, who can be reached at (305)936-0474 and/or hope@laprp.com and ruth@laprp.com

I hope this answers your question.

AK

Dr.Krongrad,

Thank you for your response..I guess there's no ballPark price on this surgery because there are so many variables involved.. What do you think about this procedure or do you already do this..

http://www.prostate-report.org/__prostate_surgery_need_not_mean_loss_of_potency.php Can this be done with laparoscopic radical prostatectomy???

What percentages do you see of sexual function coming back when the cancer is not in the nerve bundles after laparoscopic radical prostatectomy???

After laparoscopic radical prostatectomy do you see your patients the same for the most part as they were before getting the surgery except no more fluid on ejaculation. Like when you have your appendix out your back to normal.

When I watched the Arthur 'Bud' Burnett, MD, video it kind of freaked me out. Just sounds like not much of a chance of being whole again (Sexually) because so many things can go wrong like no more erections, no more libido, penis deformity and color deformity.

http://www.laprp.com/article.php?aid=351&type=7&r=6&page=4


Sorry for all the questions. I just think it’s nice to hear from a Doctor that has done so many of these operations so maybe we can see what the chances of being sexually active again and what penis deformity's if any after laparoscopic radical prostatectomy when your in shape don’t smoke or drink no other health problems??? You know like 30% 50% 80% or better yet 99% ..

Thank you for all you insight.

Hi Soso. I have not used Cavermap but don't really see the point. We can see the nerves just fine and there is no evidence that it adds anything.

The likelihood of return of function coming back varies with age, baseline function, illness (diabetes), smoking history, obesity, mood ... it's a complicated formula. Here is the story of one young man who regained his erections. I would expect that for a 39-y old, but not a 79-y old.

Hello Dr. Krongrad,

Thats great to hear you can see those nerves I wasn't sure about that.. when I looked at it being done on the net everything looks the same to me..LOL . Thank you for your time and showing me the testimony. That's great!!

I understand what you're saying, Dr Krongrad: which is, what worked for Pete the Plumber, may not work for me. I appreciate your candour.
Also, I get the impression that you think I should lower my expectations in respect to LRP--especially post surgery. I would just like to say that after reading Dr Eden's reply to my latest question regarding his sixth chronic prostatitis patient, my expectations can't get much lower.

Anyway, I have decided to do an internet blog on your forum regarding my upcoming LRP surgery; starting from entering hospital to leaving it--followed by periodical bulletins regarding my progress (or lack of) while recuperating.

I feel if I am going to be a sacrificial lamb, I want the whole world to know about it. If you have any objections to the blog, please say so.

I would welcome any questions. The idea of the blog is to educate the patient considering such a radical medical procedure, and to give first-hand knowledge of exactly what he will have to go through--the highs and the lows.

I feel I must warn you, though, Dr Krongrad, that I put up a daily blog on another prostatitis forum about my failed treatment in China, which attracted 32,000 hits. That was last year. Since then, the prostatitis forum has been forced to close down, because the doctor who treated me was discovered to be a fraud.

I'm sure nothing so dramatic will happen twice over.

dr krongrad.. will any side effects from the surgery be collected and displayed after each surgery.. I think men will want to see that data along with the cure in order to make a informed decision. thanks

mike

Happy new year Dr Krongrad.

I was just wandering if the 31 year old cancer patient you operated on was lucky enough to have bi-lateral nerve sparing or not, and if so have you heard how is he doing with regards to erectile function & continence?

Thanks

Nik

Fantastic news Dr Krongrad. Just what we all want to hear. Especially as I am 37 LOL...!!! I am becoming more and more tempted to do this just as soon as my partner & I try IVF and god willing succeed.

Thanks for the info.

Happy new year Dr. Kongrad.

I was wondering how many patients you have operated for prostatitis so far? Are they doing ok?

Hi Dr Krongrad.

It might be interesting to note in the trial how many sufferers have had this problem start due to past hemorrhoid treatments (Injections, banding, hemorrhoidectomy etc.) . I know mine and many other's prostatitis was caused by similar rectal treatments.

Regards

Nik

Totally understand your point Dr Krongrad, although it would be worth noting aside from the trial just out of interest-nothing official!

Hey Doctor Krongrad!
Yes Sir. I was diagnosed with prostatitis one year ago July 6.I'm only 22 years old by the way. It's been a year worse than any before "medically". I've been on some kind of antibiotic every month besides last November and March of this year(2 different Urologist one in Savannah and one in my hometown about 30 minutes from Savannah). I'm currently taking Noroxin...it helps in high doses but it makes my elbows hurt so my Urologist has bumped me down to on pill a day. I have the golfball feeling, blood in semen, yellow semen with gel type stuff in it, back pain. It clears when I'm on a high powered antibiotics like Cipro or Noroxin, but returns when finished...so I'm positive it is bacterial. Thanks for doing this research and and updating this site. I posted a link to this site on the Prostatitis Group on Facebook and I think it recruted more folks here...I hope it will bring more! I found out about you on CBN's website. You know what you are doing thats for sure, and it is more than apparent that you truly care about prostatitis and the people it effects and that is AWSOME! Any new findings in the trial you can talk about or is that hush hush until the trial is finalized? God Bless Dr. Krongrad.

That isn't me in the picture there, hahaha...I wish I were at the beach though!

Dr Krongrad, thanx for being interested in this group, actually i have 19 points, i dont know if its bad o good or which kind of level am i, but im pretty sure that my only sympthom is that i urinate a lot of times a day, my leucocits were high and now are in average, all my studies are ok but i dont stop going to urinate a lot of times every day, and im loosing weight, i only know one case in guatemala and my third urologist prescribe me Permixon, the second Cardura (doxasozine) and they told me to take it for 3 months and the cardura for 8 months, do u think i will recoverate? can i have this my hole life?
thank you very much Dr Krongrad

Hi Doctor.. Happy to help in any way I can.. please let me know what i need to do..

Dr K:
From your other group, as you know I am a Registered Dietitian. Since I don't have a picture on display, you don't know, I ethnically am African American.

I will be starting a non-profit organization, along with two other health professionals, which will target African American Men who we all know are at high risk for prostate cancer, using innovative methods to get them into their physicians for their physicals and prostate screenings, as well as to compel their friends and family members men to get their prostate screenings as well.

In my family, two of my 3 maternal uncles have had prostate cancer. One expired from it. Currently my father in law has prostate cancer, his brother died of prostate cancer and I have one son, who is apparently be high risk for pc as well.

By joining these "online groups" and via personal study, I endeavor to continue to educate myself about all types of prostate disorders for personal/family as well as professional reasons.

Hi Arnon,
Thank you for the information. I will read on it at a later time. It looks very helpful.
Regards
AED

Hi Doctor, thank you for responding, and providing a great forum. The CPSI opens as a PDF that I cannot edit....I want to submit it, how do others usually submit their results?

Thank you...I scored a 21. I am going to see another doctor today, but I am concerned as nobody seems to help, or know what to do. The heating method is the DOT method. My urologist wants me to do a Cytoscopy to see if I am eligible for a DOT treatment. My concern is that I do not seem to have an enlarged prostate, but a chronically inflammed prostate. No serious urination problems, or ejaculation pain, just chronic irritation inside and often eminating in my penis. In addtion it seems to affect up into my lower stomach area and manifests as somewhat of a nausea, or awkward feeling. I am going to try accupuncture for the first time on Tuesday also.

Hello Dr. Krongrad,

First, thank you for your informative answer. It seems most urologists don't want to deal with prostatitis at all, ignoring the facts and just saying "learn to live with it". It's good to see someone who cares.

I'm not a merchant marine, although it sounds like a cool job. It's great to hear though that I can speak Hebrew with your office, it can be much easier for me (and I have also discovered now that you have an Hebrew site).

I do believe that my problems come from the prostate. First came the premature ejaculation, two weeks later began the frequent urination, and a month later my ejaculation became very weak (The sperm is "dripping" instead of "squirting"). I think it can't be a coincidence that these different problems appeared in about the same period, and they can all be related to the prostate.

I'm interested in removing the prostate because it seems to be the only possible solution. I had a meeting with a new urologist yesterday, he looked at the tests and medicines I had, and said "Wow, you did the whole list.There is nothing more to do". Then he told me to learn to live with it, and decided I should do cystoscopy again - The third cystoscopy I do in the last 5 years. He said the problem can't be in the bladder, and unfortunately most urologists in Israel will agree with him about that. I have no chance to find someone here who will agree to remove my prostate.

I would like to ask, considering that prostate removal is still my favorite (and only) option, what is the next step? I understand the risks of the surgery and that it might not help me, but I'd like to know what is the possibility of making the surgery in your clinic. Should I do any more tests? Should I just call your office and get all the information from Ruthie? Or is there a recommended urologist in Israel that I should go to before we can make a decision?

Ofir.

Thanks for the welcome Doc. Hoping to spend more time on here. Great site.

Ill do that in future.

On the subject of cancer found in prostatitis patients like the 47 year old you just posted about and the majority of us who have had prostate removal as part of your study:

Is the discovery of cancer to be expected in a large number of patients given its frequency in the general non prostatitis community?

yes that would be fine with me.

Hello:

Thank you for your reply. I am still considering the surgery we talked about. I thought this site would give me more information on this disease and the treatment.

Hi Doctor,

Thank you for your reply.

I guess my query came from the comment regarding high percentage of men with chronic prostatits developing prostate cancer .. PSA level is ok at 1.2. My father had acute prostatitis, but no cancer..

Thanks again.

Hi.Dr.Krongrad,

Thanks a lot! Just a couple of question from you initially.

1. Is there any proof to suggest that people with Chronic Prostatitis have a strong chance of developing prostrate cancer on the long run (i.e. if the condition in not resolved, say in a certain number of years for example).

2. My main symptoms now are pain when sitting (back of the thighs burning, and tingling perineum), low force when ejaculation and burning soles. The former of the 2 symptoms comes only when i sit. My last EPS check though was not bad, which showed marginal between normal and abnormal in White Blood Cell count, and no pluss cells. I have been told that the pain when sitting is because i have a sensitized nervous system due to the long term nature of the decease and neurogenic inflamation. Can some one in my position benefit from surgery and how much would such a surgery cost?

Thanks again, and great to see a website with so many other individuals sharing there stories.

Shehan.

Hi Dr.Kongrad,

Thanks a lot for your answers. I will certainly speak with Ruth, and will also check out the links you suggested.

Regards,

Shehan

My score on the CPSI was : 23. In the beginning it was a lot higher.

I have been diagonised of prostatitis for five years.All attempts to cure has fail.what is the next step to follow?

I'm greatly encouraged by all the new material on the website. After a quiet period on the forum, suddenly there's a lot of positive new information. I'm hoping that when the study is published increased awareness among doctors will mean that many more men (including myself) will benefit.

Hi,
thanks for responding so promptly. I´m 45 years old. I´m desesperate and I don´t know, if the best way is removing my prostate gland. I bet that sexual satisfaction without pain after, will be impossible for the rest of my life. My next step. I have no idea.

Thank for helping. Juan

I have a question regarding the "Inclusion Criteria" for the LRP study. Why does the age have to be 30 years or greater? I know plenty of other sufferers on their mid-late 20s who may consider the treatment as an option.

Thanks

I’m 36 years old and I’m from Romania.
Approximate of one year I suffer from chronic prostatitis/pain pelvic syndrome.
Symptoms are:
Pain in all of pelvic area (pubis, penis, testicles, perianal, anus), burn on my urethra, especially after urination.
Urinary disorders: frequent urination, with small quantities of urine, nicturia, sometimes cloudy urine or with bad smell.
Sexual disorders: loss of libido, Erectile dysfunction and abnormal penile sensitivity, performance anxiety.
Treatments were with antibiotics, alpha blockers, pain medications, natural treatment, all with no substantial improvements. Last ultrasound showed calcifications in the prostate.

My name is George i am 25 years old from Bulgaria.
Many years before doctors discovered me glumeronefritis
After several years I began a hemodialysis.
In 2008 i had a successful kidney transplantation.
Several months after transplantation had
complaints expressed in this: difficult urination,
pain on urination, urinary retention in the bladder,
discomfort in the area of gender RA.
From tests of sperm they find chronic bacterial prostatitis
due to E.Coli.I started to take antibiotics.
but without any effect.I think for surgery,maybe that is only option to cured this simptoms and this disease.I'm desperate from this pain and my condition is not good.

I mainly use Benadryl for Interstitial Cystitis and get some sleep, I have not been on Benadryl vary long but I can't tell the difference yet ,you think should get off of it ?

I was diagnosis chlamydia but it took them 7 years and I was given a shot azithromycin and
4 pills.

Have the symptoms but haven't had a DRE or prostate fluid checked.
only had a urine culture don't and it was negative.

I have had the current symptoms for 4 for months after having epidymitis.
The worst symptom would the urge to urinate straight after urinating.

Hello Dr. Krongrad,
I'm 41 and I've had it for 2.5 years now. I've been following you trial since Dec 2008 reading everything silently until couple of weeks ago, when I was not able to access any posts without registration anymore - so had to register.
Symptoms:
Pain - only on the right side. Perineum, right side of the penis, right side of the tip of the penis, right testicle, right side of rectum, right side of lower abdomen, right side of lower back, radiating - you guessed it - right leg! Burning on urination - sometimes, discomfort during sexual climax. I don't really pee that often, but almost always feel like I need to go. I experience difficulty passing urine and stream is weak. I had mostly urinary symptoms in the beginning, but now always discomfort in perineum and pain most of the time.
Treatments:
Levaquin 500 mg 6 weeks, 750 mg 2 weeks
Bactrim 6 weeks
Doxycycline 4 month
Flagyl 4 weeks
Prostate massage - 3 times a week for 3 month simultaneously with antibiotics
Flomax
Sanctura
Detrol
Vesicare
ProstaQ
Lyrica 25mg x 3 times a day, 50mg x 3 times a day, 150 mg x 3 times a day
Don't take any of this anymore.
Ultrasound of scrotum - epididymal cyst
Ultrasound of prostate - calcificaions, small nodule on the right
PSA 0.5
CT abdomen & pelvis w/contrast - nothing
Cystoscopy - nothing
Saw couple of urologists + 2 professors of surgery, one of them "internationally recognized expert on prostatitis". Asked him about your trial - he called you crazy. "Don't go to Miami" - hi said - "You'll wake up with the same symptoms, impotent and leaking urine." At the same time he mentioned a patient of his who had prostatitis and was diagnosed with prostate cancer. Had prostatectomy after which all prostatitis symptoms disappeared. Another professor offered "INTERSTIM" therapy for urinary control www.interstim.comI asked if he thinks it's gonna help and he said: "I don't think so, but I can do it anyway because I've been doing it for 8 years." I respectfully declined.

I guess only prostate injections and trip to China are still missing from my list...
I appreciate what you are doing.

"Asked him about your trial - he called you crazy. "Don't go to Miami" - hi said - "You'll wake up with the same symptoms, impotent and leaking urine." At the same time he mentioned a patient of his who had prostatitis and was diagnosed with prostate cancer. Had prostatectomy after which all prostatitis symptoms disappeared."

I would refuse treatment off any Dr who contradicted himself so obviously as this. He see's that one of his own patients is cured from prostatitis symptoms, yet still says you will still have the symptoms-PRICELESS LOL....!!!!

What do we know and what do we not know about helping men get rid of their symptoms. Does the expert quoted have a solution for men with severe, treatment-resistant chronic prostatitis other than LRP? If so, can we see the data?

The corollary is this: Is LRP effective in helping men get rid of the symptoms of severe, treatment-resistant chronic prostatitis? Fair question. So how do we answer it?

The first step was the case of the LRP done for David Radford. That LRP provided complete, immediate, and durable relief with no side effects. You can see an interview with David 2.5 years after his LRP on this site and on the Prostatitis Surgery site. David's case caused us to wonder if his was the unusual or the unusual case?

The second step was the initiation of a prospective clinical trial to quantify the symptom response in men with severe, treatment-resistant chronic prostatitis? That trial is ongoing. It will not be the last word on the subject but it is a better word than a single case with a great narrative.

Until the trial is done and reproduced and expanded, we will have only case reports -- with all their attendant limitations -- upon which to base any decisions. Because the idea of LRP is new and because the argument for it is based upon symptoms as reported by patients, not by doctors,we have made every effort to let the patients publicly and directly speak for themselves: This social network and the recorded videos. Perhaps the expert quoted would join us here and interact with David, Ike, Rich, Robert, Christof, and Dr. Muff and see for himself.

I'd be interested in hearing from patients who have had effective treatment with approaches other than LRP for their severe, treatment-resistant chronic prostatitis. Are they available?

Peer-reviewed Journal Articles:
Radical prostatectomy for chronic prostatitis: BJU International, 91 (3cr), 300, 2003.

I would be very interested to know more about that.

Silent Reader, you and I have seen the same doctor. Funny, he basically said the same things to me about the prospects of prostate surgery. Lyrica and Prosta-Q did nothing for me either......

Overall, IMO, a good doctor, just does not agree with the surgery part of things, yet this seems to be showing the best results so far.

None of this is personal. Since the purpose of this forum is to elevate knowledge, the emphasis is on
data, from the simplest comment ("Lyrica and Prosta-Q did nothing for me") to the sort of randomized trial as
shown here. As to various proposed treatments: Where are the data? With surgery, we have at this stage the video reports of three men who had it. They are men with some of the
most severe forms of chronic, treatment-resistant prostatitis. We also have a few more text reports, including a few in this forum. Case reports are incomplete knowledge. For this reason, there is an ongoing clinical trial, to elevate the knowledge to a more firm standing, looking at some of the worst cases of chronic, treatment-resistant prostatitis. The trial results are not yet available. So how can anybody dismiss surgery when these patients' lives are essentially ruined by their illness, when there are no data to show that surgery makes them worse, and when available cases show the results shown in the reports cited above? Nobody should suggest surgery for all patients. Nobody should be doing surgery outside clinical trials reviewed by IRBs and designed to advance our knowledge. And nobody should be doing surgery for other than some of the worst cases of the disease: Severe, treatment-resistant chronic prostatitis. Applying this logic to other proposed treatments for men with severe, treatment-resistant chronic prostatitis: Where are the data? What do we do for men who fail?

Guess 'resume' was a bad idea, sorry.
I guess the point I was trying to make is that it shows where the things with prostatitis stand: Here is a good Doc with great reviews, 30+ years of experience, sitting on every possible and impossible 'prostatitis' board and committee, directing tens of 'prostatitis' trials, having his name under hundreds of 'prostatitis' publications. What's he got up his sleeve? Lyrica and Prosta-Q. And Detrol. And it's not because he is mean or not willing to help. He just does not know any better. Same as everyone else in medical and patient community.
So I am for the surgery trial! I wish it had been already completed. I wish it had 10000 patients and 99% success rate. I wish prostatectomy for CPPS was FDA approved and my insurance did not mind paying for it. I wish... I did not have prostatitis in the first place. Meanwhile I come here often hoping to find another report, good or bad. And when I do, I read it... more then once... So I admire people who make their experience available to the rest of us and who are not so quick to call ideas 'crazy', but take their time to explore them instead.

No harm done. But given that one of our objectives is to draw patients and doctors out of their respective and often fragmented corners, it just seemed useful to take down what might be perceived as a "red flag." If someone thinks a treatment is crazy, he's invited to join us and make his case.

I've heard from colleagues that LRP is crazy but they don't have data to support this and they have not joined us here to review relevant options and data.

Incidentally, the day Radford was referred to me by a colleague I thought the idea was crazy. The trouble was that Radford the man didn't seem crazy and the LRP worked completely, immediately, and durably (he's now 3 years out and absolutely pain free, reporting great erections, great urination, happy a pig in ... um ... a corn field). So the beauty of observation is that it can cause us to change our opinions. Sometimes the earth is really not flat, you know.

Yes, he does seem like a good guy. His problem, like that of all doctors, is that the state of the art simply does not permit a scientific basis for effective action. It is an argument for greater knowledge, which means research: The hard-won acquisition of data. Your post makes a superb case for research.

Nothing I know has a 99% success rate: Not antibiotics, not chemotherapy, not radiation, and not surgery. But moving higher than the current 0% now available to men with severe, treatment-resistant, chronic prostatitis, even 90% would seem like a huge step up.

PS: The FDA is not relevant here in that there are no new drugs or devices being tested. And as for insurance companies, they always mind paying. Which introduces an interesting point: Pay for a remedy that works or pay for 20 years of consultations, tests, and medications. It's an argument I once effectively made on behalf of a patient.Yes, there actually is an economic argument to health.

Maybe Arnon. I have asked her to think about anything she wants to say so we will see. She is getting quite big now with the twins..!!