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Prostatitus Advice


Batty

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Could anyone with experience in this give me a little direction?  I have been diagnosed with Prostatitus by local Urologist in Udon Thani.  I have had this bladder thing for a few weeks and had a full health screening at Bumrungrad 2 weeks ago, all is great im a very healthy chap apart from the prostatitus.  They actualy didnt find it as Bumrungrad because I stupidly didnt have the two finger exam and so they said it might be a UTI.  5 days later local urologist had a poke around and said it is prostatitus.  He assured me its not cancer or anything as my report from Bumrungrad showed normal levels of something or other that points to prostate cancer.  Something in the blood - could be lippy count or something I dont know to be honest, but he is adamant it is not prostate cancer.

 

I have just finished one week of antibiotics and went back to local urologist last night for appointment.  I told him it was no better and he gave me another week of the antibiotics.

 

It seems there are 2 or 3 different types you can have.  Chronic, bacterial, or chronic bacterial?  The treatment given depends on which one you have.  Am I right in saying to truly identify what it is you need urine cultures and digital probes?  I asked local urologist guy and he just shook his head and said no need (he also said its difficult?)

 

An ex-pat friend of a friend up here recommended a urologist at Bangkok Pattaya hospital.  Im just trying to decide if it is worth seeing this guy for a second opinion?  Is there anything he can do differently to the local urologist?  If so, does that then mean I will have to stick it out with Pattaya doc and ditch the local doc sort of burning my bridges in the process?  Will I then have to visit Pattaya every week or two all the way from Udon?

 

Im not sure what to do here.  I know there are far worse things to have and its a common thing for blokes over 40 (i am 45) nothing to panic about, but i am anxious about it a little.  I have heard of people who still have this after 2 or 3 years.  Even 2 or 3 months of this would freak me out.  As I said its not a serious thing but its not a nice thing to have - feeling like you need to pee all the time and going to the toilet 3 times an hour just for a trickle is no fun at all.  I guess im a little worried that the local urologist fella isnt maybe doing his level best and possibly the expert down in pattaya might be able to nail this for me?  Also my Dad had prostate cancer and whilst the local guy (two local urologists actualy) looked at my health screening report and insist its not prostate cancer there is still that nagging doubt in my mind.

 

Any advice appreciated, thanks so much.

 

 

 

 

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I am afraid I can not help you much on this as I had prostatitis when I was 18 and that is well over 50 years ago now.  Even then a course of antibiotics fixed it and it has never recurred fortunately. You say you have "this bladder Thing" so what are the symptoms as mine was a stinging sensation whilst urinating ?  I live in Udon thani and always found Bangkok Hospital there to be extremely good, is that where you saw the local urologist ?

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2 hours ago, Batty said:

Something in the blood - could be lippy count or something I dont know to be honest, but he is adamant it is not prostate cancer.

Likely "PSA".

https://en.wikipedia.org/wiki/Prostate-specific_antigen

Value up to 4 is considered inconspicuous.

Urologist lately told me that for my age of about 60 a value of 6 would be "OK".

Unfortunately mine is much higher and currently on medication.

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Unless you have some other reason to visit Pattaya it hardly makes sense to travel there as some of the best urologists in the country are in Bangkok. Dr. Viroj at Bumrungrad is especially recommended as is Dr. Thanoo at Samitivej.

You would also find some good urologists at Khon Kaen University Hospital (Srinagarind) and might prefer to go there first.

A urine culture should have been taken initially before starting the antibiotics. Fine to start treatment pending the results of the culture and then adjust after results come in, but should have gotten the sample. It may be a bit problematic to get one now that you have already started antibiotics.

Acute prostatitis normally needs at least 6 weeks of antibiotic treatment so not feeling better after just one week in itself does not mean anything.

Basically you have 2 choices at this point:

1. Continue treatment with your original urologist until you have had 6 weeks antibiotics. If still symptomatic at that point go elsewhere (or do so before then if symptoms worsen) Bring your medical records with you. If all symptoms cleared after 6 weeks antibiotics then assume treatment was successful.

2. Go elsewhere now.

In either case from here on insist on culture and refuse to start new antibiotic without one. For some reason Thai doctors are reluctant to get cultures. Maybe 80-85% of the time it won't matter but when it does, it really does and not having gotten one at the outset makes successful treatment a whole lot harder.

Regarding your concerns re prostate cancer the test they refer to is probablya PSA. A normal PSA combined with normal findings on digital (rectal) exam of the prostate makes cancer unlikely as does your age. In addition your symptoms are consistent with infection. It is understandable that with a family history you are concerned about orostate cancer and that is a good reason to have periodic screenings (PSA and digital rectal exam) every year or two. But nothing you say raises concerns right now. Find out what your PSA was though and keep for future reference.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

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On 10/16/2018 at 1:17 PM, Sheryl said:

Unless you have some other reason to visit Pattaya it hardly makes sense to travel there as some of the best urologists in the country are in Bangkok. Dr. Viroj at Bumrungrad is especially recommended as is Dr. Thanoo at Samitivej.

You would also find some good urologists at Khon Kaen University Hospital (Srinagarind) and might prefer to go there first.

A urine culture should have been taken initially before starting the antibiotics. Fine to start treatment pending the results of the culture and then adjust after results come in, but should have gotten the sample. It may be a bit problematic to get one now that you have already started antibiotics.

Acute prostatitis normally needs at least 6 weeks of antibiotic treatment so not feeling better after just one week in itself does not mean anything.

Basically you have 2 choices at this point:

1. Continue treatment with your original urologist until you have had 6 weeks antibiotics. If still symptomatic at that point go elsewhere (or do so before then if symptoms worsen) Bring your medical records with you. If all symptoms cleared after 6 weeks antibiotics then assume treatment was successful.

2. Go elsewhere now.

In either case from here on insist on culture and refuse to start new antibiotic without one. For some reason Thai doctors are reluctant to get cultures. Maybe 80-85% of the time it won't matter but when it does, it really does and not having gotten one at the outset makes successful treatment a whole lot harder.

Regarding your concerns re prostate cancer the test they refer to is probablya PSA. A normal PSA combined with normal findings on digital (rectal) exam of the prostate makes cancer unlikely as does your age. In addition your symptoms are consistent with infection. It is understandable that with a family history you are concerned about orostate cancer and that is a good reason to have periodic screenings (PSA and digital rectal exam) every year or two. But nothing you say raises concerns right now. Find out what your PSA was though and keep for future reference.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

 

Sheryl thank you so much for the detailed reply, I appreciate the effort you out into that!  I have taken your advice on board and feel relieved actualy that I dont have to venture to Pattaya every week or so.  I guess you are right, it makes little sense and if the doctor there is going to prescribe antibiotics just as the local udon doctor is, then realy whats the point.

 

Im not going to lie, this is playing on my mind quite a bit.  I seemed to have picked up a sore tonsil on the right side now, which I am sure is related to my body fighting the infection and nothing to worry about but then again, I have a wild imagination.

 

I have been feeling low energy last couple of days, earlier today I googled 'does prostatitus make you tired'.  Worse thing I could have done because yes indeed it does make you fatigued.  Actually Google is just full of page after page of people worried about being fatigued months into the illness.  I am hoping that particular side affect is not as common as it seems on google - a slightly painful bladder and frequent trips to the loo I can handle just about, but if I am going to be run down and tired for months that will drive me crazy.

 

I cant believe such a low-danger, non-serious illness can completley bugger you up like this.  I hope to god it doesnt last months.  A friend of mine in the UK has had this for a few years and says he often gets fatigued and 'shivers'.  Is that what I have to look forward to?  Just from a bacteria thing?

 

By the way I remember you from you years ago!  You live on Koh Pagnan is that right?  We have never met but i lived in Samui from 2003 - 2005 and remember you being pretty6 active in that group.  Glad to see you are still around.

 

Thanks so much for the advice I truly appreciate it very much indeed

 

 

 

 

 

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On 10/16/2018 at 11:58 AM, KhunBENQ said:

Likely "PSA".

https://en.wikipedia.org/wiki/Prostate-specific_antigen

Value up to 4 is considered inconspicuous.

Urologist lately told me that for my age of about 60 a value of 6 would be "OK".

Unfortunately mine is much higher and currently on medication.

 

I hope it improves for you soon - thanks for the feedback.

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31 minutes ago, Batty said:

 

Sheryl thank you so much for the detailed reply, I appreciate the effort you out into that!  I have taken your advice on board and feel relieved actualy that I dont have to venture to Pattaya every week or so.  I guess you are right, it makes little sense and if the doctor there is going to prescribe antibiotics just as the local udon doctor is, then realy whats the point.

 

Im not going to lie, this is playing on my mind quite a bit.  I seemed to have picked up a sore tonsil on the right side now, which I am sure is related to my body fighting the infection and nothing to worry about but then again, I have a wild imagination.

 

I have been feeling low energy last couple of days, earlier today I googled 'does prostatitus make you tired'.  Worse thing I could have done because yes indeed it does make you fatigued.  Actually Google is just full of page after page of people worried about being fatigued months into the illness.  I am hoping that particular side affect is not as common as it seems on google - a slightly painful bladder and frequent trips to the loo I can handle just about, but if I am going to be run down and tired for months that will drive me crazy.

 

I cant believe such a low-danger, non-serious illness can completley bugger you up like this.  I hope to god it doesnt last months.  A friend of mine in the UK has had this for a few years and says he often gets fatigued and 'shivers'.  Is that what I have to look forward to?  Just from a bacteria thing?

 

By the way I remember you from you years ago!  You live on Koh Pagnan is that right?  We have never met but i lived in Samui from 2003 - 2005 and remember you being pretty6 active in that group.  Glad to see you are still around.

 

Thanks so much for the advice I truly appreciate it very much indeed

 

 

 

 

 

Most people with prostatitis do not suffer severe fatigue or other systemic issues. Those who tend to post on internet groups are more likely to be those who either have unusually severe symptoms or are ascribing everything they feel (real and sometimes imagined) to the condition. Try to take it easy and do not overly focus on every little ache, pain etc.

 

You have me confused with someone else, I've never lived on KPG or anywhere in that region.

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First of all I do believe that Sheryl was right in as much as your symptoms sound very similar to having a UTI infection, so another course of antibiotics, once they have managed to culture something, would not go amiss.

 

I have suffered from prostatitis for 30 years or more and for a great deal of people it is fairly incurable!

Bacterial prostatitis should be able to be cured with antibiotics, but very often it is difficult to culture a particular bacteria from the prostate, although the best way to try is by the urologist giving the prostate a massage and collecting the prostatic fluid for culturing.

 

Even then it's possible that no bacteria will be found, and that's one of the problems with this, because if there is an infection and it is deep within the prostate, it is to a great extent untouchable, not only protected by the prostate itself but also by biofilms which shield the bacteria from antibiotics.

 

Having said that, you may be lucky with an extended course of many months of a particular antibiotic, so let's hope that is the case.

 

If it is nonbacterial prostatitis, then nobody knows what causes it, so if that's the case you have to live with it. But there are some good points in as much as the condition can settle down on its own for many months on end, before rearing its ugly head again.

 

Strangely enough, even though bacteria can't be proven, the antibiotic doxycycline does have a settling effect and was commonly prescribed for this condition, sometimes for three months at a time, and that did work for me............. until the next time, but at least I got some respite.

 

Anti-inflammatories can also help, which would seem to suggest that some sort of inflammation in the prostate is taking place.

 

I posted quite a few posts on this some while back to someone else who was suffering, so it may be worthwhile looking through the archives to find the articles because there were some promising outcomes with combining a couple of antibiotics/drugs and some of those posts might be of help to you.

 

One thing you do not want to do is to worry about it, because it does not lead onto anything else if it is nonbacterial prostatitis, and the symptoms can be allayed quite remarkably by those which I have mentioned above.

 

If it is actually bacterial prostatitis and it can be cultured, then you are in good shape to be able to treat it, but be prepared for a long treatment time and possibly different drugs.

 

Learning to live with it is very often one way to overcome it, and of course not worrying about it.

 

PS. One last thing worth considering, this especially if you think it's a "bladder thing" is that it could be BPH (benign prostate hyperplasia) which can restrict the urine flow from the bladder, thereby the residual urine in the bladder causes an infection, and this can be a re-occurring situation.

 

Back on the subject of prostatitis, is the fact that it is hard to diagnose because there is nothing which specifically says that it is this, and with it usually come other effects such as an aching in the perineum and possibly testicles as well as the rump, then sometimes a little feverishness and backache, not to mention feeling under the weather for quite a few days.

 

Early on in the piece it will be trial and error, so good luck in your efforts. 

 

 

 

 

 

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On 10/17/2018 at 6:43 PM, Sheryl said:

Most people with prostatitis do not suffer severe fatigue or other systemic issues. Those who tend to post on internet groups are more likely to be those who either have unusually severe symptoms or are ascribing everything they feel (real and sometimes imagined) to the condition. Try to take it easy and do not overly focus on every little ache, pain etc.

 

You have me confused with someone else, I've never lived on KPG or anywhere in that region.

Sheryl I am sorry I must have you confused with someone else.  

 

I was in Pattaya anyway and went to see Dr Nitti today.  The pain in my bladder realy escalated over the last 2 days so I decided to make a last minute appointment before I flew back today.  It looks like the Doctor in udon has misdiagnosed me, although Im not certain.  Dr Nitti examined my prostate and this time around it didnt hurt.  When the Udon Doctor examined the prostate it hurt like a swine, but there was a marked difference between the way Dr Nitti carried it out, and udon Doc carried out.  The Udon doc was pretty damned hard when he 'went in' which might be the reason it hurt.  Im not being crass when I say it was a borderline rogering he gave me i mean he was very very hard in his examination.  I just figured thats how they are carried out.  Dr Nitti just eased 2 fingers up and 'touched' the prostate a couple times.  It didnt hurt at all.

 

Urine test showed nothing bacterial or wrong in anyway.  Ultra sound showed nothing wrong also.

 

He said its probably not prostatitus and probably not a UTI, but the only way to be sure was to put a camera up my uretha to look inside the bladder as he susepcts the issue is bladder related.  The cost was 50,000 Baht, and there were no flights back to Udon untill Thursday (our return flight was today) so with 2 new flights, hotels and the examination I was looking at the best part of 75K just for that, not including the urine test and scans etc.  I dont have insurance and business has been tough this year (i made great money for years but ironically since I have spent all my savings on a house I lost my two biggest customers and the last year has been a struggle).  Long story short, I just couldnt afford it and said to the Dr if it is absolutely crucial I will do it, but is there another way?  Before I spend all this money?

 

He said he would give me the 'correct' antibiotics and various pills for bladder/prostate related issues, as maybe (just maybe) they will help. If they dont, i must go back in 2 weeks and have the camera thing.  When I say 'correct' antibiotics he actualy said the Udon Doctor had gave me the lowest form of antibiotic for prostate related issues so if it is that, those pills wouldnt have helped anyway.  

 

I am worrying about this quite a bit now.  I am not imagining this pain I promise you - driving back from the airport just now I felt every tiny bump in the road and my bladder hurts like a bugger.  I was close to tears last night with it.  But if its not prostate related, and the urine test/scans show nothing wrong, what on earth is wrong with me?  He said it is 'probably' not bladder cancer as I dont have the usual symptoms but who knows?

 

Im going to take the pills for 2 weeks and just hope to god i have nothing truly serious.  If after 2 weeks its no better I will take your suggestion and visit the hospital in Khon Kean as I suspect 50,000 baht might be a little extreme for the camera thing?  Plus flights and hotels to Pattaya?  And I know you are suggesting Kohn Kean not because it might be cheaper than bangkok Pattaya, but because it is a great hospital.  Im just assuming it would cost as much as BKK Pattaya.

 

Once again, thank you so much for your help.  It feels odd relying on a complete stranger for medical guidance, but it is sincerely appreciated very much indeed so again, thank you.  

 

 

 

 

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On 10/17/2018 at 6:46 PM, xylophone said:

First of all I do believe that Sheryl was right in as much as your symptoms sound very similar to having a UTI infection, so another course of antibiotics, once they have managed to culture something, would not go amiss.

 

I have suffered from prostatitis for 30 years or more and for a great deal of people it is fairly incurable!

Bacterial prostatitis should be able to be cured with antibiotics, but very often it is difficult to culture a particular bacteria from the prostate, although the best way to try is by the urologist giving the prostate a massage and collecting the prostatic fluid for culturing.

 

Even then it's possible that no bacteria will be found, and that's one of the problems with this, because if there is an infection and it is deep within the prostate, it is to a great extent untouchable, not only protected by the prostate itself but also by biofilms which shield the bacteria from antibiotics.

 

Having said that, you may be lucky with an extended course of many months of a particular antibiotic, so let's hope that is the case.

 

If it is nonbacterial prostatitis, then nobody knows what causes it, so if that's the case you have to live with it. But there are some good points in as much as the condition can settle down on its own for many months on end, before rearing its ugly head again.

 

Strangely enough, even though bacteria can't be proven, the antibiotic doxycycline does have a settling effect and was commonly prescribed for this condition, sometimes for three months at a time, and that did work for me............. until the next time, but at least I got some respite.

 

Anti-inflammatories can also help, which would seem to suggest that some sort of inflammation in the prostate is taking place.

 

I posted quite a few posts on this some while back to someone else who was suffering, so it may be worthwhile looking through the archives to find the articles because there were some promising outcomes with combining a couple of antibiotics/drugs and some of those posts might be of help to you.

 

One thing you do not want to do is to worry about it, because it does not lead onto anything else if it is nonbacterial prostatitis, and the symptoms can be allayed quite remarkably by those which I have mentioned above.

 

If it is actually bacterial prostatitis and it can be cultured, then you are in good shape to be able to treat it, but be prepared for a long treatment time and possibly different drugs.

 

Learning to live with it is very often one way to overcome it, and of course not worrying about it.

 

PS. One last thing worth considering, this especially if you think it's a "bladder thing" is that it could be BPH (benign prostate hyperplasia) which can restrict the urine flow from the bladder, thereby the residual urine in the bladder causes an infection, and this can be a re-occurring situation.

 

Back on the subject of prostatitis, is the fact that it is hard to diagnose because there is nothing which specifically says that it is this, and with it usually come other effects such as an aching in the perineum and possibly testicles as well as the rump, then sometimes a little feverishness and backache, not to mention feeling under the weather for quite a few days.

 

Early on in the piece it will be trial and error, so good luck in your efforts. 

 

 

 

 

 

I will reply to this properly tomorow - just a bit wiped out at the minute.  Thanks for the feedback.

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27 minutes ago, Batty said:

Sheryl I am sorry I must have you confused with someone else.  

 

I was in Pattaya anyway and went to see Dr Nitti today.  The pain in my bladder realy escalated over the last 2 days so I decided to make a last minute appointment before I flew back today.  It looks like the Doctor in udon has misdiagnosed me, although Im not certain.  Dr Nitti examined my prostate and this time around it didnt hurt.  When the Udon Doctor examined the prostate it hurt like a swine, but there was a marked difference between the way Dr Nitti carried it out, and udon Doc carried out.  The Udon doc was pretty damned hard when he 'went in' which might be the reason it hurt.  Im not being crass when I say it was a borderline rogering he gave me i mean he was very very hard in his examination.  I just figured thats how they are carried out.  Dr Nitti just eased 2 fingers up and 'touched' the prostate a couple times.  It didnt hurt at all.

 

Urine test showed nothing bacterial or wrong in anyway.  Ultra sound showed nothing wrong also.

 

He said its probably not prostatitus and probably not a UTI, but the only way to be sure was to put a camera up my uretha to look inside the bladder as he susepcts the issue is bladder related.  The cost was 50,000 Baht, and there were no flights back to Udon untill Thursday (our return flight was today) so with 2 new flights, hotels and the examination I was looking at the best part of 75K just for that, not including the urine test and scans etc.  I dont have insurance and business has been tough this year (i made great money for years but ironically since I have spent all my savings on a house I lost my two biggest customers and the last year has been a struggle).  Long story short, I just couldnt afford it and said to the Dr if it is absolutely crucial I will do it, but is there another way?  Before I spend all this money?

 

He said he would give me the 'correct' antibiotics and various pills for bladder/prostate related issues, as maybe (just maybe) they will help. If they dont, i must go back in 2 weeks and have the camera thing.  When I say 'correct' antibiotics he actualy said the Udon Doctor had gave me the lowest form of antibiotic for prostate related issues so if it is that, those pills wouldnt have helped anyway.  

 

I am worrying about this quite a bit now.  I am not imagining this pain I promise you - driving back from the airport just now I felt every tiny bump in the road and my bladder hurts like a bugger.  I was close to tears last night with it.  But if its not prostate related, and the urine test/scans show nothing wrong, what on earth is wrong with me?  He said it is 'probably' not bladder cancer as I dont have the usual symptoms but who knows?

 

Im going to take the pills for 2 weeks and just hope to god i have nothing truly serious.  If after 2 weeks its no better I will take your suggestion and visit the hospital in Khon Kean as I suspect 50,000 baht might be a little extreme for the camera thing?  Plus flights and hotels to Pattaya?  And I know you are suggesting Kohn Kean not because it might be cheaper than bangkok Pattaya, but because it is a great hospital.  Im just assuming it would cost as much as BKK Pattaya.

 

Once again, thank you so much for your help.  It feels odd relying on a complete stranger for medical guidance, but it is sincerely appreciated very much indeed so again, thank you.  

 

 

 

 

The hospital in Khon Kaen is a government hospital attached to a university. Even using their after hours clinic (which I recommend, in order to be treated by senior docs directly) costs will be about 1/4 that of the hospital you went to in Pattaya, so do not worry on that score.

 

Suggested urologist to ask for there:

 

Prof. Sombat Borwornpadungkitti

Prof. Kajit Pacheerat

 

There is also a very well regarded urologist at Khon Kaen hospital which is a different government hospital also in Khon Kaen. His name is Chagkrapan Predanon and he also has his own clinic on on Prachasamosorn Road. Mon-Fri 1800-2100 and Sat/Sun 09.30-1200. Directions are to go past the Centara Hotel heading out of town about 2-3 km. The clinic is in a line of small shops on your right just before the traffic lights. Tel 080 4037 474. This info is a couple of years old so could have changed, but worth a try.

 

it would greatly help if you could get a medical summary from Dr. Nitti including his recommendation for additional testing. Lacking that at least get your medical record from BPH to show. (Get from medical records department, just show your hospital number and ID, may be a small fee for photocopying).

 

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14 hours ago, Batty said:

The pain in my bladder realy escalated over the last 2 days

 

14 hours ago, Batty said:

I am not imagining this pain I promise you - driving back from the airport just now I felt every tiny bump in the road and my bladder hurts like a bugger.

In my experience, that of others and from what I have read, pain like that which you have described is not usually a feature of prostatitis, so something else could be happening...…...bladder stones are a possibility and can be very painful.

 

A cystoscopy will enable the urologist to view the prostate, bladder neck and the inside of the bladder, so that is an option you should consider and it is not painful and is over in about 10-15 mins.

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9 minutes ago, xylophone said:

A cystoscopy will enable the urologist to view the prostate, bladder neck and the inside of the bladder, so that is an option you should consider and it is not painful and is over in about 10-15 mins.

Although it should not be too painful it is not painless and as he is already in pain might require more pain control than the norm.  I also had one done in a government hospital and indeed that was the most painful few minutes of my life so it can make a difference who performs.  

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42 minutes ago, lopburi3 said:

Although it should not be too painful it is not painless and as he is already in pain might require more pain control than the norm.  I also had one done in a government hospital and indeed that was the most painful few minutes of my life so it can make a difference who performs.  

I feel for you on that.....I have had about 6 or 7 as well as self cathetering 3 times a day for weeks, with no real pain, a little uncomfortable perhaps, but as you say it can make a difference as to who does it.

 

IMO if the xylocaine gel is applied correctly and left for a few minutes before insertion then all should be well, but technique does matter.

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I am on Ciorofloxacin for Prostatitus for 6 weeks.

You dont have bladder cancer but yes if i was you i would get a Cystoscopy just  for peace of mind.but its not urgent and remember its painful.. but wait until after a CT scan and use of antibiotics first.

 

There are 2 types one had was   Rigid Cystoscopy which is better that they  put you to sleep and check your kidneys too.

 

I would be a bit skeptical of a 15000 qoute..does that include anathestists etc..sounds like he wont be putting u to asleep to do the full cystoscopy?

Your going to need to be watched after to make sure you can pee before going home...i dont reccomend you rush into this...

 

Now...yesterday i had a Cystoscopy and now my bladder is more sorer so expect your penis and bladder to be sore for at least a few weeks after.AND still taking antibiotics again for another 6 weeks.

 

Also buy Ural powders to drink to relieve the stinging.i am ural powders plus antibiotics after yhe cystoscopy

 

I hope they put you to sleep during the op...nothing worser than being awake and feeling the camera hit your urethra.watch a youtube vid

 

 

Do i think u need a cystoscopy urgently...No..you should give the antiobiotics time to work at least 6 weeks because mate your going be be no better off after the Cystoscopy..and just like me a feel like sOmeone kicked me in the bladder...and u def dont have cancer.you have same me prostitutus

 

But the best thing you can do NOW is to get a CT Scan done of KUB ...kidney urrthra bladder ..it will tell u of any tumours etc ...it takes 5 minutes in a xray machine.your urologist SHOULD of sent you for this.. mine did...he wouldnt do a Cystoscopy without it !

 

The urologist i saw said men who have big bellies have a problem sometimes with bladder pain(.belly over bladder)

 

AND he finds men ejaculate but dont urinate aftrerwards get bladder infections a lot.

 

Next step for you should be a CT Scan KUB...kidney bladder urethra....not the cystoscopy yet...see the results of the CT Scan if nothing shows...then continue on with the antibiotics but far better to get a CT Scan to see any tumours. 

If next year your still in pain then get then wait to get the cystoscopy, because as i said your going to be in worse pain after the cystoscopy for a few weeks just like i am believe me.penis stinging...peeing blood...bladder pain

 

I would be interested in your CT Scan KUB results. .  

 

 

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On 10/17/2018 at 6:46 PM, xylophone said:

First of all I do believe that Sheryl was right in as much as your symptoms sound very similar to having a UTI infection, so another course of antibiotics, once they have managed to culture something, would not go amiss.

 

I have suffered from prostatitis for 30 years or more and for a great deal of people it is fairly incurable!

Bacterial prostatitis should be able to be cured with antibiotics, but very often it is difficult to culture a particular bacteria from the prostate, although the best way to try is by the urologist giving the prostate a massage and collecting the prostatic fluid for culturing.

 

Even then it's possible that no bacteria will be found, and that's one of the problems with this, because if there is an infection and it is deep within the prostate, it is to a great extent untouchable, not only protected by the prostate itself but also by biofilms which shield the bacteria from antibiotics.

 

Having said that, you may be lucky with an extended course of many months of a particular antibiotic, so let's hope that is the case.

 

If it is nonbacterial prostatitis, then nobody knows what causes it, so if that's the case you have to live with it. But there are some good points in as much as the condition can settle down on its own for many months on end, before rearing its ugly head again.

 

Strangely enough, even though bacteria can't be proven, the antibiotic doxycycline does have a settling effect and was commonly prescribed for this condition, sometimes for three months at a time, and that did work for me............. until the next time, but at least I got some respite.

 

Anti-inflammatories can also help, which would seem to suggest that some sort of inflammation in the prostate is taking place.

 

I posted quite a few posts on this some while back to someone else who was suffering, so it may be worthwhile looking through the archives to find the articles because there were some promising outcomes with combining a couple of antibiotics/drugs and some of those posts might be of help to you.

 

One thing you do not want to do is to worry about it, because it does not lead onto anything else if it is nonbacterial prostatitis, and the symptoms can be allayed quite remarkably by those which I have mentioned above.

 

If it is actually bacterial prostatitis and it can be cultured, then you are in good shape to be able to treat it, but be prepared for a long treatment time and possibly different drugs.

 

Learning to live with it is very often one way to overcome it, and of course not worrying about it.

 

PS. One last thing worth considering, this especially if you think it's a "bladder thing" is that it could be BPH (benign prostate hyperplasia) which can restrict the urine flow from the bladder, thereby the residual urine in the bladder causes an infection, and this can be a re-occurring situation.

 

Back on the subject of prostatitis, is the fact that it is hard to diagnose because there is nothing which specifically says that it is this, and with it usually come other effects such as an aching in the perineum and possibly testicles as well as the rump, then sometimes a little feverishness and backache, not to mention feeling under the weather for quite a few days.

 

Early on in the piece it will be trial and error, so good luck in your efforts. 

 

 

 

 

 

Excellent  summary !

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15 minutes ago, georgegeorgia said:

I am on Ciorofloxacin for Prostatitus for 6 weeks.

You dont have bladder cancer but yes if i was you i would get a Cystoscopy just  for peace of mind.but its not urgent and remember its painful.. but wait until after a CT scan and use of antibiotics first.

 

There are 2 types one had was   Rigid Cystoscopy which is better that they  put you to sleep and check your kidneys too.

 

Now...yesterday i had a Cystoscopy and now my bladder is more sorer so expect your penis and bladder to be sore for at least a few weeks after.AND still taking antibiotics again for another 6 weeks.

 

Also buy Ural powders to drink to relieve the stinging.i am ural powders plus antibiotics after yhe cystoscopy

 

I hope they put you to sleep during the op...nothing worser than being awake and feeling the camera hit your urethra.watch a youtube vid

 

 

Do i think u need a cystoscopy urgently...No..you should give the antiobiotics time to work at least 6 weeks because mate your going be be no better off after the Cystoscopy..and just like me a feel like sOmeone kicked me in the bladder...and u def dont have cancer.you have same me prostitutus

 

But the best thing you can do NOW is to get a CT Scan done of KUB ...kidney urrthra bladder ..it will tell u of any tumours etc ...it takes 5 minutes in a xray machine.your urologist SHOULD of sent you for this.. mine did...he wouldnt do a Cystoscopy without it !

 

The urologist i saw said men who have big bellies have a problem sometimes with bladder pain(.belly over bladder)

 

AND he finds men ejaculate but dont urinate aftrerwards get bladder infections a lot.

 

Next step for you should be a CT Scan KUB...kidney bladder urethra....not the cystoscopy yet...see the results of the CT Scan if nothing shows...then continue on with the antibiotics but far better to get a CT Scan to see any tumours. 

If next year your still in pain then get then wait to get the cystoscopy, because as i said your going to be in worse pain after the cystoscopy for a few weeks just like i am believe me.penis stinging...peeing blood...bladder pain

 

I would be interested in your CT Scan KUB results. .  

 

 

I might add to that if you have a large belly that may have contributed to your bladder pain whilst driving

 

Right now after this Cystoscopy im laying on my side rather than sitting up.

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On 10/22/2018 at 8:03 PM, Sheryl said:

The hospital in Khon Kaen is a government hospital attached to a university. Even using their after hours clinic (which I recommend, in order to be treated by senior docs directly) costs will be about 1/4 that of the hospital you went to in Pattaya, so do not worry on that score.

 

Suggested urologist to ask for there:

 

Prof. Sombat Borwornpadungkitti

Prof. Kajit Pacheerat

 

There is also a very well regarded urologist at Khon Kaen hospital which is a different government hospital also in Khon Kaen. His name is Chagkrapan Predanon and he also has his own clinic on on Prachasamosorn Road. Mon-Fri 1800-2100 and Sat/Sun 09.30-1200. Directions are to go past the Centara Hotel heading out of town about 2-3 km. The clinic is in a line of small shops on your right just before the traffic lights. Tel 080 4037 474. This info is a couple of years old so could have changed, but worth a try.

 

it would greatly help if you could get a medical summary from Dr. Nitti including his recommendation for additional testing. Lacking that at least get your medical record from BPH to show. (Get from medical records department, just show your hospital number and ID, may be a small fee for photocopying).

 

Greatly appreciated Sheryl thanks so much.  We are heading over to Khon Kean today.

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23 hours ago, georgegeorgia said:

I am on Ciorofloxacin for Prostatitus for 6 weeks.

You dont have bladder cancer but yes if i was you i would get a Cystoscopy just  for peace of mind.but its not urgent and remember its painful.. but wait until after a CT scan and use of antibiotics first.

 

There are 2 types one had was   Rigid Cystoscopy which is better that they  put you to sleep and check your kidneys too.

 

I would be a bit skeptical of a 15000 qoute..does that include anathestists etc..sounds like he wont be putting u to asleep to do the full cystoscopy?

Your going to need to be watched after to make sure you can pee before going home...i dont reccomend you rush into this...

 

Now...yesterday i had a Cystoscopy and now my bladder is more sorer so expect your penis and bladder to be sore for at least a few weeks after.AND still taking antibiotics again for another 6 weeks.

 

Also buy Ural powders to drink to relieve the stinging.i am ural powders plus antibiotics after yhe cystoscopy

 

I hope they put you to sleep during the op...nothing worser than being awake and feeling the camera hit your urethra.watch a youtube vid

 

 

Do i think u need a cystoscopy urgently...No..you should give the antiobiotics time to work at least 6 weeks because mate your going be be no better off after the Cystoscopy..and just like me a feel like sOmeone kicked me in the bladder...and u def dont have cancer.you have same me prostitutus

 

But the best thing you can do NOW is to get a CT Scan done of KUB ...kidney urrthra bladder ..it will tell u of any tumours etc ...it takes 5 minutes in a xray machine.your urologist SHOULD of sent you for this.. mine did...he wouldnt do a Cystoscopy without it !

 

The urologist i saw said men who have big bellies have a problem sometimes with bladder pain(.belly over bladder)

 

AND he finds men ejaculate but dont urinate aftrerwards get bladder infections a lot.

 

Next step for you should be a CT Scan KUB...kidney bladder urethra....not the cystoscopy yet...see the results of the CT Scan if nothing shows...then continue on with the antibiotics but far better to get a CT Scan to see any tumours. 

If next year your still in pain then get then wait to get the cystoscopy, because as i said your going to be in worse pain after the cystoscopy for a few weeks just like i am believe me.penis stinging...peeing blood...bladder pain

 

I would be interested in your CT Scan KUB results. .  

 

 

Thanks so much for the reply.

 

The doc at Bangkok Pattaya hospital gave me these meds:

 

Levofloxacin 750mg per day

Prostagutt 320mg per day

Ibuprofen

 

So this was Monday.  My plan was to get back to Udon and then Tuesday or Wednesday go to Khon Kean as per Sherylls advice.  By Wednesday though, I am urinating quite normaly, in comparison to the last 3 weeks at least which has always been a trickle and a feeling of being full of pee all the time, even after urinating.  I woke up Weds morning and its been 80% normal.  So i thought hang on, maybe these news pills are working.  Based on that, decided not to visit KK and see if it improves.  Bladder pains seem to have stopped also.

 

Then last night (Thursday) I feel it creep back in a little.  Not the same as before but absolutley not urinating properly - still much better than last three weeks though.  Bladder pains are more like very slight twinges, and not actual real pain like before.  But then a new thing - lower back ache.  Feels like my left kidney, and low back area.  Its not real pain like 'doubled over in agony' type pain, feels like i have been lifting something heavy all day and now my back is aching a bit.  The bladder is now twinges and very low pain spasms.  I am urinating normaly though.

 

So we are off to KK today.  I should have gone 2 days ago.  

 

I will ask the doctor for blood and urine tests and a CT scan - appreciate the advice on that and to be honest, anything to avoid that camera up the uretha.  I cant bare the thought of that at all.

 

Its a mind game, all this.  Whenever I have been sick with something before it has always been a 4 or 5 day thing and and immediate diagnosis.  This is different, its coming up to 4 weeks now, I have no clue what is wrong with me and the symptoms seem to be swapping around and changing every few days.  I have been diagnosed with a UTI at Bumrungrad, then told that is incorrect by Udon Urologist who said I have prostatitus, then told that is incorrect by Bangkok Pattaya hospital who said my prostate feels normal - but gave me meds for infected prostate anyway.  It seems I cant get an actual confirmed diagnosis and in the meantime I lie in bed all day allowing my imagination to run wild, worried sick someone has missed something serious.  After all my Dad had prostate cancer, my mother died from cancer, my sister has had it and a whole list of aunts and uncles have had one form or another of it.  Im trying to get a grip and think logically because the chances are this is only a prostate infection or something but i cant stop thinking the worse.

 

One thing I should note - and I dont think Sheryl will appreciate this (being from a medical background, I guess) the severe bladder pains I had for 2 or 3 days might be related to a herbal drink the local Chinese medicine doc gave me.  I went there last week with the wife and asked for something to help with prostate/gall stone issues.  he gave me a bag of what looked like twigs, leaves, and something that resembled an old birds nest with the instruction to brew it up and drink three times in one day.  The bladder pain started the very next day, so im guessing there is a chance it might be related to that because my wife now tells me 'the drink causes pain while it fights the bad stuff'.  I know, it sounds stupid - but these people have been knocking up herbal stuff for 5000 years and I figured it wouldnt hurt to try.  Of course I dont know for certain if that caused the bladder pain, but there is half a chance.

 

Anyway, off to KK hospital today so I will ask for the tests and CT scan.  Maybe have to check in for a couple of days I guess.

 

Thank you all so much for the feedback and advice - its truly appreciated.

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The camera up the urethra (cystoscopy) is really no so bad. A local anesthetic is used to completely numb the urethra. And it is a very tiny, tiny camera attached to a long tube that is not too large. Nothing like what you may be imagining. You could tell the doctor you are scared of the test and request mild sedative beforehand (or self medicate if you have any on hand). Just don't drive after taking.

 

Don't tie the doctor's hands by refusing medically indicated tests.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

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41 minutes ago, Batty said:

Thanks so much for the reply.

 

The doc at Bangkok Pattaya hospital gave me these meds:

 

Levofloxacin 750mg per day

Prostagutt 320mg per day

Ibuprofen

 

So this was Monday.  My plan was to get back to Udon and then Tuesday or Wednesday go to Khon Kean as per Sherylls advice.  By Wednesday though, I am urinating quite normaly, in comparison to the last 3 weeks at least which has always been a trickle and a feeling of being full of pee all the time, even after urinating.  I woke up Weds morning and its been 80% normal.  So i thought hang on, maybe these news pills are working.  Based on that, decided not to visit KK and see if it improves.  Bladder pains seem to have stopped also.

 

Then last night (Thursday) I feel it creep back in a little.  Not the same as before but absolutley not urinating properly - still much better than last three weeks though.  Bladder pains are more like very slight twinges, and not actual real pain like before.  But then a new thing - lower back ache.  Feels like my left kidney, and low back area.  Its not real pain like 'doubled over in agony' type pain, feels like i have been lifting something heavy all day and now my back is aching a bit.  The bladder is now twinges and very low pain spasms.  I am urinating normaly though.

 

So we are off to KK today.  I should have gone 2 days ago.  

 

I will ask the doctor for blood and urine tests and a CT scan - appreciate the advice on that and to be honest, anything to avoid that camera up the uretha.  I cant bare the thought of that at all.

 

Its a mind game, all this.  Whenever I have been sick with something before it has always been a 4 or 5 day thing and and immediate diagnosis.  This is different, its coming up to 4 weeks now, I have no clue what is wrong with me and the symptoms seem to be swapping around and changing every few days.  I have been diagnosed with a UTI at Bumrungrad, then told that is incorrect by Udon Urologist who said I have prostatitus, then told that is incorrect by Bangkok Pattaya hospital who said my prostate feels normal - but gave me meds for infected prostate anyway.  It seems I cant get an actual confirmed diagnosis and in the meantime I lie in bed all day allowing my imagination to run wild, worried sick someone has missed something serious.  After all my Dad had prostate cancer, my mother died from cancer, my sister has had it and a whole list of aunts and uncles have had one form or another of it.  Im trying to get a grip and think logically because the chances are this is only a prostate infection or something but i cant stop thinking the worse.

 

One thing I should note - and I dont think Sheryl will appreciate this (being from a medical background, I guess) the severe bladder pains I had for 2 or 3 days might be related to a herbal drink the local Chinese medicine doc gave me.  I went there last week with the wife and asked for something to help with prostate/gall stone issues.  he gave me a bag of what looked like twigs, leaves, and something that resembled an old birds nest with the instruction to brew it up and drink three times in one day.  The bladder pain started the very next day, so im guessing there is a chance it might be related to that because my wife now tells me 'the drink causes pain while it fights the bad stuff'.  I know, it sounds stupid - but these people have been knocking up herbal stuff for 5000 years and I figured it wouldnt hurt to try.  Of course I dont know for certain if that caused the bladder pain, but there is half a chance.

 

Anyway, off to KK hospital today so I will ask for the tests and CT scan.  Maybe have to check in for a couple of days I guess.

 

Thank you all so much for the feedback and advice - its truly appreciated.

Well, you certainly seem to be "all over the place" with this and with the advice you have been given, but then that's not surprising as prostatitis, if indeed that is what it is, is still a bit of a medical mystery according to one of the leading urologists in the USA.

 

A couple of things here though, I notice you have been given levofloxacin, and that antibiotic can come with some side effects, whereby it can cause tendons to weaken and tear and it is one of the drugs I steer away from completely, because it has that effect on me.

 

Interesting to note that one hospital diagnosed you with a UTI, yet another one didn't, and yet another urologist examined the prostate, said that it appeared normal and then gave you antibiotics. As I said in a previous post, because an infection of the prostate is very hard to access (by antibiotics) and can't always be identified, then fairly long-term antibiotics are sometimes prescribed, however if I were in that position again I would not choose one of the quinolones (ciprofloxacin, levofloxacin etc) for that.

 

The Prostaglutt tablets you have been prescribed are mostly saw palmetto (from what I can gather) and neither that nor the other many natural remedies which have been "proposed"/used in the past seem to have any real effect on prostatitis/the prostate because nothing has been proven in that regard. I say this, even though beta sitosterol "seems" to help in my case.

 

One thing I will state again for you, is that a cystoscopy, performed by a caring urologist who ensures that the "numbing gel" has had time to work in your urethra, is not painful and I have had enough of them to know, as well as carrying out the same procedure with catheters over a total of many months.

 

It appears that a couple of posters have had an unpleasant experience with this procedure, but I would suggest that the vast majority of folks who have had it view it as just another procedure which feels just a little uncomfortable at worst, and if it could be the "window" into viewing what is causing your symptoms, then it has to be worth a try.

 

Good luck in your endeavours and please update this thread as there would be a lot of folks in similar situations who are keen to know the outcome.

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8 minutes ago, xylophone said:

It appears that a couple of posters have had an unpleasant experience with this procedure,

I am one of those - but as said it was one of the three I have had and by an inexperienced training doctor.  That was 2 years ago and had another two months ago and with that no more than the normal slap on arm type pain as it starts its trip.  It is not something to fear and is required to obtain samples and get a good view for many things.  Another completely safe and painless test first test might be ultrasound.  It found my suspect cancer and can often find stones. 

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Thanks everyone for the replies and feedback, and sorry for the delay in replying.  I did go to see Dr Catchit at Khon Kean Hospital - thanks Sheryll for the advice on that.  Out of the three docs I have seen so far he is by far the best.  It took a good few hours to get in and see him, despite getting there at 7am - but it was worth it.  He asked a ton of questions, way more than any other doc so far, and gave me two pretty thorough exams.  He even asked the wife to join the room so she could answer some questions relating to my general day to day health, from an observers point of view I guess.  

 

The only downside is he could not tell me exactly what is wrong, not yet anyway.  I had a blood test and urine test and have to go back this Saturday morning to see him again, so a full 7 days since I did the test.  Only then can he be more precise.  Dr Catchit only works Saturday mornings but as Sheryll pointed out he truly is the best in the area.

 

He did give me some extra pills to take, something that relaxes the bladder and prostate, and told me to continue with the levofloxacin 750mg per day.  The good news is I have been feeling much better this week, I still feel something is wrong in the bladder area but there is zero pain now (discomfort but no pain) and I am peeing almost normaly now, and only visit the loo half as much.  So thats great.  The downside is I think I am suffering side affects of the Levofloxacin.  Nothing too horrible, just a constant low level dizzy feeling and foggy and have no energy to do anything.  Its unnerving a little as the confidence in my own health has been shaken a bit this last month, so I hope they are symptoms of the pills and nothing else.  It feels almost like a head cold, but with no other symptoms - just a dizzy feeling.  

 

Another appointment on Saturday then and its a long day all the waiting around and getting in line (20 minute line up with other patients to have BP taken lol) but well worth the wait as he truly does seem like a Urologist who actualy cares quite a bit, compared to the others. So again Sheryll, thanks for that I wouldnt have gone there if not for your suggestion.

 

And indeed thanks to everyone on here, it is all great advice and appreciated very much.

 

Ill post back on Saturday when I have seen him.

 

Something else that might be linked to this is sleep apnea, I have been struggling with that for the last couple of months.  I wake up usually 30 minutes after falling asleep having stopped breathing and my heart racing wildly.  It always passes after 30 seconds or so but it happens almost every night, 2 or 3 times, over the first couple of hours.  Never in the mornings, only just after I have started sleeping.  Im not realy much of a drinker, and I have lost weight through excercise and diet in the last few months so it has been totaly out of the blue. I have found something on-line which says there is possibly a link between sleep apnea and prostate issues?  When this prostate thing (or whatever it is) is over I will check into Brumrungrad for a sleep test.  Pricey, but worth it, I guess.

 

Thanks again

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On 10/17/2018 at 6:08 PM, Batty said:

 

I hope it improves for you soon - thanks for the feedback.

When I have a flair up I double my dose of finisteride and double my dose of saw palmento usually takes about four or five days and back to normal. Spicy food will set it off

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Truly sorry to drag this thread on even more - but I am again a little lost what to do here.

 

I went back to KK hospital yesterday (Saturday) to see the Urologist Prof.  I told him that for the last few days I have had no bladder pain and peeing normaly, and this is my last day on the levofroxacin.  He said my PSA was normal (low actualy), prostate still feels normal and urine test was fine so he could not say what the issue was, but whatever it was it has gone now so no more pills, just go home all is well.

 

Then I woke up today with bladder pain again.  Its back, just as it was before.  Seems I had a few days of respite and it has reared its ugly head again.  Im guessing then that this is either bladder stones or bladder cystitus.  Youve gotta figure its one of those two issues?

 

So my options, I guess, are:

 

Go buy some levofroxacin from the pharmacy and start taking them again, in the hope it kills off whatever the issue is.  Maybe it wasnt completely eradicated before and I need another week or two back on them.

 

Or, go to hospital and have a cystoscapy to 'see' inside the bladder.

 

Or, go to hospital and have a CT scan.

 

Im not looking forward to the cystoscopy and just wondered if going private at bangkok Udon hospital will be a safer bet for the procedure.  From what I can gather, the level of discomfort/pain depends on who does the procedure.  Am I wrong in thinking there is a better chance of less pain at a private hospital?  The downside is the cost, probably.  But its going to be in and out in a couple of hours.  KK hospital seems to have great doctors but my god the system is terrible, you have to get there at like 7am just to get in line and see a doc by 10 or 11am.  Hundreds of people in every area of the hospital looking fed up and tired of waiting.  Thats not too much of an issue if your just having a check up, but the thought of all that messing around for hour upon hour lying around on gurneys for a cystoscopy is pretty daunting.

 

CT scan would be nice and easy compared to the cystoscopy but obviously I want the most relevant/necessary, not the most comfortable.

 

Im realy fed up with this now.  I have said before, there are far worse things that people are suffering with and im lucky this is a treatable thing and not in any way serious (probably) but its been 4 or 5 weeks now, 4 different hospitals, flights, hotels, 4 hours round trip drives each saturday... I thought it had gone away and then it hits me hard this morning its such a bloody drag and im lost what to do now.

 

Again, sorry to drag this on I appreciate its probably getting repetitive now but I am struggling to figure out what my next move should be.  As always, any advice very much appreciated.  Thanks so much.

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I had pain but believe it was an exception and that public hospital likely as good or better bet than many private hospitals on basis doctors will likely have more experience doing.

 

Another test that can discover things is ultrasound and that is cheap, painless and no radiation - that was used before cystostomy in my case.

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3 minutes ago, lopburi3 said:

I had pain but believe it was an exception and that public hospital likely as good or better bet than many private hospitals on basis doctors will likely have more experience doing.

 

Another test that can discover things is ultrasound and that is cheap, painless and no radiation - that was used before cystostomy in my case.

Thanks Lopburi.  I have had three ultra sounds now over 5 weeks and they couldn't see anything.  If it is bladders stones and they are small, an ultra sound wont pick that up apparently.  Same for cystitus.  I guess my only option is CT or cystoscopy.  There is a local army hospital in Udon that can do both but i just have this (possibly wrong) notion in my mind that an army/government hospital might be a bit more brutal than private.  But then even just typing that statement out seems silly, I have nothing to base that opinion on, just how I imagine it.

 

 

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3 minutes ago, lopburi3 said:

I had pain but believe it was an exception and that public hospital likely as good or better bet than many private hospitals on basis doctors will likely have more experience doing.

 

Another test that can discover things is ultrasound and that is cheap, painless and no radiation - that was used before cystostomy in my case.

As LB and I have said before a painless cystoscopy is the norm with a few rare exceptions so see the most experienced urologist and BEFORE it goes ahead and at your meeting with him ask if he will be using the numbing gel, Xylocaine gel, during the procedure...…….this is a must for pain free experience.

 

At least this will show up any abnormalities and then you will certainly know. As for ultrasound, well yes a good option to try first, however in my experience with this the results have been mixed and have never shown the true nature of the condition, hence me going ahead with the cystoscopy.

 

Taking the Levofloxacin is an option however it is a pretty powerful antibiotic with possible long reaching side effects.

 

If it were me the cystoscopy would be my next move, with perhaps the ultrasound given a try first (inexpensive and quick).

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I can recall basic training but would not associate it with hospital care.  Although the only time I used a US military hospital, as a civilian, was not impressed (wanted to do nuclear scan due my white coat blood pressure - scheduled blood tests only valid for different race).

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