Any information on intraprostatic injection??

[Federico Guercini MD PhD]

I send you our accepted abstract on the next AUA Annual Meeting in Chicago. The quoted J of Urology paper talk about bacteria; but what about Chlamydia, Micoplasmata, Gonococcus, Yeasts?

DOES ABACTERIAL PROSTATITIS REALLY EXIST?
Federico Guercini*, Rome, Italy; Sandra Mazzoli, Florence, Italy; Elisabetta Costantini, Perugia, Italy; Cinzia Pajoncini, Perugia, Italy; Massimo Porena, Perugia, Italy
Introduction and Objective: In the National Institute of Health Classification, prostatitis syndroms are categorized in clinical practice on the basis of bacteriuria and the number of inflammatory cells in prostatic secretion. According to these indications many patients are considered carriers of abacterial prostatitis and are treated as such. The presence of an agent infecting the prostate cannot however be completely excluded. It could nest in acini or in fibrous-calcifications but still be active and capable of rendering the so-called abacterial prostatitis chronic

Methods: We recruited 56 of last 350 patients referred to our Centre because of prostatitis. The age-range was 18-46 years(average age 32 years). No patients was affected by bacteriuria. In the prostatic secretion all had at least 10 leucocytes per microscopic field according to Stamey's method(1966). Two-four weeks before prostatic secretion sampling, urethral swabs showed no patient was positive for Trichomonas vaginalis, Chlamydia Tracomatis, Micoplasma Hominis, Ureaplasma Urealyticum, HPV and Herpes Genitalis. Using the transperineal route, ultrasound guided needle aspirates were taken from sonographically dishomogenous areas in the prostate. Samples underwent histological analysis, routine cultures and DNA extraction to detect Chlamydia Tracomatis, Neisseria Gonorrhoeae and HPV using PCR amplification.

Results: Histological findings were indicative of inflammation in all 56 patients, with lymphocite aggregates being found rarely within the gland(19%)and mostly in the peri-gland area(46%)and stroma(35%). Cultures were positive for aerobic(56%) and anaerobic(23%)agents Twenty-one patients(38%)presented with more than 2 species of microorganisms and 9(15%)with more than 3. DNA infected with Chlamydia Tracomatis was found in 19(34%)patients. The 9 samples(16%)with only anaerobic bacteria were associated with a high number of leucocytes in Stamey's test(>15).

Conclusions: The accuracy of needle sampling under ultrasound guidance using the transperineal route, excludes false positive results caused by contamination with pathogens in urethra. The high frequency of positivity for microorganisms detected, using these techniques, indicates studies on more patients should be performed, in order to revise the classification of prostatic syndromes and to define them more accurately.

[Ralph]

How do your findings compare to samples taken for a controlled population without prostatitis?

[webslave]

but what about Chlamydia, Micoplasmata, Gonococcus, Yeasts?

PCR does not support a role for these organisms. You need to read the study abstract carefully:
viewtopic.php?t=203

And Dr Schaeffer's editorial opinion in Feb 2003 J Urol:
viewtopic.php?t=206

These new opinions and research confirm for me that the positive effects of your intraprostatic injection treatment are wholly due to the anti-inflammatory and immunomodulatory effects of the steroid and antibiotics.

[dshoskes]

How do your findings compare to samples taken for a controlled population without prostatitis?

I think the Berger paper published this month in J Urol was pretty conclusive on that point: no difference in bacteria found on transperineal biopsy between patients and controls.

[Ralph]

I agree. I think it's a good study done with controls and a significant sample size. I couldn't find much bias in this study. Looked like good science to me. I would like to see it reproduced by another investigator to reinforce the conclusions.

[Ralph]

By the way Dr. Shoskes, I almost accepted a job less than a year ago at the Cleveland Clinic Naples division as an interventional and MRI radiologist. Maybe I should have. I could have gotten some treatment.

[webslave]

Just a comment about Ralph's input - I think it is very useful for men to see that even members of the medical profession suffer this condition. I think knowing this helps to ease the "us and them" feeling you sometimes get in these discussions.

[Ralph]

Thank you for pointing that out. If you live long enough, you'll eventually become a patient afflicted by one disease or another. Even doctors get sick. It certainly has given me a new appreciation for chronically ill patients. There are few things worse than living in chronic pain. I wish I had a magic potion I could give everyone so they could get better, but no one does. I'm sure all the other docs and health care people on this board feel exactly the same way. At least we're all in good company.

[Cornetta]

I have been suffering from prostitus for two years now. I am an otherwise healthy 39 year old white American male. A Doctor FUggazotto in SD has said that he found strep in my urine and now something in my sperm sample. Cipro for a month and augmenten for 5 months have not helped. I am thinking of flying to Rome to have dr. Guercini work on me. Is this a good idea. I can not live like this.

[webslave]

Fugazzotto:
viewtopic.php?t=822

If you are fixed on intraprostatic injection, try Dr Bahn in California. He's closer. Note - I do not recommend this type of treatment.
https://ucpps.men/intraprostatic-injections-of-antibiotics-and-steroids-in-prostatitis

[Cornetta]

Thank you. What treatments do you reccomend? I like FUggazotto but I think he finds Strep in everyone. But please what would you do and what are your qualifications. Thank you in advance.

[webslave]

My recommendations here:
https://ucpps.men/prostatitis-tips-things-that-help-and-hurt

I am not a doctor, just an experienced patient.

[Cornetta]

okay thank you. I am moving along. So you say basicaly it is not curable. Use supplements and comon sens approach. What about the Manila proceedure and that at the Clevland Clinic in South Florida? More reliable then Rome and California? Safer? I am taking Saw Palmeto and just ordered any accredited quercetin product Am also considering Broccali treament. The more info you give the better.

[webslave]

Not curable, but I never think of it. Am I cured? No, because I know it can come back, and I know how to make it come back.

All your other questions are already answered on this forum (use SEARCH function) and on my website. Happy reading!

[james-d]

I can share my perspective on injections.

I find them to be a very useful tool that brought my symptoms under controll 100%.

I do NOT think they are a cure - but a treatment (of last resort) that can help some people. They helped me. My doctor uses Dr. Bahn's protocol.
It is actually a very easy procedure - any Uro could do it if they were so motivated - if you have a local Uro you like - ask them to review Dr. Bahn's web page on prostatitis treatment - they may do it for you - thats what mine did.

It has been a wonderful treatment for me - but not a cure - I am still using many things daily to keep this beast at bay - but I do have my life back - and that was my goal.

Good luck in finding a tretment that works for you - if you have any specific questions of injection (pain, expectations, etc) message me and I will try to answer. There are one or two others on this board that have had them done as well - they are NOT a cure all - but for some people - they do help.

Not curable, but I never think of it. Am I cured? No, because I know it can come back, and I know how to make it come back.

All your other questions are already answered on this forum (use SEARCH function) and on my website. Happy reading!