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 Múltiple acute bacterial prostatitis 
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Joined: Sun Aug 05, 2018 4:32 pm
Posts: 4
Post Múltiple acute bacterial prostatitis
Dear all. I have been suffering from ABP in the past 9 years. I have a history of urethral estenosis probably due from heavy mountain biking since I was 30. I am now 55. Ten years ago I did a internal optical urethrotomy that failed three weeks after . Since then I started having bacterial acute Prostatitis episodes twice a year. Two years ago I did an open urethroplasty procedure and my urinary flow has improved so much (23,5 ml/s Q Max) but after the surgery I have had 4 more episodes of acute bacterial prostatitis. Every episode is caused by a different microorganism, E Coli, Morganella, Proteus and Serratia, so I think there is not a Nidus from the prostate tissue. I have external hemorrhoids and in my work am sitting on a chair for 8-10 hours a day with a lot of stress. My theory is that rectal venous stasis and the hemorrhoids have a link on the way the microorganisms reach my urinary tract. I would thank for some comments about that. Thank you.


Fri Nov 23, 2018 12:40 pm
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Joined: Sun May 01, 2016 9:48 am
Posts: 643
Post Re: Múltiple acute bacterial prostatitis
I have suffered hemmorhoids, and worse, chronic anal fissures. When I am suffering from those, my prostatitis symptoms were way worse. This has nothing to do with bacteria escaping from my rectum to infect the prostate (that.doesnt even make sense), but it's totally due to muscle tension in the pelvic floor, especially the sphinctor causing a flare in symptoms. And that alone should give you pause as to the whole infection vs. muscle tension debate. Even when I had bad diarrhea my symptoms flared up, again due to tension in the pelvic floor.


Fri Nov 23, 2018 7:04 pm
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Joined: Sun Aug 05, 2018 4:32 pm
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Post Re: Múltiple acute bacterial prostatitis
In ma case, during the last months, every time I have a diarrhea, I have my urine infected. That’s why I was thinking that maybe thre is apathway between the rectum and the lower urinary tract, and also because the bacteria are different microorganisms, not a single one. I have performed an MRI and there is no macroscopica fístula but I am pending for a colonoscopy to check the rectum and sigma. Will see. Thanks for your reply.


Sat Nov 24, 2018 1:05 am
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Joined: Tue Apr 12, 2016 11:55 am
Posts: 428
Post Re: Múltiple acute bacterial prostatitis
Since I had hemorrhoids, I have developed worse prostatitis problems. When the hemorrhoids are gone or at least have decreased, prostatitis pain and problems are less. You could research the size of the bacteria found, and compare with size of pathways within permeable tissues, but that is probably information which is difficult to acquire for you. What I was thinking was synchronous infection via my urinary tract and colon rather than the less plausible bacteria transmigrating across tissue layers or through bloodstream. But since hemorrhoids are an open pathway to the bloodstream, it could be an evidence-based case for bacteria traveling from one organ to the other with the bloodstream as a bridge. Do you have any other health problems, internal and/or external?


Sat Nov 24, 2018 3:31 pm
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Joined: Sun Aug 05, 2018 4:32 pm
Posts: 4
Post Re: Múltiple acute bacterial prostatitis
In my case I have had three episodes of Acute bacterial prostatitis; in all three episodes I had diarrhea one or two days before, with rectal inflammation and hemorrhoids with some bleeding. In every episode de bacteria that caused the prostatitis was different (Proteus, E Coli and Enterobacter Cloacae). That’s why I am thinking in that I have a pathway connection the rectum with my urinary tract. I did an MRI in which no fistula is seen.


Sun Nov 25, 2018 2:13 am
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Joined: Tue Apr 12, 2016 11:55 am
Posts: 428
Post Re: Múltiple acute bacterial prostatitis
The pathogens you listed are all nosocomial (hospital-acquired) infections, whether during surgery, operation, or simply being in the hospital (communicable). Have you ever had catheterization?

Your theory sounds plausible. If it happens in the legs, it could easily happen in the pelvis. However, why would it be a different bacteria every time? I'd think that if there were a link, then at least one of the bacterial species would show up again as the culprit. Not saying it's not possible at all, but a question for consideration.


Sun Nov 25, 2018 2:06 pm
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Joined: Sun Aug 05, 2018 4:32 pm
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Post Re: Múltiple acute bacterial prostatitis
Dear presto423: I am a physician, especialist in ophthalmology. As I said in my first post, I suffered from urethral stenosis since I was 30. I was having urethritis once a year due to E Coli always. The urine flow was slowly decreasing and when I was 45, I wrongly did an internal optical urethrotomy that failed three months later. I had severe bleeding in the immediate postop, probably to a too deep urethral cutting with the cold knife urologist use for this procedure.

Six months later my first acute prostatitis happened, due to E Coli. The acute prostatitis was recurring once or twice a year with no symptoms in between episodes, only the weak urine stream. Finally I decide to perform an open urethroplasty with pediculated scrotal flap of 6 cm. Surgery was on July 2017 and I had an excellent result; the urine Max flow was 26,9 ml/sec and one week ago, 18 months after surgery it is still in 22 ml/sec. The operation site was examined by flexible cystoscope and everything was fine.

I believed that, performing the surgery and unblocking the obstruction, intraprostatic urine reflux causative of the infections will disappear, but in the past 18 months I had 4 episodes of prostatitis with fever, chills, etc. What has changed in the past months are the bacteria. No more E Coli. And all episodes are related with a previous diarrhea or a very long operation of getting rid of new infections session ( we operate seated and sometimes surgical session can last for 5-6 hours, which is not good for the prostate congestion). As I also have hemorrhoids, and being this bacteria typical of the normal flora ( Proteus, Morganella, Entrrococus and the las Enterobacter Cloacae are usually present in the human microbiota) I am thinking about of a pathway between my rectum and my operated urethra.

I am pending to perform a rectal exam and a colonoscopy to check if there can be any sign of weakness of the mucosa. Because urologists are very closed in there theory of an intraprostatic reservoir and the are proposing me surgical removal of the prostate, which scares me because there is no guarantee of getting rid of new infections. This is my hypothesis in my personal case and, as a physician, I will try to discard any other possible cause of my multiple bacterial prostatitis before going through a prostatectomy with it’s possible side effects


Sun Nov 25, 2018 4:35 pm
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Joined: Mon Jun 19, 2017 11:11 pm
Posts: 151
Location: Canada
Post Re: Múltiple acute bacterial prostatitis
prostate454 wrote:
I have suffered hemmorhoids, and worse, chronic anal fissures. When I am suffering from those, my prostatitis symptoms were way worse. This has nothing to do with bacteria escaping from my rectum to infect the prostate (that.doesnt even make sense), but it's totally due to muscle tension in the pelvic floor, especially the sphinctor causing a flare in symptoms. And that alone should give you pause as to the whole infection vs. muscle tension debate. Even when I had bad diarrhea my symptoms flared up, again due to tension in the pelvic floor.


Yup, this is me too. Diagnosed with fissure 9 years ago, All that chronic rectal spasm started all my prostatitis type symptoms. I agree, it's spasm of the muscles in the pelvic floor. I cannot comment on bacteria.


Sun Nov 25, 2018 8:57 pm
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