New Here: Could I have typical CPPS?

[JJavman]

History (all heterosexual) : Normal "no discomfort" very active sex life, up until the age of 24 with same partner. Age 24: One night stand with a different partner, resulting in discomfort at tip of penis, golf ball feeling. Trip to GP, no tests, assumed STI, and 2 weeks of penicillin. Many months of discomfort with even a red rash periodically on penis shaft, before finally seeing a Uro who said prostate felt "boggy" and prescribed 3 months of Vibramycin. Systems abated after this.

During the next 36 years (same partner), off and on symptoms, with dribbling, nocturia when inflamed, golf ball feeling, burning and small stream. Always attributed to prostatitis, and GP and Uros would always say prostate felt boggy! Some treatments with Vibramycin were a year in length! I think I had semen tested for pathogens during this time period (especially in the beginning) and of course always the standard urine panels. Nothing was ever discovered, and I was always given the vague diagnosis of "probably Non-bacterial" prostatitis. It got so that in the last 15 years, any oral or vaginal sexual activity with partner would set off the condition. My partner was tested for all the usual pathogens several times. Nothing. Interestingly, I had several encounters with 2 other partners during this period, which DID NOT inflame the situation, leading me to believe that there was some flora not being discovered in my usual partner!

When Ciprofloxacin was invented, treatment for flareups switched to that drug, which was always prescribed for a month per occasion and the systems would usually abate during that time.

Fast forward to present day, and about 5 years ago a different urologist performed DRE, and Flo tests, and also cystoscopy. Altho I had the usual symptoms, he suggested that I probably never had prostatitis all those years, and diagnosed me with an overactive bladder neck sphincter (involuntary) ; which he said is reducing flow and causing the symptoms. I then started a regimen of Flomax (couldn't breathe thru' the nose), and then Rapaflo. During the past year or so, the Rapaflo seemed to be less effective, so I am back on the Flomax.

During a flareup, I am still prescribed a month of Cipro for it's additional anti-inflammatory effect (according to GP). With the Flomax seemingly becoming less effective, my URO is suggesting he could cut the bladder neck muscle, leaving the involuntary sphincter permanently relaxed! Had anybody had this done, and is it recommended or something to shun???

Thanks to anybody who read this lengthy post.

[webslave]

Horrible history of antibiotic abuse for their anti-inflammatory effects. Readers take note how bad antibiotic abuse can be in CPPS: a year taking vibramycin!

The episode at 24 may or may not have resulted in an infection; it's just speculation at this point. But it did cause your symptoms, that's the key point. If it was an infection, the initial course of vibra seems to have stopped it. 36 years later, we are not talking about an infection — this is CPPS. Your speculation about your partner and non-partner sexual experiences are not helpful because all it shows are your attempts to construct a cause and effect scenario that is not real. This is one of the most persistent fallacies that plague CPPS patients: the rumination about partners and suspicions of transmission.

You may also have a BPH or OAB problem if the alpha-blockers are helping.

Do not take any antibiotics again in the absence of clear indications of infection.

In your shoes, I'd see a second uro and ask for another cystoscopy to confirm the bladder neck issue before proceeding to surgery. Unfortunately, uros are primarily surgeons and he may simply be trying to convert you into a quick, profitable surgical patient rather than tackle the hazy and comparatively intractable problem of CPPS

[JJavman]

Thanks. I think I would get a second uro opinion before any surgery.
I'd really be curious if anyone else has ever been told they have an overactive bladder neck sphincter, and what was done about it?

[Sleeper Service]

I've had prostate surgery three times now - first time was 10 years ago and after nine rough months it gave me six good years before the bladder neck closed up again (tissue continues to grow). That took 11 months to calm down and lasted for 18 months after that before the bottom of my prostate grew and I needed a TURP, which I had six months ago. Things are calming down as they did last couple of times.

A few points:

1) A BNI or TURP is primarily to remove an obstruction, which will improve urinary flow. However, it will not cure CPPS although it may remove the factor that causes it - this was the case for me.
2) Do not consider surgery until you have had a videourodynamics test, not just a cystoscopy, to confirm there is an obstruction.
3) There are side effects. Makes sure you are aware of them.

I don't regret the surgeries I had, as they were absolutely needed to remove the cause of my CPPS and they have immeasurably improved my quality of life both times so far (and look like doing so again), but each time has been a hard road with ups and downs, and I wouldn't have considered them without thorough testing, including the videourodynamics test.

[JJavman]

Thanks for the info Sleeper!

[Micha Seb76*]

A question to Sleeper Service :

I am 41 years. I suffer from CP since 2011. Probably bacterial cause because a lot of biofilms (staphylococcus and enterococcus)

Today I am very tired with this condition. I felt in serious depression. Nothing had worked for me, even a 6 weeks treatment in Greece. I am fed up .

I've arrived to consider prostate surgery in last resort. But in France they wouldn't accept to do it.

Could you tell me please if you are better / worse after your surgeries ? Would you do it again the same way ? (with hindsight)

Thanks in advance

[ivanbulgaria]

@ Micha Seb76 : Hello first sorry for my English. Can you explain me about your treatment in Greece? What happen,because I also think about going to see dr. Giorgiadis?

[Sleeper Service]

I had prostate surgery to remove an obstruction. It did not cure my CPPS although it did remove the instigating factor. Time and relaxing whilst keeping active along with (maybe) fish oil and MSM and glucosamine took care of my symptoms the first two times and appear to be doing the same this time. I would not have surgery just for CPPS because it doesn't work.