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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: 7
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
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Joined: Wed Apr 04, 2018 8:43 am
Posts: 131
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
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Joined: Sun Jan 12, 2020 1:21 pm
Posts: 7
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
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Joined: Sun Jan 12, 2020 1:21 pm
Posts: 7
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
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Joined: Wed Apr 04, 2018 8:43 am
Posts: 131
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
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Joined: Sun Jan 12, 2020 1:21 pm
Posts: 7
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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Joined: Sun Jan 12, 2020 1:21 pm
Posts: 7
Post Re: Past prostatitis 10 years ago, now having symptoms again
The urologist appointment was uneventful. She did state she was confident there was no bacterial issue going on. She found upon exam that the pelvic floor muscles were extremely taut and she was confident this was the origin of the symptoms. I do have a follow up appointment in a few months though to see how I’m doing.

I also went to my second PT appointment where they performed a technique called “dry needling”. Similar to acupuncture, but it’s more intramuscular and focuses on releasing trigger points and stuck muscles. I’m not sure it had as much effect as the manual therapy I had prior, but I have another appointment for manual therapy next week.
Anyways-that’s the road I’m on at this point. Hopefully I keep seeing progress.
I have worried I may have more IC like symptoms, but I know these symptoms are very similar to CPPS.

Anything else I should be looking into? There was no prostate fluid check or anything. I was told my prostate appeared very normal and not inflamed, due to this they did not recommend any further testing in the bacterial spectrum.
Thanks! I hope everyone is doing well :)


Fri Jan 24, 2020 6:34 pm
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Joined: Sun May 19, 2019 9:47 pm
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Post Re: Past prostatitis 10 years ago, now having symptoms again
Please let us know how this PT works for you. I am going to ask family dr. if anyone locally does that for me.


Sun Jan 26, 2020 10:57 pm
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Joined: Sun Jan 12, 2020 1:21 pm
Posts: 7
Post Re: Past prostatitis 10 years ago, now having symptoms again
I will certainly keep this thread updated with how it works out.
I will say I have definitely seen some improvement after just the one manual PT session and the dry needling, which also seemed to have helped some, it just took a couple of days.
Certainly not 100% better, but the symptoms are down to a dull roar much of the time where as before I would always have at least a couple hours of the day where it was pretty bad symptom wise.

I’m not sure where you live, but I got lucky and the next town over has a very highly rated PT practice that specifically specializes in PFD. Other than this office, the next stop would be Boston, Ma. I live in NH. I know as this is still an up and coming therapy, there doesn’t seem to be a lot of options depending on where you reside.
Definitely give it a shot though if you can find a place that offers it!


Mon Jan 27, 2020 4:20 am
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Joined: Mon Jun 19, 2017 11:11 pm
Posts: 208
Location: Canada
Post Re: Past prostatitis 10 years ago, now having symptoms again
AC1972 wrote:
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.


Good suggestions but what to do when Urologist does not agree or do these procedures?

Can I send my own semen sample to a lab?????


Mon Jan 27, 2020 4:59 pm
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Joined: Sun Jan 12, 2020 1:21 pm
Posts: 7
Post Re: Past prostatitis 10 years ago, now having symptoms again
I attended my second PT appointment and they again found several trigger points internally on my left side. It was pretty painful at parts of it, but felt quite a bit better after. If nothing else, there is absolutely a muscle tension issue going on. The right side of my pelvic floor feels normal and no pain or tenderness when inspected.
I was told to plan on 3-6mo recovery time and then I would need to keep up with certain exercises after to keep the issue at bay. The timeline seems about spot on as when I had this before I remember dealing with it for 4-6 months.
It was also suggested I try a slight heel lift for my right leg to place in my shoe, as my right leg is shorter than the left and could be contributing to the issue. I was also told this when I had my bout with this in my 20s. So-I ordered a heel lift and I’ll see how that goes.
I have another dry needling appointment next week and the more PT after.
I would say my symptoms didn’t abate as well as they did before following PT, but muscle tension is an odd thing. I was told I’ll have good days and bad days, so trying to remain positive. I certainly feel I’m on the correct path though.


Sat Feb 01, 2020 6:45 pm
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