Prostatitis

[Lorry]

There was a thread about this in 2016, long closed.

 

I am suffering from prostatitis for 6 weeks now. Just like Mike555 wrote in 2016, i got it after unprotected sex with a girl. She turned out to have vaginosis with god knows which bacteria. I had a burning head of the penis first, 2 weeks later developed symptoms of prostatitis. No urethritis, no burning when peeing, no discharge, no visible symptoms. 

I also have a very tight bladder neck. I had a bladder neck incision 10 years ago, peeing got a lot better, but now it's back to where it was, even I take Tamsulosin.

At the time,  the urologist told me "if you were 10 years older,  i would have recommended TURP". (I am now 65)

 

I went to 9 different doctors,  got lots of antibiotics for STDs even STI PCR  were all negative (done twice) and then the advice "nothing can be done".

I then went to Dr Umaporn (recommended by Mike555 in the old thread), she did a prostate massage and found Klebsiella in the culure, sensitive to Levofloxacin.

I have now taken Levofloxacin for 11 days, no real improvement so far. 

 

I will make an appointment with Dr Suntchai (also recommended by Mike555).

The urologist at Bangkok Hospital who said nothing can be done suggested to see Dr Damrongpan there. He has a machine www.qrspelvicenter.net. Does anyone know anything about this? 

 

I would be very happy for any advice. 

[Sheryl]

The link you provide seems to be training in pelvic floor exercises, useful for incontinence but hard to see what that would have to do with prostatitis unless there is oemthing nto shown on the website.

 

Bacterial prostatitis takes very long courses of antibiotic to treat.4-6 weeks is not unusual.  So that you don't feel better after 11 days in itself does nto mean you need a different treatment. That said, antibiotic resistance is common. Did your culture report show antibiotic sensitivities?

[Lorry]

5 hours ago, Sheryl said:

Did your culture report show antibiotic sensitivities

Yes. Sensitive to levofloxacin.

What worries me a bit is that it showed sensitivity to some other antibiotics (ceftriaxon, augmentin) that i had taken before (but less than 2 weeks) without any effect. 

[Sheryl]

16 hours ago, Lorry said:

Yes. Sensitive to levofloxacin.

What worries me a bit is that it showed sensitivity to some other antibiotics (ceftriaxon, augmentin) that i had taken before (but less than 2 weeks) without any effect. 

As explained, usually a very long course of antibiotic is needed for prostatitis.

 

Levofloxacin penetrates prostate tissue better than the other antibiotics you mention

 

Whatever you do, do nto prematurely stop antibiotics based on not seeing a result quickly, unless advised to do so by a urologist.

 

A repeat culture may be recommended after a few weeks

 

Exactly what symptoms are troubling you? You say "No urethritis, no burning when peeing, no discharge, no visible symptoms". Is it just difficulty urinating? If so doxazosin sometimes works better than tamsulosin but discuss with Dr. Umaporn first.

 

Since Dr. Umaporn was able to identify a casuative organism I wonder why you are planning to go to yet another doctor If it were me I'd be inclined to follow through with her first.

 

It is possible your trouble peeing is due to the bladder neck issue (maybe some new scarring) which would need totall y different measures but clear up the infection first

[The Hammer2021]

Bad news that unprotected sex can lead to  such a complex,  demoralising ailment. Prostratis comes and goes. I think I got mine from a massage. It went eventually and I remember the the length of Anti biotic course too a long time after I recovered I now  have to take medication  daily.

For anybody reading this tale of woe- ALWAYS use a condom...

[Lorry]

40 minutes ago, Sheryl said:

Exactly what symptoms are troubling you?

Pain at the perineum,  and burning pain at the head (glans) of the penis (outside, the skin of the glans is burning,  not the foreskin and not the urethra inside).

Peeing is not worse than before the prostatitis.

40 minutes ago, Sheryl said:

 

Whatever you do, do nto prematurely stop antibiotics

Yes, certainly. (All the other doctors before Dr  Umaporn told me to stop antibiotics...:()

 

40 minutes ago, Sheryl said:

 

A repeat culture may be recommended after a few weeks

Good idea

 

40 minutes ago, Sheryl said:

I wonder why you are planning to go to yet another doctor

For prostate drainage several times a week.

But in the meantime i learned that this is quite controversial,  so maybe i first just try levofloxacin for 4 weeks. Not sure what to do.

40 minutes ago, Sheryl said:

 

It is possible your trouble peeing is due to the bladder neck issue (maybe some new scarring) which would need totall y different measures but clear up the infection first

Yes, exactly my thoughts. 

[Lorry]

20 minutes ago, The Hammer2021 said:

unprotected sex can lead to  such a complex,  demoralising ailment

Yes, the first doctors examined and empirically treated the usual STIs (Go, Chlamydia, Mycoplasma, Ureaplasma, Trichomonas - PCR all negative, twice).

Then the urologists at Samitivej and Bangkok hospital both diagnosed prostatitis, and both advised to stop antibiotics...

20 minutes ago, The Hammer2021 said:

ALWAYS use a condom...

Yes. We have known each other for 4 years,  this was the first time without condom.  Had we checked for STIs before sex it wouldn't have helped because this isn't a STI.

 

20 minutes ago, The Hammer2021 said:

It went eventually

May I ask where you were treated?

[Sheryl]

2 hours ago, Lorry said:

Pain at the perineum,  and burning pain at the head (glans) of the penis (outside, the skin of the glans is burning,  not the foreskin and not the urethra inside).

 

This sounds like it might be balanitis, which is most often due to a fungal infection. Antibiotics such as you are taking for the prostatitis can worsen fungal infections by disrupting normal skin flora.

 

It might help to apply an antifungal cream to the outside of the glans. Any pharmacist can suggest one, look for something that contains clotrimazole or simliar.

[bkk6060]

For any Prostatitis symtoms, I suggest to not sit so much and get plenty of exercise, eat a recommened diet.  Also, ejaculate as much as possible. Maybe train your suspected STI lady to do a prostate massage for you.  Masturbation is okay, just keep continuing to clean it out.

 

[The Hammer2021]

9 hours ago, Lorry said:

Yes, the first doctors examined and empirically treated the usual STIs (Go, Chlamydia, Mycoplasma, Ureaplasma, Trichomonas - PCR all negative, twice).

Then the urologists at Samitivej and Bangkok hospital both diagnosed prostatitis, and both advised to stop antibiotics...

Yes. We have known each other for 4 years,  this was the first time without condom.  Had we checked for STIs before sex it wouldn't have helped because this isn't a STI.

 

May I ask where you were treated?

BTW I was not trying to preach about the condom thing. Just that we  all need reminding and it's not  just aid. I was treated at BPH. I was in serious agony in my bolleaux so first was broad spectrum AB till lab results then changed  AB. But even after it cleared according to lab I requested a further 2 weeks of AB to the  limit.

[Lorry]

13 hours ago, Sheryl said:

This sounds like it might be balanitis

This was one of the first diagnoses I got, even there is nothing visible.

Took fluconazol 200mg 11 days (no effect), and bifonazol cream more than 2 weeks (the cream made the burning sensation worse).

 

The urologist recommended lidocaine cream, yes, of course it helps. But it's not exactly a therapy. 

Steroid cream also helps, I tried one for 4 days now (recommendation from dermatologist). This just proves an inflammation, although no redness. The cream also contains some disinfectant, I would be reluctant to use pure steroids as long as I suspect some infection. 

Bepanthen cream with added chlorhexidine also helps a little bit.

[Lorry]

12 hours ago, bkk6060 said:

, ejaculate as much as possible

I think so,  too.

But its not easy to get in the mood when it's burning down there.

????

[Lorry]

6 hours ago, The Hammer2021 said:

BTW I was not trying to preach about the condom thing. Just that we  all need reminding and it's not  just aid. I was treated at BPH. I was in serious agony in my bolleaux so first was broad spectrum AB till lab results then changed  AB. But even after it cleared according to lab I requested a further 2 weeks of AB to the  limit.

It is nice to hear that something can be done.

Too many doctors told me there is nothing that can be done.

Which doctor did you go to?

[The Hammer2021]

2 minutes ago, Lorry said:

It is nice to hear that something can be done.

Too many doctors told me there is nothing that can be done.

Which doctor did you go to?

I will get his name next week for you. Twice I've had it and both  times it went  away. I'm sure it will go away eventually with the appropriate antibiotics for the  correct duration of time and the usually attempts at good  health  care and urinary  tract health care drinking extra  water etc.. I am old BTW . I also have to take  a daily medication.

[CanNot]

One warning to levofloxacin you take. As its a quinolone antibiotic it has a black box warning and can have devastating and long lasting adverse effects.

 

I don't want to scare you but as being affected I felt I need to let you know.

[HauptmannUK]

I suffered with prostatitis and balanitis a couple of years ago. Probably acquired in the same way. Took  about three months to shift with ciprofloxacin (has associated risks) and an antifungal/antibacterial cream for the balanitis.  It was quite a 'long haul' but did eventually get rid of it....

Here is UK NHS treatment advice....

https://www.nice.org.uk/guidance/ng110/chapter/summary-of-the-evidence

 

[Lorry]

On 9/1/2022 at 5:51 PM, The Hammer2021 said:

I will get his name next week for you. Twice I've had it and both  times it went  away. I'm sure it will go away eventually with the appropriate antibiotics for the  correct duration of time and the usually attempts at good  health  care and urinary  tract health care drinking extra  water etc.. I am old BTW . I also have to take  a daily medication.

Can you still get his name? 

Thx

[AsianAtHeart]

If it's a fungal infection, as has been mentioned, antibiotics may work counter to what needs to be done.  Bacteria, fungi, and molds all compete with each other, and killing one (bacteria, in this case) may make it easier for others (like fungi) to take over. 

 

I would wonder if what you have is actually yeast infection--which is something many women have but without significant symptoms.  If so, it's quite similar to a fungal infection, and I would suspect that a hot shower would make it feel worse.  You may prefer to keep things cooler down there.  Yeasts feed on sugar--they absolutely love it.  So one way to get ahead of it would be to reduce your consumption of sugars--down to zero, if possible--and keep your diet simple for awhile.  This will also help to strengthen your immune system, so regardless of the cause, it can't hurt to take these simple measures.

 

I would be curious if rubbing a little yogurt, for the bacteria, would do any good--but would hesitate suggesting it without you first doing a little research and/or consulting your doctor (who may never have even thought of doing such a thing).  I know, if I were in your place, I might be willing to experiment a bit.  No one would like to have such discomfort for very long.

 

I have avoided antibiotic soaps and shampoos for many years, after realizing that they increased the risk of fungal infections--so that might be something to consider if it applies in your case.  These days with all the alcohol craze, I have managed to avoid it 99.9% of the time--again, because I don't want to disrupt the natural flora of my skin.  But I doubt you've been putting any of that down there.

[Lorry]

47 minutes ago, AsianAtHeart said:

If it's a fungal infection, as has been mentioned, antibiotics may work counter to what needs to be done.  Bacteria, fungi, and molds all compete with each other, and killing one (bacteria, in this case) may make it easier for others (like fungi) to take over. 

 

I would wonder if what you have is actually yeast infection--which is something many women have but without significant symptoms.  If so, it's quite similar to a fungal infection, and I would suspect that a hot shower would make it feel worse.  You may prefer to keep things cooler down there.  Yeasts feed on sugar--they absolutely love it.  So one way to get ahead of it would be to reduce your consumption of sugars--down to zero, if possible--and keep your diet simple for awhile.  This will also help to strengthen your immune system, so regardless of the cause, it can't hurt to take these simple measures.

I have been thinking along these lines, too.

There are doctors who give antifungals in these cases,  and I just started this today.

[Lorry]

PS the Balanitis (burning head of penis,  but nothing visible) improved and disappeared completely on ciclopirox, an antifungal cream.  Maybe coincidence,  maybe there is really some fungus. 

[Sheryl]

19 hours ago, Lorry said:

PS the Balanitis (burning head of penis,  but nothing visible) improved and disappeared completely on ciclopirox, an antifungal cream.  Maybe coincidence,  maybe there is really some fungus. 

Balanitis is usually fungal