BCG for male CPPS

[jd]

Any thoughts of BCG for male patients with CPPS....in relation to the NIH funded BCG studies going on at 10 centers across the US now?

I know they are studying this for IC.....but aren't doctors starting to believe that CP/CPPS in is a variant(not sure if this is the right word) of IC?

In relation to that, I'm always wondering how many guys on this board have actually had a cystoscopy and bladder hydrodistention. In my case, my uro. told me I have "classic Prostatitis symtoms," and I had the cyst. and hydro. and it turned out I have IC.

I have read that BCG is one of the most promising future therapies for IC, I guess people who benefitted from it had a long term reduction of pain and IC symptoms from a well executed (but small) study.

Thoughts on all of this?

[Richard.N]

I had a BCG jab at school 20 years ago when I was 11, and I sometimes wonder (since I have calcification in my prostate - sometimes associated with TB scarring) whether it wasn't this that set the ball rolling...

[webslave]

In relation to that, I'm always wondering how many guys on this board have actually had a cystoscopy and bladder hydrodistention.

I've had cystoscopy, but not hydrodistension. I don't think many men get hydrodistension.

In my case, my uro. told me I have "classic Prostatitis symtoms," and I had the cyst. and hydro. and it turned out I have IC.

IC may be the same/virtually the same as CPPS. The treatments don't differ all that much currently, and I expect the treatments to be identical eventually.

I have read that BCG is one of the most promising future therapies for IC, I guess people who benefitted from it had a long term reduction of pain and IC symptoms from a well executed (but small) study.

Unfortunately, BCG therapy is associated with a high incidence of granulomatous prostatitis (there are a bunch of papaers describing this). Granulomatous prostatitis is a kind of allergic reaction. One of the earliest papers describes it well:

Clin Exp Immunol 1976 Oct;26(1):137-47

Experimental cellular allergic reactions in normal canine and malignant human prostate.

Robinson MR, Rigby CC, Pugh RC, Vaughan LC, Dumonde DC.

This paper describes the histopathology of chronic tuberculin-type hypersensitivity reactions in the normal canine and malignant human prostate. Seven dogs were sensitized by injection of Freund's complete adjuvant and the histological response to the subsequent intra-prostatic injection of 6 mg tuberculin PPD was documented. A chronic mononuclear cell prostatitis persisted for 4 weeks and was accompanied by paracortical distension and follicular hyperplasia in regional lymph nodes. Six patients with carcinoma of the prostate were given multiple intraprostatic injections of BCG, which induced a chronic mononuclear cell prostatitis with some evidence of tumour-cell necrosis. The study indicated that the prostate can support chronic cell-mediated allergic reactions to extrinsic antigens and that intra-prostatic injections of BCG can be administered without harmful effects to patients with malignant prostatic disease

[dshoskes]

I had a BCG jab at school 20 years ago when I was 11, and I sometimes wonder (since I have calcification in my prostate - sometimes associated with TB scarring) whether it wasn't this that set the ball rolling...

He was referring to BCG instilled into the bladder. The problem with using it for chronic prostatitis / chronic pelvic pain syndrome IF the disease is in the prostate is that penetration into the prostate for the BCG is lousy. When we use BCG for bladder cancer that involves the prostate, we often have to resect the prostatic tissue first to get any penetration.

[Richard.N]

JD - I remember you saying that you were thinking of trying Elmiron. Any luck? Richard.

[jd]

Richard--

I talked with my Uro. and he thought it would be best to just stick with Algonot Plus, since I seem to be getting better with it and have been on it close to 4 1/2 months.