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 Past prostatitis 10 years ago, now having symptoms again 
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Joined: Sun Jan 12, 2020 1:21 pm
Posts: 4
Post Past prostatitis 10 years ago, now having symptoms again
Good morning,
I was active on the boards about 10 years ago when I had prostatitis like symptoms(urgency, incomplete bladder emptying, weak stream, stop and starting during urination and the golfball like pain near the prostate. I went through all the normal testing(bladder scope, prostate fluid secretion, kidneys etc) and I was told they could not find a bacterial issue, but were more of the belief I was experiencing bladder spasms and a pelvic floor dysfunction. I was referred to PT which seemed to help and also started going to accupuncture. From what I remember my symptoms went away over time and I’ve really had no issues the last decade. I remember having symptoms for 5-6 months.

Fast forward to November when I was at work one night, the sudden urge to urinate badly came back along with pain. I work in law enforcement and had been drinking a lot of caffeine for weeks leading up to this with little water, so I believe that may have brought it on. I visited my doctor the next day who referred me to a urologist. The urologist did locate a varicocele on one of my testicals, but stated this would not be causing the symptoms. I’m not sure if I agree with this, because other articles online state otherwise.

I was prescribed Alfuzosin(Uroxatral) which seemed to have helped. I continued to have issues and eventually was given the bladder scope where they found a small kidney/bladder stone in my bladder, but my urologist said this would not be causing the symptoms.
I asked about checking my prostate fluid again and he said my prostate was normal during testing and when he checked it via DRE. Ultimately, I was told it was most likely a muscle issue again and not much else.

The month of December went by with no real issues and I was feeling a lot better minus intermittent ED which my urologist stated was mostly likely due to lack of sleep/stress.

My symptoms returned last Thursday randomly and I now feel the urge to urinate frequently, weak stream and sometimes incomplete bladder emptying. I’m going to look into PT for this and I’ve already been in touch a facility that offers it.

I’m just concerned there may be bacteria that’s hidden in my prostate that’s not being picked up this time as my urologist now hasn't done a fluid test. My bladder was also checked recently twice to make sure I was emptying properly, and it was found to be working properly with no left over urine.
My fiancé who works in the medical field suggested getting a second opinion somewhere else and stated she was concerned about the kidney stones as kidney issues can cause similar symptoms.

I’ve started walking/running again and trying not to sit as much as possible as I do that a lot at work.

I know this is long winded, but any suggestions?

Sun Jan 12, 2020 2:08 pm

Joined: Wed Apr 04, 2018 8:43 am
Posts: 123
Post Re: Past prostatitis 10 years ago, now having symptoms again
Sorry to hear this. I am not sure why so few doctors don't want to test EPS for bacteria. It is rather strange as I have found numerous studies online stating that there are bacteria that cause Prostatitis! My only suggestion would be to research urologists in your area and start calling or emailing them to see if they would be willing to do an EPS culture, PCR test and microbiology review (looking at the EPS fluid with a microscope (high power screen) to see if there are any Gram + bacteria).

Sun Jan 12, 2020 4:11 pm

Joined: Sun Jan 12, 2020 1:21 pm
Posts: 4
Post Re: Past prostatitis 10 years ago, now having symptoms again
Good idea. I was thinking about reaching out to my old urologist. I saw two different doctors there. The first one wasn’t much help, just told me I shouldn’t be having these issues at my age and put me on uroaxtral. I continued to have issues and was eventually seen by another urologist, a female one this time who did the prostate fluid test first appointment and put me on Cipro for a couple months as she stated even if the test comes back negative, bacteria can still be present and it’s her protocol to do that. Following that I was moved onto PT.

Just frustrated it came back, but I remember my PT telling me I may have issues with this on and off the rest of my life.

Mon Jan 13, 2020 10:40 am

Joined: Sun Jan 12, 2020 1:21 pm
Posts: 4
Post Re: Past prostatitis 10 years ago, now having symptoms again
I have an appointment for PT with a pelvic floor dysfunction specialist tmrw and then I also made a second opinion appt with my old urologist who I saw when I dealt with this before in my past. I remember her being pretty helpful, certainly more helpful than the current urologist I was referred to recently.
So-hopefully I’ll get some answers or at least get on the path to healing.
Anything in particular I should ask at my urology appointment or things to check other than what’s been mentioned?
Thanks in advance!

Tue Jan 14, 2020 4:07 am

Joined: Wed Apr 04, 2018 8:43 am
Posts: 123
Post Re: Past prostatitis 10 years ago, now having symptoms again
I would suggest

1. Expressed Prostate Secretion (EPS) - uro will do a Digital Rectal Exam (DRE) and massage prostate to collect a sample of EPS. (Doctor may have you on your side or all fours depending on their style. Don't contaminate the sample with any skin or hair). Uro should then send it in for at least a 3-day culture (5-7 days is better) and remember you will need to be off antibiotics for that for at least 4 days and preferably longer.

2. Post EPS Massage Urine Sample - pee in a cup - urine should also be cultured as many days as possible

3. Both samples should be viewed under a microscope to look for gram + or - bacteria, mucus threads, blood cell counts, pus,

4. PCR test on the EPS also to look for mycoplasma and ureaplasma

The trick is you have to do everything you can to find the bacteria and the culture should tell you what antibiotics can kill it.

Then if you are issued antibiotics you have to make sure the course is long enough. It is incredibly frustrating I can't post links but i have some papers suggesting minimum 30 days course in chronic cases.

Wed Jan 15, 2020 2:39 pm

Joined: Sun Jan 12, 2020 1:21 pm
Posts: 4
Post Re: Past prostatitis 10 years ago, now having symptoms again
Good info.
I made an appointment for the 21st with my old urologist. From what I remember she had done a prostate secretion test when I had this before and it came back showing nothing. She did put me on cipro for quite a while and I felt a lot better while on it. I then went to PT and it faded away through time after that.

I also had my first PT appointment at the pelvic floor dysfunction place. They did and internal exam and found several trigger points on the left side of my pelvic floor. I was told the left side is mostly locked up and this could explain my symptoms. I felt probably 50% better following the appointment, but it only lasted 4-5 days. I was told it would come back and I’ll have to keep going to PT until they can get the muscles to loosen more. Also told it’s not an overnight fix and it takes time. Anyways-I was happy this seemed to help and I’ll be pursuing more appointments with PT.
They also said they thought the second opinion appointment with the urologist was a good idea to ensure there’s not a bacterial issue taking place. They did tell me a large number of prostatitis cases are due to a muscular issue and a lot of urologists don’t know what they’re doing with cases like this and just throw medications around.
Anyways-some progress at least. Hoping for more answers on Tuesday!
Thanks for listening and the advice
I’ll update!

Sat Jan 18, 2020 4:52 pm
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