My Problem

[MickVedder]

I am 25 years old and have had symptoms of CP for 1.5 years now. My symtoms are urine stream decreased significantly, hesitancy and urgency after ejaculation. Luckily I have no pain, just slight discomfort. I have seen two urologists about this and they has done several tests. I have had a sensitivity and culture test done, digital rectal exam and my bladder scoped. It was confirmed that I have bacteria in my prostate fluid. He said my bladder looked fine. I have taken all kinds of antibiotics including Cipro and Levoquin as well as Flomax. Nothing helped. I can only basically manage. I can't go out and have beers because I have trouble urinating. I can't drink too much water at work because it takes a while for me to urinate. I can deal with the discomfort but not the feeling of not opening up my urethra all the way for urine to flow easily. This sucks. I have had ultra sounds of my bladder to see if I am emptying and for the most part I am. I just don't like the hesitancy and lack of stream flow. Can anyone please advise or comment on my situation. This sucks so bad. All is comments are welcome. What does my situation sound like to you.

[Michael in Boston]

Does doubling up the Flomax to 0.8 mg day and taking it after a meal (improves peak concentration) helpful?

Have you looked into the muscle tension materials that are increasingly being discussed and shown to be significant?

Do you take imipramine, or Elavil or any other of the tricyclics? these can contribute to hesitancy.

[tractor316]

Did the docs tell you if your prostate was swollen or enlarged or boggy .
Might make a difference on what you should use to treat it. I agree with Michael about reading all the posts on this web site to help you decide how to treat it and how to ask the right questions of your Doc. or Uro.
Sorry you had to start at a young age . It aint fun .

[J Dimitrakov]

You seem to fit the classical "new" definition as outlined in another thread. It is really a pity that so many young men do not fit the current definiton of "CPPS" and are left undiagnosed. On another note, the IC community seemed to be more open about men with classical chronic prostatitis / chronic pelvic pain syndrome symptoms at the recent AUA Meeting in Chicago. We presented our results on a series of men with CPPS/IC where the most prevalent symptoms actually occurred AFTER EJACULATION. I think you can read the abstract somewhere else on this site. From my perspective (and do not take this as medical advice) hesitancy in your case seems to be related to the nerves in the bladder/pelvic area delivering the right signal (hence the lack of energetic contraction manifesting as "hesitancy") - a condition similar to what is called "atrial fibrillation" in older people and it occurs in the heart. Some antiarrhythmic drugs have shown some promise in treating this kind of bladder "dysrhythmia"

[MickVedder]

Thanks fellas for the quick responses. I even have been taking Fluvoxamine because my general physician thinks I have OCD. I saw a shrink for 12 weeks because I have anxiety and he taught me some relaxation techniques. I admit that I can not urinate if anyone is near me. I am extremely bladder shy. I can' t even urinate in a stall in the mens restroom until the restroom is empty. I have been like that my whole life and now its worse because of my chronic prostatitis. My Uro did say some of it is in my head. When the Uro scoped me he said my Prostate is inflamed. I guess I can't complain too much since a lot of you guys are in terrible pain when I have just a little discomfort. When I first noticed my problem, I thought I had like kidney disease, bladder cancer and I was just thinking the worse. I never heard of prostatitis before this. I only knew of prostate cancer and enlargement. Then I went to WebMD to look of CP and it said if antibiotics dont work then surgery is an option. I became really worried about that. Then I found this site and feel way more comfortable about it. After I ejaculate it seems like my pelvic region gets spasms. I never had back pain due to this, never had blood in my urine except for a few hours after my Uro scoped my bladder, no pain during digital rectal, no pain sitting. Also, it seems when I drink a lot of liquids, my bladder muscles or something in that region gets so tense that it seems like it don't want to release. Currently I have a cold and am taking antibiotics, nasal spray an decongetant but before that I was only taking the fluvoxomine that I mentioned above. I took the antibiotics that I mentioned in my first post off and on for about a years for periods of 2 months or so and was on Flomax for 5 - 6 months with no results whatsoever. Anymore suggestions on open up my urine stream will be so much appreciated. I can deal with the discomfort but that is whats probably causing my problem. Thanks guys.....

[J Dimitrakov]

Fluvoxamine can actually cause bladder spasms and instability.

[tractor316]

Yes all the scenarios you mentioned went thru my mind . And to my horror my Doctor who is 49 developed prostate cancer while he was treating me . Then I was really worried . He had to get most of his prostate removed . I thought I was on my own for the last 2.5 years . Then I found this web site a few weeks ago . What a relief to see all my symptoms are not in my head and not life threating . I too do not have cp as bad as some of the people on this web site . But when it flares up it is not fun . I learned to control it from surfing web sites . I have been 90% for about 3 mos . Now with the new info I have found on this site I hope to get even better . My new Doc said I may always have some pain but I'm not going to die from it . I can learn to live with that . My prostate is slightly soft and I know after an exam I can't pee for a few days . But it gets stronger after awhile . Stress is a big factor . The knowledge I got from this web site has lowered my stress more than my Docs word . Good luck

[tractor316]

Yes I forgot that my very first bout of cp was after I was off work for 8mths of depression I quit drinking . Had an attack of cp . Took low level anti biotics too clear . But also started trazadone for my depression at the same time . Took traz for abouta year . Learned how to sleep again . Had a cp attack a few mnths later .After I had been off stress meds . Did not even put this together as being related until I read webslaves post . Always can learn something new .Thanks .

[MS]

I even have been taking Fluvoxamine because my general physician thinks I have OCD.

Have you talked to your physician about Buspirone (BuSpar) for anxiety and OCD?

Currently I have a cold and am taking antibiotics, nasal spray and decongestant but before that I was only taking the fluvoxomine that I mentioned above

For your cold: I believe decongestants can exacerbate urinary hesitancy-- perhaps you could switch to a cold medicine that is an antihistamine -- check with your doc about this. (comments--Dr. Dimitrakov? Mark? MastCells?)

My Uro did say some of it is in my head. When the Uro scoped me he said my Prostate is inflamed.

Of course any pain/difficulty urinating is going to "get in your head." Expanding on relaxation techniques may help your symptoms. I understand your hesitancy from personal experience. As silly as it sounds, I found ways of distracting myself while urinating, such as whistling and thinking relaxing thoughts. The hesitancy eventually went away. Also, if your prostate is inflamed, have you taken any anti-inflammatories (Ibuprofen/Anaprox/Vioxx/etc.)?

Take comfort in knowing you are not alone...

[MickVedder]

I am just curious. Since I am in practically no pain, will my problem progress to that stage when I get a lot of pain like the rest of the sufferers here even though I have had CBP for 1.5 years now. My Uro also emphasizes that I need to find a woman and get laid..... I don't know what to do anymore about my problem. Thanks guys...

[MS]

will my problem progress to that stage when I get a lot of pain like the rest of the sufferers here

If you think it will, then it probably will.

If you think it won't, then it probably won't.

Use the information on the Board and on the web for general info. Don't catch "Medical Student's Syndrome":

As medical students learn about new illnesses, they often "develop" the symptoms of the disease they are studying.


Seriously MickVedder, don't worryyourself about it. Count your blessings. Follow your Dr's advice! If your problems get worse, you know where to find us.
MS

[MickVedder]

Thanks MS. I believe that it may be mind over matter. But I have an appointment with my Uro this Friday the 18th and I'll see what he says. I saw him last in January and he put me on a 4 week dosage of Levoquin antibiotics will no results whatsoever. I keep reading that if one has prostatitis they have a possability of developing Diabetes and other ailments on top of the alread CBP. I get nervous about this stuff. I'll keep everyone posted on what my Uro says.

[MastCells]

I've just started Lorazepam for stress. It's great! I definitely need this stuff. I take 1mg a day (at night) and I'm chillin' like a villain.

LOL! No drooling in this nice forum, please. I was wondering which benzo you'd get. 1 mg sounds like the right dose, but I wonder if you'd develop a tolerance to it pretty quickly if you took it every single night? The "only as needed" method has worked well for me, but maybe a different approach would work for you? I dunno.

A little over a year ago I was a real anxious mess, and my GP said, "Look, I always keep a couple of these (Xanax pills) in my pocket in case I need them. They just take the edge off. I think Xanax (alprazolam) might help you, but you should take them only as needed."

When I saw a pdoc, he agreed with my GP that I should continue taking benzos PRN (but we switched to lorazepam) and added Effexor XR (which has worked quite well for me) to the regimen. Sometimes just knowing that I have the benzos if I need them is all it takes to prevent an anxiety attack.

I compare the treatment of my anxiety to the treatment of my asthma. Effexor keeps my anxiety in check, just as Flovent keeps my asthma in check, but when I have an acute anxiety attack, the lorazepam is a lifesaver, just as my rescue inhaler (albuterol) would be a lifesaver if I had an acute asthma attack.

[MastCells]

For your cold: I believe decongestants can exacerbate urinary hesitancy-- perhaps you could switch to a cold medicine that is an antihistamine -- check with your doc about this. (comments--Dr. Dimitrakov? Mark? MastCells?)

Salt water nasal sprays can be useful, and of course, they are prostate/bladder-safe. Decongestants will cause the prostate's smooth muscle to contract, so if he has difficulty voiding now, taking decongestants will likely make matters worse.

As far as antihistamines are concerned, they can worsen voiding problems in some men with prostatitis, because they are anticholinergics that relax the bladder (making complete emptying of the bladder more difficult). The good news is that Allegra doesn't seem to exacerbate my problems much at all. It's the most bladder/prostate-friendly antihistamine I've tried. Thanks to Mark, who brought it to my attention.

[webslave]

MickVedder represents a type of patient we don't cater to at this board: a chronic bacterial prostatitis patient. Mick says he has a culture-verified infection, and he also says in other threads that he has no pain. This is the typical profile of a Chronic Bacterial Prostatitis (CBP) patient - no pain, positive culture, and possible some urgency/frequency.