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 MRI 
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Joined: Mon Jun 19, 2017 11:11 pm
Posts: 191
Location: Canada
Post MRI
I am getting a pelvic MRI next week. Gotta say I am beyond desperate for some answers.

To be honest I hope they find something wrong, something tangible, something......the irritating almost constant irritation is driving me crazy. I have stopped working. It's the burning (rectal), and the pressure, tightness of the bladder that makes even driving the car difficult. I cannot sit, straight up, it's painful,

My urologist never did a prostate or semen test for bacteria, that disappoints me. He did put me on a 30 day course of cipro, no help.

Sorry for the rant I have to go try and squirt a little liquid out of the inflamed hose.

Has anyone had an MRI done that helped with a diagnosis and successful treatment?


Thu Jul 12, 2018 11:49 pm
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Joined: Tue Aug 04, 2015 6:50 pm
Posts: 1131
Post Re: MRI
Hi Race,

I just had an MRI with a 3-Tesla machine (no constrast). A few days later my doctor's nurse called me back and said things were fine, but they could tell I was still dealing with prostatitis, whatever that means. I guess they could probably see some inflammation or something.


Fri Jul 13, 2018 2:17 pm
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Joined: Mon Jun 19, 2017 11:11 pm
Posts: 191
Location: Canada
Post Re: MRI
thank you for the reply

That is interesting that the MRI shows “something “

I don’t expect much to come from this scan although I’m
hopeful that is shows something is wrong


Fri Jul 13, 2018 6:37 pm
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Joined: Mon Jan 29, 2018 6:42 am
Posts: 42
Post Re: MRI
I've had 2 MRI scans and like you I was hoping that something showed up. They were also re-examined for potential pudendal neuralgia. Nothing was ever discovered


Mon Jul 16, 2018 9:53 am
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Joined: Fri Apr 13, 2018 4:05 pm
Posts: 48
Post Re: MRI
You guys needa to a transrectal ultrasound. I was viably able to see my infection back of the prostate and some calcification but ive had this for like 10 years might not be the same for others.


Mon Jul 16, 2018 10:51 pm
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Joined: Mon Jun 19, 2017 11:11 pm
Posts: 191
Location: Canada
Post Re: MRI
ok

A what?

Forgive me I have not heard of a transrectal ultrasound

Did the findings help you?


Tue Jul 17, 2018 11:46 pm
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Joined: Fri Apr 13, 2018 4:05 pm
Posts: 48
Post Re: MRI
Yup you can see what side has more of the infection on but its not really necessary most important thing is testing and using correct antibiotics with massage


Wed Jul 18, 2018 12:54 am
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Joined: Mon Jun 19, 2017 11:11 pm
Posts: 191
Location: Canada
Post Re: MRI
My problem is that the urologist I saw doesn't test anything beyond urine and blood.

No semen or prostate fluid were ever done.

Do I have to find another urologist?


Wed Jul 18, 2018 1:02 pm
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Joined: Fri Apr 13, 2018 4:05 pm
Posts: 48
Post Re: MRI
racebannon wrote:
My problem is that the urologist I saw doesn't test anything beyond urine and blood.

No semen or prostate fluid were ever done.

Do I have to find another urologist?



Yup. I assume you are in america. Most don't know here or are ignorant to the disease. Makes you feel like you have a made up disease when you explaining it to them. You need your prostate fluid tested most don't do it cause you need proper testing facility. Also a gram stain test they press your urethra onto a slide shows your yeast count. Most of us have bacteria + yeast its usually not 1 thing causing the problems because your WBC can handle 1 problem its when the immune system gets overwhelmed you start getting more symptoms. Thats why we get flare ups after unprotected sex because you are adding more bacteria.


Wed Jul 18, 2018 11:22 pm
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Joined: Mon Jun 19, 2017 11:11 pm
Posts: 191
Location: Canada
Post Re: MRI
well this is all so depressing. My pain is constant and don't know where to turn next. Where would I find a urologist who performs these specific tests?

I'm at the point where I would travel and pay whatever it costs.


Thu Jul 19, 2018 4:21 pm
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Joined: Thu Jun 28, 2018 9:36 pm
Posts: 52
Post Re: MRI
They really should test the EPS for bacteria (via culture) and for inflammatory cells ( via microscopic observation)....You dont really need all that hi-tech stuff for this...This is not an expensive or complicated procedure at all...

However, you can pretty much narrow much of this down on your own..Given what has already been done

Bacterial prostatitis is relatively rare.. only between 5-10%. ..Overwhelmingly, that responds to Cipro. Your case did not. Other infective etiologies are even more unlikely...Most of the gram-positive bacteria which may or may not be found are but secondary colonizers. Which are unlikely to be causing symptoms..When those r eliminated by antibiotics, theyre replaced by other --usually benign-- colonizers...So-- I'd go to the next stage..

NIH non-bacterial prostatitis: Type III.

(You can eliminate Type IV because that's by definition asymptomatic..)

Type IIIa: is prostatitis with inflammatory cells

Type IIIb: the most common is pain and voiding symptoms without those white cells.. Though there may be inflammation anyhow..Just not detected

Both are quite difficult to treat but after some trial and error, theyll eventually respond to something. The pain is likely driven by tightness and spasms in smooth muscles of the prostate and bladder neck. As well as tension in the pelvic floor. Accompanied by varying degrees of inflammatory response. The key is to try and treat those two culprits..It may not be all necessary to narrow it down further between Type IIIa or Type IIIb

My point is to try to treat the symptoms and not hope they find some sort of "smoking gun" lesion..They likely will not even with hi tech

Best wishes

~elias~


Thu Jul 19, 2018 5:34 pm
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Joined: Mon Jun 19, 2017 11:11 pm
Posts: 191
Location: Canada
Post Re: MRI
thank you Elias

My MRI result was "normal"...okay

Pudendal Nerve.....maybe, but I had no reduction in pain when they injected my nerve with anisthetic

Yes it could be pelvic floor malfunction/tightness. Pelvic physio did not help, already went down that road.


Thu Jul 19, 2018 6:06 pm
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Joined: Thu Jun 28, 2018 9:36 pm
Posts: 52
Post Re: MRI
Hi racebannon:

OOops..just re-read and saw u were scheduled for that MRI this . I had thought u already had it n not much was found...Curious waht the MRI showed?

Apologies..

My point still holds that a culture and microscopic observation of prostatic secretion shouldve been done first. As youre insisting...It's way simpler than an MRI. Why not call urology offices and specifically ask whether they will do this. All it requires is a prostatic massage to get the fluid. a microscope to look for inflammatory cells and a lab to send sample off for C&S testing...

But as i explained above...Since Cipro didnt help, you pretty much can narrow it down to CPPS Type IIIa or Type IIIb..


Thu Jul 19, 2018 6:23 pm
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Joined: Fri Apr 13, 2018 4:05 pm
Posts: 48
Post Re: MRI
I think theres places in Canada that help. I just noticed you are in Canada. There was a big thread about it on here


Thu Jul 19, 2018 9:52 pm
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Joined: Fri Apr 13, 2018 4:05 pm
Posts: 48
Post Re: MRI
elias wrote:
They really should test the EPS for bacteria (via culture) and for inflammatory cells ( via microscopic observation)....You dont really need all that hi-tech stuff for this...This is not an expensive or complicated procedure at all...

However, you can pretty much narrow much of this down on your own..Given what has already been done

Bacterial prostatitis is relatively rare.. only between 5-10%. ..Overwhelmingly, that responds to Cipro. Your case did not. Other infective etiologies are even more unlikely...Most of the gram-positive bacteria which may or may not be found are but secondary colonizers. Which are unlikely to be causing symptoms..When those r eliminated by antibiotics, theyre replaced by other --usually benign-- colonizers...So-- I'd go to the next stage..

NIH non-bacterial prostatitis: Type III.

(You can eliminate Type IV because that's by definition asymptomatic..)

Type IIIa: is prostatitis with inflammatory cells

Type IIIb: the most common is pain and voiding symptoms without those white cells.. Though there may be inflammation anyhow..Just not detected

Both are quite difficult to treat but after some trial and error, theyll eventually respond to something. The pain is likely driven by tightness and spasms in smooth muscles of the prostate and bladder neck. As well as tension in the pelvic floor. Accompanied by varying degrees of inflammatory response. The key is to try and treat those two culprits..It may not be all necessary to narrow it down further between Type IIIa or Type IIIb

My point is to try to treat the symptoms and not hope they find some sort of "smoking gun" lesion..They likely will not even with hi tech

Best wishes

~elias~


This is misinformation ^^^^ Its the other way around. Non bacterial is rare. Most people don't get properly tested or results don't show on the first massage. A lot of the times the infection is at the back of prostate if you have had it for a while. Also theres the yeast/fungus factor which is transferred sexually or as result of antibiotic use over time. Most of us suffering have both problems Bacteria + Yeast. Sometimes the species even mix fun stuff.. Candida + Bacteria. https://www.sciencedirect.com/science/a ... 821400067X Odds are you caught a case of Cipro resistant bacteria from someone. Get tested properly thats my suggestion then make the non bacterial/fungus argument. Prostate fluid test + Gram stain. Don't throw drugs at your problems till you know what you have thats what I did. Then your bacteria will be resistant to a buncha drugs =/


Thu Jul 19, 2018 10:01 pm
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Joined: Thu Jun 28, 2018 9:36 pm
Posts: 52
Post Re: MRI
Quote:
"
This is misinformation ^^^^ Its the other way around. Non bacterial is rare. Most people don't get properly tested or results don't show on the first massage.
"


Actually, I do hope youre right. Was only presenting the NIH formulation into those 4 categories from years ago. The key to that formulation was that often an inflammatory process exists without ongoing infectious cause.

So it is possible they oversimplified it into overly neat categories. Also urinary reflux which can occur in inflammation/muscle spasm can (theoretically at least) move urethral pathogens up into the prostate--where they can take a firm foothold and be hard to detect...So it is possible that this difficulty in detection had lead to the dictum that 90-95% are non-infectious. I cant say for certain

In any case, we do agree that throwing toxic antibiotics like Cipro without a culture and sensitivity test is very wrong and can generate other microorganisms. Its also not reasonable to run an MRI without first observing EPS for inflammatory cells and attempting a culture.

I know urologists love their shiny new toys a lot...But sometimes the older method yields more

Racebannon: You can try calling a few urological offices and asking if they would do a prostatic massage so as to examine the EPS for the above..This is standard in the dx of any kind of prostatitis. So someone near is bound to agree to do this


Sun Jul 22, 2018 8:47 pm
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