Bacteria

[Wally]

How can you be sure if you have bacterial related prostatitis?
I have done ordinary semen culture but it did not show any bacteria, but I know for sure that my prostatitis symptoms started by a true infection. Can there be bacteria lurking inside my prostate hiding away for antibiotics?
a lot of docotrs are claiming that bacterial prostatitis cannot be treatded by orally antibiotic. That injections and systemic treatment is requiered. Is that true?
If you do have bacterial infection can this one be cured? According to many doctors it is very difficult or impossible if the bacteria have been growing inside the prostate for a while.
What is the most reliable test for determing if bacteria is present?
Along with my impotence and frequency I also have noticed change in semen consistency, it is almost like glue. What can be done to improve the semen quality? I also feel very cold in my body I usually have terrible cold feeling in my feet and hands. Sounds like infection doesn`t it?

Wally

[webslave]

Wally, please read the main site. Your questions are all answered there.

[J Dimitrakov]

How can you be sure if you have bacterial related prostatitis?

The answer from the most brilliant minds in the field:

J Urol 2002 Sep;168(3):1048-53

Leukocyte and bacterial counts do not correlate with severity of symptoms in men with chronic prostatitis: the National Institutes of Health Chronic Prostatitis Cohort Study.

Schaeffer AJ, Knauss JS, Landis JR, Propert KJ, Alexander RB, Litwin MS, Nickel JC, O'Leary MP, Nadler RB, Pontari MA, Shoskes DA, Zeitlin SI, Fowler JE Jr, Mazurick CA, Kusek JW, Nyberg LM; The Chronic Prostatitis Collaborative Research Network Study Group.

Department of Urology, Northwestern University, Chicago, IL 60611, USA.

PURPOSE: We examine whether leukocytes and bacteria correlate with symptom severity in men with chronic prostatitis/chronic pelvic pain syndrome.
MATERIALS AND METHODS: All 488 men screened into the National Institutes of Health Chronic Prostatitis Cohort Study before close of recruitment on August 22, 2001 were selected for analysis. The National Institutes of Health Chronic Prostatitis Symptom Index, including subscores, were used to measure symptoms. Urethral inflammation was defined as white blood cell (WBC) counts of 1 or more (1+) in
the first voided urine. Participants were classified as category IIIa based on WBC counts of 5 or more, or 10 or more (5+, 10+) in the expressed prostatic secretion, or 1+ or 5+ either in the post-expressed prostatic secretion urine (voided urine 3) or semen. Uropathogens were classified as localizing if the designated bacterial species were absent in voided urine 1 and voided urine 2 but present in expressed prostatic secretion, voided urine 3 or semen, or present in expressed prostatic secretion, voided urine 3 or semen at 2 log concentrations higher than at voided urine 1 or 2. Associations between symptoms, and inflammation and infection were investigated using generalized Mantel-Haenszel methods. RESULTS: Of all participants 50% had urethral leukocytes and of 397 with expressed prostatic secretion samples 194 (49%) and 122 (31%) had 5+ or 10+ WBCs in expressed prostatic secretion, respectively. The revalence of category IIIa ranged from 90% to 54%, depending on the composite set of cut points. None of the index measures were statistically different (p >0.10) for selected leukocytosis subgroups. Based on prostate and semen cultures, 37 of 488 men (8%) had at least 1 localizing uropathogen. None of the index measures were statistically different (p >0.10) for selected bacterial culture subgroups. CONCLUSIONS: Although men with chronic prostatitis routinely receive anti-inflammatory and antimicrobial therapy, we found that leukocytes and bacterial counts as we defined them do not correlate with severity of symptoms. These findings suggest that factors other than leukocytes and bacteria also contribute to symptoms associated with chronic pelvic pain syndrome.

I have done ordinary semen culture but it did not show any bacteria, but I know for sure that my prostatitis symptoms started by a true infection.

Yes, they could have started by an infection which is gone now and you still have the symptoms.

Can there be bacteria lurking inside my prostate hiding away for antibiotics?

Theoretically, yes. There are ways to overcome this, too

a lot of docotrs are claiming that bacterial prostatitis cannot be treatded by orally antibiotic. That injections and systemic treatment is requiered. Is that true?

No evidence in the literature for that. If you really have bacterial prostatitis, it is easy to cure with oral antibiotics.

If you do have bacterial infection can this one be cured? According to many doctors it is very difficult or impossible if the bacteria have been growing inside the prostate for a while.

No evidence of that in the literature.

What is the most reliable test for determing if bacteria is present?

PCR

Along with my impotence and frequency I also have noticed change in semen consistency, it is almost like glue. What can be done to improve the semen quality? I also feel very cold in my body I usually have terrible cold feeling in my feet and hands. Sounds like infection doesn`t it?

Sounds like a systemic inflammatory response.

[doghead]

"If you really have bacterial prostatitis, it is easy to cure with oral antibiotics."

Huh? Chronic Bacterial Prostatitis, easy to cure?

Mine was acute bacterial, it is now
settled somewhat, 6 years on.
* Ejaculation still burns.
* A recent TRUS caused a 2-week acute relapse, which was settled by SEPTRA.
*I must use condoms or suffer relapses, dispite my better half's
having tested negative for vaginal bacteria which would normally be considered pathenogenic to the prostate.

Yet, PCR has found no guilty bacteria, and 2 doctors of infectious diseases - well known on the bacterial circuit - shake their heads. The Canadian Prostate Wizard had his gnome pound my shrunken prostate for 5 minutes, got no fluid, so took a urine sample instead (chuckle..). It was of course negative, and it was decided that I have no bugs.

My favourite study was one which looked at prostates which tested negative for bugs, were later removed, and when biopsied, were found crawling with the things.

I buy the biofilm theory, 100%.

Also, I think that my prostate is so compromised from past infection, that it is now susceptible to vaginal bugs which would not bother a healthy prostate.

I read Tarfusser with interest.

[webslave]

"If you really have bacterial prostatitis, it is easy to cure with oral antibiotics."Huh? Chronic Bacterial Prostatitis, easy to cure?

Yes, it is. Several studies show that CBP yields to repeated courses of quinolones in the vast majority of cases.

Mine was acute bacterial, it is now settled somewhat, 6 years on.
* Ejaculation still burns.
* A recent TRUS caused a 2-week acute relapse, which was settled by SEPTRA.
*I must use condoms or suffer relapses, dispite my better half's
having tested negative for vaginal bacteria which would normally be considered pathenogenic to the prostate.

Burning ejaculation and flares suggest CPPS. Septra (Bactrim) has recently been shown useful in the treatment of autoimmune diseases, such as rheumatoid arthritis. Bactrim therapy also reduces the elevated levels of soluble IL-2 receptor and IL-6 in parallel in another inflammatory disease, Wegener's granulomatosis, so you cannot be sure why Septra is helping you.

Yet, PCR has found no guilty bacteria, and 2 doctors of infectious diseases - well known on the bacterial circuit - shake their heads. The Canadian Prostate Wizard had his gnome pound my shrunken prostate for 5 minutes, got no fluid, so took a urine sample instead (chuckle..). It was of course negative, and it was decided that I have no bugs.

If you had CBP your first void urine would show it after a prostate massage.

My favourite study was one which looked at prostates which tested negative for bugs, were later removed, and when biopsied, were found crawling with the things.

I have not heard of this study. Was it ever published?

I buy the biofilm theory, 100%.

Bacterial etiology theories like this have been the common belief for decades now, and unfortunately they have led us nowhere. Newer research paints a very different picture.

Also, I think that my prostate is so compromised from past infection, that it is now susceptible to vaginal bugs which would not bother a healthy prostate.

I think you may have developed a complex system of beliefs, most of them erroneous and possibly harmful to your relationships, around your disorder.

I read Tarfusser with interest.

Tarfusser quit the field in defeat several years ago, asking men with CP/CPPS not to contact him please.

[TK]

..Several studies show that CBP yields to repeated courses of quinolones in the vast majority of cases.

>>> Can you direct us to any of these studies. Is any text available online?

I am not particularly an advocate of "bacterial" theories. In my own case, I tend to think in terms of inflammation being the primary problem at this point.

But still, it would be helpful to learn more about these studies.

Thank you!

[webslave]

Several studies show that CBP yields to repeated courses of quinolones in the vast majority of cases.

Can you direct us to any of these studies. Is any text available online?

Here's one, you can use Medline (Pubmed) to find others.