Prostate Cyst Removal/Decompression

[Blaze87]

I had a 2.5cm cyst located in my prostate (technically called a mullerian duct cyst) and after a few years of chronic prostatitis flare ups I was convinced that was the root of all my pain and discomfort. My pain was burning in the rectum with occasionally the "golfball" in the rectum sensation and urinary hesitancy/frequency at night. After finding a few medical studies that showed an amazing success rate by transurethrally decompressing the cyst I had the procedure done (via a laser). It leaves a tiny 1-2mm hole to let the cyst drain (shouldn't be an issue if guys go through TURPs and feel better, right?)

Unfortunately this only brought on more pain in addition to really odd sensations at the base of my penis and pelvic floor. Never burning during urination, but lots of rectal burning after. For the past year I've had rectal burning every day compared to a flare-up period of a few months. The head of my penis feels very rough as well... erections feel like I am stretching my urethra. MRIs and ultrasounds show no complications from surgery. I've attended the Wise clinic, but I'm only one month in so I don't have much improvement (yet) if it originally was the case.

If you do have a prostate cyst, do not get surgery unless it is HUGE or directly affects fertility.

[webslave]

Your case looks very much like up-regulation of the nerve response in the area.

You'll need to concentrate on calming these nerves. Short of recommending Botox, which I am not sure about at this point, I'd say paradoxical relaxation, relaxation CDs, meditation, benzos etc is the way to go.

[Blaze87]

Benzos help take the edge off the pain, but the weird uncomfortable sensations and burning are ever present. What bothers me is I find out after the procedure that the typical method is aspiration via a needle, not by punching a permanent hole in the prostate. I'm never seeing that doctor again. I'm seeing a top NYC doctor to at least confirm the surgery wasn't botched and I can focus on the Protocol's methods for relief without a doubt in my mind.

I've been doing paradoxical relaxation, but so far nothing. I usually just either lie in boredom, get impatient, or fall asleep. I still keep it up, however.

[robertpagen]

I wonder what happened with this case. A routine prostatic ultrasound today showed that I have a cyst in my prostate as well as calcifications. The doctor suggested that it is best to do nothing. He says it is common. He said to strictly avoid alcohol for the rest of my life.

WS. Even I know much about all aspects of the prostate and urinary system but I don't know the importance of either a cyst or the calcifications. Are they relevant to chronic irritation? Does aspiration safely remove a cyst from the prostate? What is aspiration?

This is the first time I have had a prostatic ultrasound. Why don't urologists offer these in the USA? This test was in Beijing using a SIEMENS 2000. Beautiful piece of equipment.

What causes a cyst?

Web Slave. I would appreciate your perspective.

Be well,

Robert

[webslave]

Calcifications are unremarkable and should be ignored unless very large or obstructive.

Aspiration is the insertion of a fine needle and the sucking out of fluid.

What sort of cyst is it? How large? About 5-10% of asymptomatic men have midline prostatic cysts, so it may have no significance, and if small not worth draining.

The comment on alcohol makes no sense.

[robertpagen]

1. Is there any evidence that either calcifications or a cyst can contribute to irritation symptoms? Even if it does not obstruct it might just irritate. Then the muscles guard against the irritation and over time there is PFD.
2. Once calcifications are there I imagine they are there to stay, is that true? The calcifications are all close to the urethra.
3. What do you think of this prostatic ultrasound test? Is it not widely used? Years of going to Uros and I have never had one before.

He simply described it as a cyst. He said it may be the result of an old infection which is now long gone or born with it. I don't know anything about cysts. He said it is of no importance.

I respect this doctor and his care he has shown over the years. He says that he believes that alcohol always irritates the urinary tract. I do recall you posted something similar about alcohol a while back. That it is a solvent. He recommends that any man with any urinary issues give up alcohol. That is a reasonable suggestion to me. I intend to be a teetotaller for this entire year of 2014. I will advise everyone of the results.

[webslave]

1. Unless the stone or cyst is large or obstructive, no evidence.
2. They can be dissolved with EDTA; not worth it IMO. Calcifications elsewhere in the body can resolve spontaneously, so perhaps this is true of the prostate as well, not sure.
3. New fangled, whizz bang tech. You can already get most of that data from a TRUS. Imaging is of very limited to no use in CPPS.
4. I queried the alcohol comment because you seemed to link it to cysts/stones. Yes, avoiding it is best, but it has nothing to do with cysts or stones

.

[robertpagen]

WS,
Do the terms abscess and cyst describe the same condition?

[webslave]

No, definitely not! An abscess is an infected, pus-filled cavity. Prostatic abscess mainly affects diabetic and immunosuppressed patients, and most commonly found in the elderly.

From the sound of it, and until you get further clarification, you may have a Retention Cyst

Retention cysts of the prostate gland result from obstruction of prostatic glandular ductules causing dilatation of the glandular acini. They are true acquired cysts that contain clear or occasionally viscid fluid on aspiration; they never contain spermatozoa. They usually do not cause symptoms but may rarely cause obstructive symptoms if located close to the bladder neck. The sonognaphic features of prostatic retention cysts are those of a smooth-walled, uniloculan cyst, usually measuring 1-2 cm in diameter or less. They typically occur away from the midline and may be located within any of the three glandular zones of the prostate . Retention cysts usually occur in the 5th and 6th decades of life and if located in the transitional zone may be indistinguishable from the cystic changes of benign prostatic hyperplasia. The distinction is not important, since both conditions are rarely associated with symptoms.

Prostatic Abscess Most prostatic abscesses are complications of acute bacterial prostatitis. Coliform organisms, most commonly E coli, are the infectious agent in most cases. Most patients with prostatic abscesses are in the 5th and 6th decades of life. Patients with diabetes are especially prone to develop prostatic abscesses. The patient usually has the typical signs and symptoms of prostatitis, which may include fever, chills, urinary frequency and urgency, perineal and low-back pain, difficulty in voiding, dysuria, and hematuria. The prostate gland is enlarged, often focally, and is tender at digital rectal examination. Any cystic lesion of the prostate gland in a patient with the appropriate clinical findings must be viewed with suspicion as a possible abscess. Abscesses may involve any portion of the prostate gland. These lesions appear as focal, hypoechoic or anechoic masses that may have thickened on irregular walls, septations, or internal echoes. Abscesses usually occur away from the midline. The diagnosis can be confirmed by means of aspiration performed under US guidance.

http://pubs.rsna.org/doi/pdf/10.1148/ra ... .4.1696019

[robertpagen]

I appreciate the clarity of the distinction and I am again impressed with the depth of your knowledge and your capable research. My cyst is described as less than .5 cm or 5mm.

It's presence makes me suspect some long past anamoly like an infection. Meaning one that is no longer there. Is that reasonable? I mean really long ago like when I was a kid as I grew up in a rather filthy environment. My symptoms predates my sexual activity.

I am a firm believer in the dysfunctional muscle template, but I believe that there is often an earlier initiating cause.

[robertpagen]

The report notes that no blood flow is seen in the cyst. Why is that important?

[webslave]

No blood flow = no cancer. It's a small cyst, almost certainly has nothing to do with your CPPS.

[Blaze87]

I know this is a late reply, but cysts that are less than ~2cm may not be worth decompressing and just may be a coincidental finding. It depends if it extends into and compresses your urinary tract. In most cases, don't get surgery.

I'm still dealing with pain from the surgery. Sitting is usually painful, especially when leaning forward. It feels like someone is jabbing their thumb on the bottom of my prostate. It also still feels like urine gets trapped in the tunnel they made to get to the cyst (5mm deep from the urethra) and makes my perineum uncomfortable and even painful (I will rub my perineum and then I will have an intense burning sensation at the base of my penis.)

Interesting you mention that an abcesses, my "cyst" was filled with pus, but my doctor still referred to it as a cyst.

Doctors still insist the surgery should not be causing pain. I've just been dealing with it, but it is depressing living every day in pain.