Do I have Prostatitis??? Very Confused Please Help!!

[Jimmy7223]

Hi Everybody,

Hopefully with the experience on this forum someone can shed some light on my condition.

Here is my story... 3 months ago, after sitting of 5 hours on a plane and then another 5 hours in a business meeting, I had a bowel movement which caused an anal fissure, which was accompanied by the constant urge to urinate, the feeling like I could not completely empty my bladder, dribbling sensation, and being unable to urinate, even though I had the urge (because my bladder was actually empty). While I knew something was wrong with my anus, it was the urinary issues that really startled me. I had NO General pain, other than in my anus, and No pain with ejaculation. These symptoms did not go away so I went to my Doctor and told him about the urinary symptoms. He did a DRE, told me that I had NO PROSTATE INFLAMMATION, no bacteria from the urinalysis, and gave me a 7 day course of Levaquin and sent me on my way. After 7 days, still had the symptoms.

Went to a Urologist who barely looked at me, did NO prostate exam, just listened to the urinary symptoms and gave me a 30 day course of bactrim. Could not have cared less. Very unprofessional. Still no relief from the symptoms. Started realizing that most of this pain and discomfort was related to my anus.

At this point I still had not addressed the fissure, and after doing some research which indicated that these urinary symptoms could be a associated with the fissure, I went to a proctologist who diagnosed me with a fissure and gave me nifedipine ointment. Also he checked my prostate and confirmed that there was NO INFLAMMATION.

After 6 weeks of using Nifedipine My fissure has visibly cleared and with it, my urinary symptoms have gradually subsided. While I am not totally out of the woods with the fissure (still have some ongoing discomfort which feels like a bruise) I still have discomfort within my scrotum in my urethra though and in my perineum area... but that is mostly when I sit for an extended period of time. There is still a bit of an ache, but it is night and day from when this nightmare started.

So, Do I or did I have prostatitis??? I had no prostate inflammation so the "itis" diagnosis seems ridiculous. The CPPS diagnosis would seem the most reasonable if anything. Are there any tests I can recommend that my doctor have run on me other than the standard urine sample. I still have this slight burning within the urethra deep in the scrotum which I can pin point which gets more uncomfortable when I urinate. Could that just be referred pain/discomfort from the anus?

I am just concerned that maybe there is something else wrong that is being ignored because Doctors really don't seem to have much concern about this.

Thank you!

[Burner2k]

Sorry to read that you are having these issues. I am not an expert and I am not saying you have CPPS...so take it FWIW.

One possibility is that your anal fissure caused some kind of a trauma in the pelvic floor muscles and your muscles became tight in reflex to the trauma leading to formation of trigger points and hence these urinary/burning symptoms. Burning might be due to nerve cross talk. The tight muscles press on the surrounding nerves and they react by producing a range of symptoms...from tingling to burning to pain. Just do a little bit of research on this forum and you'll get acquainted with these terms.

As far as your doc is concerned, if he/she is an urologist and if he/she is aware of IC/CPPS, ask him/her to do a internal pelvic floor examination. If the outcome is that you have tight pelvic floor muscles, then they might recommend pelvic floor physical therapy. It is also possible that your doc might suggest some medication along with PT.

Or you can find a Pelvic floor PT near your area and talk to them about performing an initial examination. They will be able to guide you better on further course of treatment based on the outcome.

CPPS is more of a functional disorder. I don't think conventional tests which are designed to look for pathogens, work on detecting functional disorders.

Just remember to not let this condition affect you psychologically. You will get better with time with appropriate treatment.

[SoothingSpaces]

So sex was not a factor in this at all? Were you checked for STDs? Why the antibiotic?

[webslave]

... was accompanied by the constant urge to urinate, the feeling like I could not completely empty my bladder, dribbling sensation, and being unable to urinate, even though I had the urge (because my bladder was actually empty)....

Irritation to nerves of the pelvis from fissure.

So, Do I or did I have prostatitis???

No. The discomfort should continue to fade.

[Jimmy7223]

Sex was not a factor. There is no pain or discomfort with sex. The urologist met with me for 5 minutes, did no dre, just went through the urinary symptoms and threw out the prostatitis diagnosis like it was nothing. Gave me antibiotics, which actually made things worse for the fissure because it irritated my stomach.

I asked why antibiotics if there is no bacteria from tests. Also, had he done a dre, which was only performed by my proctologist, he would've realized that my prostate wasn't even inflamed. So attempting to treat this by targeting mysterious deep rooted bacteria in the prostate causing it to be inflamed was just ridiculous.

The urologist was just trying to get rid of me as soon as possible...no thinking, no looking into things deeper, no creativity. Very unprofessional.

Webslave I appreciate your response. I feel like getting a proper diagnosis is very tricky with this illness and the professionals don't seem willing to or capable of doing it.

[Jimmy7223]

I just want to add...I never had any actual pain or burning while urinating. It was only the feeling of urgency.

[webslave]

Post the name of the uro. Nice to know who to avoid.

[Jimmy7223]

Hi All,

So, I have been taking Bactrim for 11 days of a 21 day prescription and so far my symptoms have substantially improved, starting after day 7. For almost 5 months I have had a pretty much constant feeling of needing to urinate, discomfort after urination and these symptoms were always amplified after a bowel movement. Also, I have had a pretty consistent discomfort in my rectum.

My question is, if I am seeing this much improvement after 11 days, is my prostatitis bacterial? I was given a urinalysis and it came back clean. But, will a urinalysis detect bacteria in the prostate without a prostate massage? If this is not bacterial, then why would I feel any relief with Bactrim?

Thank you for your responses.

[webslave]

Too easy

https://ucpps.men/antib ... ry-agents/

[Jimmy7223]

Webslave, I understand that you may have your own agenda here, and I can appreciate that. However, this forum is represented as a site to help people discuss their issues as well as strategies that have worked for them. I understand that there are people that suffer from chronic pelvic pain that really has nothing to do with the prostate. But, I feel it is irresponsible for you to completely disregard any claims that antibiotics could help with this illness, or, that none of these illnesses are bacterial.

Many studies have been done to show that a standard urine culture is not sufficient to diagnose bacterial prostatitis. Many urologists will not take the proper steps to obtain an adequate sample to test for bacteria, and even when they do, not all bacteria can be found that way. So, advising people to avoid antibiotics simply because their urine culture came back negative is irresponsible.

prostatitis.org/urineculture.html

If your forum is a site dedicated to the promotion of the Wise Anderson protocol and pros-q supplements then that needs to be more clearly stated, not buried within your FAQ.

[MajorSky1]

It's not bacterial. Men with bacterial prostatitis develop a fever. Bacteria don't just hide in tissue, they multiply and attack the tissue and cause other nasty symptoms.

Also, most tests DO show if there are bacteria. In fact sometimes they show too well via contamination during testing and produce a false positive. Chances of cultures and antibody tests are extremely accurate.

Did you read the link Webslave posted? Antibiotics are known to have anti inflammatory properties. However, it doesn't last, unfortunately. Staying on antibiotics too long can cause some bad problems too. I strongly disagree with your statement that advising people to avoid antibiotics because their culture was negative is irresponsible. Too many doctors are the ones who are irresponsible by shelling out strong antibiotics like they were candy. Needlessly taking antibiotics can not only harm you, but it also helps to make other bacteria resistant for us all.

If it is bacterial in your case, despite a negative culture, then you are probably on your way to recovery. If not, then the problems will return. Hopefully they won't though.

[webslave]

Jimmy, you are linking to garbage information at a garbage site. If you want to know more about the fools at prostatitis.org, read this viewtopic.php?f=37&p=56342#p56342

In addition, what Majorsky said is correct.

[Jimmy7223]

No MajorSky that is not correct. People with chronic bacterial prostatitis rarely develop a fever. I posted a study below which states that a urine culture alone was not adequate to diagnose bacterial prostatitis. It seems that the problem could be that people may have a negative urine culture from their pcp or urologist and because of that they refuse the antibiotics or don't take them long enough the problem persists. Then they find a site like this and get sucked into all the propaganda.

It seems like this Wise-Anderson protocol along with this site are taking advantage of desperate people looking for answers to a complicated problem ...starting with the $20 charge to get onto this forum. Anyone who has anything to say not related to the headache in the pelvis is wrong. It should be clearly stated so, ethereal that this is a biased forum with an agenda.

http://pubmed.ncbi.nlm.nih.gov/18341719

[webslave]

You've just earned yourself a suspension of posting privileges for a month. Looks like you neglected to read the warning
viewtopic.php?f=36&t=1642

The obscure Brazilian study you reference (full text) is flawed and has been misinterpreted by you

I'll expand more when I have time...

[Caedar]

http://pubmed.ncbi.nlm.nih.gov/18341719

Read the editorial comments:

This interesting study follows the traditional viewpoint that bacteria found in semen have clinical relevance in the generation of symptoms in men. The well conducted study from the NIH collaborative group showed that both symptomatic and asymptomatic men had similar bacterial counts in their semen, suggesting that these bacterial commensuals have nothing to do with the generation of symptoms seen in these men. This study basically attempts to reproduce the traditional belief, but adds the wrinkle of comparing the Meares and Stamey test with their own modifications.
Although the study is of interest, one weakness should be mentioned: i.e. the semen bacteria may have nothing to do with the disease process.

Only a small percentage of all prostatitis cases involve proven bacterial infection. Prostatitis is a much wider diagnostic and therapeutic problem. The classification of National Institutes of Health (NIH) divides prostatitis into four categories. The differentiation between the categories is based on the presence or absence of bacteria, leukocytes, and clinical symptoms. Category I (acute bacterial prostatitis) and Category II (chronic/recurrent bacterial prostatitis) have infectious etiologies. Category III refers to chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS). The differentiation between IIIa and IIIb is based on the finding of inflammatory cells in EPS or voided specimen 3. Category IV refers to asymptomatic inflammatory prostatitis that is diagnosed incidentally during evaluation of the patient for other purposes.
Recent studies have presented problems with this classification system (1,2). Prostate biopsies from patients with non-inflammatory CPPS (category IIIb) display a low-grade inflammation with diffuse distribution of lymphocytes into the stroma and periglandular space. Inflammation appears to be common in both forms of category III. The traditional marker of inflammation, leukocytes in the prostatic fluid, does not correlate with the predominant symptom of pelvic pain. Schaeffer et al. (3) assessed the relationship between leukocytes and bacteria and symptom severity in men with CP/CPPS. They observed no association between inflammation in any of the specimen sites and symptoms. Further, no association between bacterial colonization and symptoms were observed. Tsuboi et al. (4) found no correlation between the aggressiveness and extent of inflammation and leukocyte count in prostatic fluid. Neither a correlation was found between the number of leukocytes in EPS and the histopathology of the prostate. The study by True et al. (5) examined correlations between the symptoms and histology of prostatitis and suggested that histologic inflammation may not be a significant factor in the process of CP/CPPS. This findings extended by the large scale REDUCE trial data which suggest that presence of chronic prostatitis-like symptoms did not provide any discriminative value for a histologic diagnosis of either acute or chronic inflammation (6). One has to conclude that leukocytes and bacteria in the prostatic fluid do not distinguish between symptomatic and asymptomatic individuals. Moreover, the lack of or weak correlation between inflammation and infection with severity of symptoms implies that factors other than inflammation and infection contribute to symptoms associated with CP/CPPS (3).