Prostatitis going on 2 months. My story, your advice.

[cam3roni]

For future reference and if anyone is interested in what raw TRUS results look like:

Technique: The patient was placed in a left lateral decubitus (lying down) position in preparation for the prostate ultrasound which was carried out using an endorectal (inside rectum) technique with ultrasound guidance.
Prostate Height 2.29 cm
Prostate Width 4.29 cm
Prostate Length 3.27 cm
Median Lobe: Absent
Prostate Volume: 16.70 cm³
Right Lateral Base: using US guidance; US is isoechoic^*; DRE Normal in this area.
Right Medial Base: using US guidance; US is isoechoic; DRE Normal in this area.
Right Lateral Mid: using US guidance; US is isoechoic; DRE Normal in this area.
Right Medial Mid: using US guidance; US is isoechoic; DRE Normal in this area.
Right Lateral Apex: using US guidance; US is isoechoic; DRE Normal in this area.
Right Medial Apex: using US guidance; US is isoechoic; DRE Normal in this area.
Left Lateral Base: using US guidance; US is isoechoic; DRE Normal in this area.
Left Medial Base: using US guidance; US is isoechoic; DRE Normal in this area.
Left Lateral Mid: using US guidance; US is isoechoic; DRE Normal in this area.
Left Medial Mid: using US guidance; US is isoechoic; DRE Normal in this area.
Left Lateral Apex: using US guidance; US is isoechoic; DRE Normal in this area.
Left Medial Apex: using US guidance; US is isoechoic; DRE Normal in this area.

* - returning waves of normal amplitude in ultrasonography.

[cam3roni]

https://sti.bmj.com/content/sextrans/42/2/134.full.pdf

I wanted to post this article as i suffer from constant nocturnal erections. I know choguy has that issue as well. Its an old but interesting case study linking CP to priapism.

[webslave]

The key quote from that very old study is this one:

Frequently repeated erections of fairly long duration, but lacking the persistence of true priapism, which are described as chronic intermittent priapism, usually occur at night (Douthwaite, 1960). This condition is not due to mechanical causes but to neural irritation arising from lesions of the central nervous system or from reflex irritation from local lesions of regions with the same segmental supply as the corpora cavernosa, i. e. the posterior urethra, prostate gland, or seminal vesicles.

The "reflex irritation" is a result of inflammation, which is called "lesions" in this old text. I told you the same thing when I talked about Spanish Fly here: viewtopic.php?p=53852#p53852

True priapism is not under discussion with any CPPS patient I have ever heard of.

[ChgoGuy]

cam3roni - after a month of nearly no nocturnal erections, they've returned. Interestingly during that month, I felt like I was in somewhat of a remission of sorts. Soon as the erections returned, I've been in somewhat of a flareup. The doctors still have been of no help. I do know there is a Urologist out of Rush Hospital that has treated priapism with an antifungal of all things. I may go see him in the New Year to see what he thinks.

[cam3roni]

Interesting, I'm guessing the flare up led to the return of the nocturnal erections, as opposed to vice versa. Treating with antifungal? I wonder what the reasoning is. Keep me updated.

[ChgoGuy]

cam3roni - I often wonder if the erections are causing the flareup in my case. The erections can get painful. So is the pain from the erections all night causing referred pain, or are the problems the other way around like you are thinking? I guess only a urologist could give me that answer, or so I would think. So far the Urologists have been of zero help though. I forgot to mention that some doctors will treat it also using a combo of Ketoconazole and Prednisone.
https://pubmed.ncbi.nlm.nih.gov/19683289

[webslave]

Careful with terminology here - getting a lot of nocturnal erections is not priapism. Priapism is quite rare (occurs in about 1 in 20,000 to 1 in 100,000 males per year). A episode of priapism is when the erection lasts for hours and hours (4-6 hours in fact) without detumescence.

Wikipedia has a good page on priapism
https://en.wikipedia.org/wiki/Priapism

[cam3roni]

Yep youre right about that. I just wish there was another name besides nocturnal erections because that term implies a normal bodily function, whereas what i experience is not normal, at least not compared to my life before all this.

[ChgoGuy]

Speaking only for myself, here are the facts as they apply to me. When I saw a Urologist at the beginning of my full blown CPPS symptoms over 3 years ago, I was asked about having ED, my response was yes. I was on HBP meds for at least 15 years which caused moderate ED for me. On day 1 of my CPPS journey, I was placed on Flomax. Shortly after starting it, I started getting these erections on and off all night. I would wake up with one, and the only way to make it go away, was to urinate. I would doze off, and it soon would return. The only reason I don't have an erection lasting 4 hours, is because I don't really sleep. I am up every 30-60min if I do doze off. So it's impossible, at least for now, that it could last longer. However, what would happen if I slept like a normal person and went 4 - 6 or 8 hours without waking up? Would I have an erection every night lasting over 4 hours? Idk, but maybe the only good thing to come out of my sleepless nights, is that I have been able to prevent that from happening thus far. Can I prove if I were asleep all night that it would happen? About as much as I can prove it wouldn't happen.

All I know is this. In my case, is it Priapism or just nocturnal erections? Well why didn't I have these nocturnal erections before CPPS and before taking Flomax? We know that Flomax causes unresolved priapism, that is a fact regardless how rare it is. I went from having ED to painful erections almost every night for the past 3 years. It hurts, it has an effect on my flareups, and call it whatever anybody wants. I can tell you this. It's not normal for me, and after 3 years, not one f__king doctor has chosen to take it serious enough to want to investigate the cause. Maybe I'll get an explanation once my erections stop happening and I have permanent ED from whatever the f__k it is! Nobody is going to convince me that this is normal. I went from being a dud to a stud no thanks to being diagnosed with Chronic Non Bacterial Prostatitis and taking Flomax. That's all it took I guess. Even though I no longer take the stuff, I'm still pitching some painful tents every night.

[webslave]

Why not try Terbutaline?
https://pubmed.ncbi.nlm.nih.gov/14999218
https://en.wikipedia.org/wiki/Terbutaline

[ChgoGuy]

This is the first I have heard of Terbutaline. I will read up a bit more on it Webslave. I feel I am always fighting an upward battle with these doctors, especially if the suggestion comes from me. Thanks for the info.

[cam3roni]

Luckily, since the erections do go away upon waking/ urinating.. I don't think we have to worry about permanent damage. As I understand it, damage occurs when the erection won't go away no matter what due to a blockage of bloodflow. Since there is no bloodflow occurring, there is no fresh oxygen being delivered to the tissue, which results in permanent damage. The fact that our erections can go away, signifies that there is not restrictive bloodflow occurring.

[ChgoGuy]

Luckily, since the erections do go away upon waking/ urinating.. I don't think we have to worry about permanent damage.

True, but like I said earlier. Speaking only for myself. What if I had CPPS, but didn't have frequent urination at night, but had the erections? What would happen if I slept 6 or even 8 hours straight a night? Over 3 years, and sleeping thru over 4 hours a night with erections, couldn't the damage slowly occur over time? Think about this cam3roni, am I willing to risk permanent ED, because a doctor doesn't have an answer one way or the other for me? That's where I am at with this. I have had doctors tell me when it happens, go to the ER. Am I supposed to go there every night? There are some nights where I initially may fall asleep for about 4 hours. I have no idea how long I was sleeping with an erection. Of course I am just semi dozed the rest of the night and up and down. But I can tell you this. The erection can go away, and return 10 min later before I doze back off. So you can see why it's somewhat a concern for me. I am in no way freaking out about it. I am more pissed that doctors actually think like it's a blessing that it's happening, regardless how painful it is and how much of an effect it has on flareups for me.

[webslave]

I have no idea how long I was sleeping with an erection.

Easy to find out. Get/hire a RigiScan device.

[ChgoGuy]

Easy to find out. Get/hire a RigiScan device.

It's always a learning experience with you Webslave. I honestly have never heard of such a device before. I would have never have thought such a device existed. Perhaps I will have to ask the Urologist about that one when I return to see him after the New Year.