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 More questions than answers 
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Joined: Wed Jun 27, 2012 4:22 pm
Posts: 1
Post More questions than answers
Hello everyone,

I'm extremely confused and frustrated by what I've been told about what may be
going on with me, and I'm hoping that perhaps someone can clear things up for me.

Background: I'm a 28 y/o male and have had the following symptoms for at least 5
years: frequency/urgency/hesitation, random shooting pains on both sides of pelvic region, testicles, or rectum,occasional mild burning sensation when urinating. I have noticed that the pains will sometimes occur when I feel an urge to urinate, but not exclusively.

After seeing a urologist, I've learned that my bladder capacity is normal, as demonstrated by morning voids. Urinalyses show no evidence of infection, and digital
exam found no enlargement of prostate. A cystoscopy found a polyp at the bladder
neck near the prostate. I was told that this may or may not be causing symptoms,
and that it could be removed by cystoscopy w/ fulgration. I had that procedure done,
and the biopsy came back showing cystitis cystica. At the follow-up the doctor diagnosed me with chronic prostatitis, prescribed me Cipro, and instructed me to
monitor my diet. After doing some research, I'm left with several questions:

1) I've learned that cystitis cystica is caused by inflammation of the bladder, as a result of infection or medical procedures, and that it can produce the symptoms that I experience. I can't find any relationship between it and non-bacterial prostatitis. Since the biopsy was taken from the bladder only, why would the doctor presume a prostate condition?

2) When the doctor said that "cystitis" was found, I asked if it was interstitial cystitis. She said that it was not because IC is a diagnosis of exclusion and in my case, an actual inflammation was found. I'm confused because from what I've read about IC, it can exist with or without inflammation of the bladder?

3) On the same point, I've learned that non-bacterial prostatitis (CPPS) falls into two categories, one with inflammation and one without, and that some doctors believe that the latter form may be the same condition as IC. Since there was no testing of my prostate, other than the digital exam, I would assume it's not known whether or not my prostate is inflamed. In that case, how could my doctor rule out IC?

4) The recent studies that I've read have indicated that treating non-bacterial
prostatitis with antibiotics may not be worth the risk of side-effects and resistance. I was given 7 days of Cipro and told to call back if my symptoms persisted. I'm assuming that they will and, if so, do you all think I should continue antibiotic treatment just in case?

Thank you so much in advance for your responses. I really just want to get to
the bottom of what's going on with me and what I should do about it.


Wed Jun 27, 2012 5:43 pm
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Joined: Thu Jun 14, 2012 3:38 pm
Posts: 50
Post Re: More questions than answers
Hi Tom

Sorry to hear its been going on for so long.
"Confused and frustrated" is a place I know well in my journey with CPPS.
Your symptoms are similar to mine.

Dealing with the medical "experts" and system has been exasperating at moments.
What works for some, doesn't work for others. What sets some off, does nothing to others.
One DR says one thing and another says something completely opposite.

I can't speak to your questions about cystitis as all my tests, scope and examinations have revealed no 'issue' or inflammation with my bladder.
However, you asked a question about CPPS and prostate inflammation.
My urologist told me that when you had the cystoscopy done and the DRE, they can usually tell if there is inflammation in the prostate.
I have seen the same thing with regard to some specialists believing that non-inflammatory CPPS is IC.
One of the telltale signs of CPPS and not IC is post-ejaculatory pain. You do not mention that in your list of symptoms.

As for the use of antibiotics on CPPS - my reading and review of studies, and my own personal experience is
that antibiotics are a waste of time, money and gave me no relief.
What you could ask is before they continue with them, they could express some prostatic fluid and examine it for signs of infection.
Also, if there is evidence of discharge from the penis, then it is often a sign of bacterial infection.
Some have found this to be the only way of confirming bacterial or non-bacterial CPPS.
But even then, some studies show bacteria present in 'normal' prostates.
Several people on these forums have suggested that if it is chronic bacterial prostatitis, then what works for them is repeated prostate massage with concurrent antibiotics.

I don't know if this will leave you more confused or help but hang in there.
From the research it is clear that even the best minds consider CPPS to be an enigma wrapped up in a mystery, surrounded by a puzzle ...
and they have more questions than answers.

Carl


Thu Jun 28, 2012 7:20 am
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Joined: Thu Jun 14, 2012 3:38 pm
Posts: 50
Post Re: More questions than answers
Here is an article that may help with understanding some of the differences between IC and CPPS.

http://prostatitis.org/redirect.php?lin ... n-syndrome

Hope it helps.
Carl


Mon Jul 02, 2012 7:36 pm
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Joined: Sun Nov 28, 2010 12:52 pm
Posts: 149
Post Re: More questions than answers
What you could ask is before they continue with them (antibiotics), they could express some prostatic fluid and examine it for signs of infection. ( The slide taken after massage may be the most important one)


Tue Jul 03, 2012 5:00 pm
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Joined: Sun Apr 08, 2012 5:53 pm
Posts: 70
Post Re: More questions than answers
would blood typically show up in a urine test for IC but less so for CPPS?


Fri Jul 06, 2012 7:30 pm
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