Chronic "Non-Bacterial" Prostatitis - 11 Years and Counting - Help?

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I’m a 45 year old male that has been fighting what I have been diagnosed as chronic non-bacterial prostatitis for many years. About 11 years ago I suddenly had frequent urges to urinate (no burning, just felt the need to pee all the time), I went to my PCP  and he said prostate (in which I didn’t even know what one was let alone how it was checked) was “boggy” and wasprescribed antibiotics. The symptoms went away for about 6 months and returned the following January (2008). He referred me to a Urologist and he also said prostate was “boggy”. He looked at a CT scan that I had done (for stomach pain about the same time) and said that I was constipated, don’t know if that helps any. He performed a cystoscopy and said there was a little bit of inflammation. After a year or so of the same symptoms on and off without any successful treatment, decided to get a second opinion. I saw another Urologist and got basically the same diagnosis. He also performed a cysto. while performing my vasectomy with the same results, a little inflammation. After about 2 years as his patient and trying several different meds, I went to a Urologist at Baylor and during the first visit he wanted to do another cysto. for himself.  I didn’t want to do that, so I never went back. I then saw another Urologist and she said that upon doing my DRE that I had hemorrhoids (internal?) and pelvic muscle spasms and needed to try Biofeedback, because she thought that initially it might have been Prostatitis, but now the pelvic muscles were “confused” and that Biofeedback and Kegel exercises would help. I tried twice and immediately knew that wasn’t going to help. That is the last Urologist I’ve seen, since Oct. 2015. I went and saw a new Urologist today and he seems to be the worst. Wants me to come in on Friday to do a urine flow test and bladder ultrasound. He just came from surgery (ran really late) and had a waiting room full of patients waiting, so I may give hime the benefit of a doubt...this time. 

 

I don’t fit the traditional Prostatitis or OAB symptoms, because there is never any pain while urinating or during sex, back pain or fevers (sometimes get a little nausea like being kicked in the groin). I do have a weak stream only during my flare-ups, otherwise pee like a horse. Never had any leakage, no blood or infection in the urinalysis. Where I do fit is that I am overweight (6’2” – 265 lbs., but was about 40 pounds lighter when this all started), I sit most of the day (at a PC, but try to get up and walk around as often as I can remember to) and am somewhat inactive. During a flare-up, after urinating I can wait a few seconds and always push out a little more once or twice. Standing up takes away the urge a little, but does get worse if I try to do any physical activity. My rectum up to behind my pubic bone feels very irritated, which makes my whole body sensitive to anyone even touching me or loud noises. I can urinate and then have a bowel movement and then urinate a lot right afterword (don’t know if that helps either). I have severe obstructive sleep apnea, so I do sleep with a c-pap. When I don’t use it I get up about 4-6 times in about a 7 hour period (even when I’m not having a flare-up). Flare-up’s can come unexpectedly every few weeks or every few months, there hasn’t been any real consistency or pattern. They can last from as little as a couple of weeks to a couple of months. Ibuprofen, anti inflammatories, herbs, cutting out caffeine and spicy foods (don’t ever drink alcohol or smoke), walking ect. don’t seem to have any affect or give any/much relief. My current PCP automatically sends in an RX for Cipro whenever I start to have a flare-up, that seems to help more often than not (or may just have some Placebo effect, however nothing else does). I know that stress/anxiety contribute to my discomfort, but after this many years it’s hard not to. One Urologist once told me to go to Walgreens and buy some “Stress Tabs”, but that didn’t help either.  I’ve read that some Dr.’s prescribe Valium to help? I do remember when I was about 20 there were nights that I would have to get up several times to go to the bathroom, but never excessively (or urgency) during the day. I did have some kind of infection about 22 years ago where there was pus coming out of my penis and it burned to pee. There was no sexual activity, so I know it wasn’t because of that and it went away on its own. That was 11 years before my current symptoms started, so my bet there is no correlation between the two, but just in case throw that out there. Between flare-ups I don’t generally have any issues, I can go 4-6 hours between having to go to the bathroom and even then it’s not urgently, no irritation at all, I go back to having practically a normal life. I’ve had the bladder scan done several times to see if I’m emptying the bladder and it’s always empty. DRE exams are almost always “boggy”, whatever that means. I do remember that on follow up visits they would say that the prostate felt “normal” again. What I haven’t ever had done are CT or MRI scans of the pelvis during a flare-up, I’ve read that inflammation can be seen by those?

This new Urologist says that the most effective drug is Flomax, it doesn't help the current flare-up, but helps prevent the next? Anyone heard of that? I do remember that I took it for a while several years ago and don't remember it helping at all.  I don't know how long I took it for, so possibly didn't take it long enough?  He is one of those Dr.'s that believes that all Prostatitis cases are due to infection even though not detectable. 

Long story short, I accept (but not happy about it) that this may be the pattern the rest of my life.  During my flare-ups my quality of life sucks and I am miserable. What I need is something that can help me tolerate them during their worst. If anyone has any ideas of what could be causing them or what I can use to ease the tension/stress during the meantime, please shoot them my direction. I'm just sick of it and really at the end of my rope.

 

During these flare-ups my quality of life is nil and not only affects me, but everyone around me as well. I see no end to this pattern and dread knowing that there will be a next flare-up, just when is the question. This has prevented me from going back to school and even pursuing other employment opportunities. I’ve exhausted myself researching and have run out of places to go, would you have any ideas or suggestions of what it might really be?

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  • Posted

    You may have a bad case of chronic constipation. Impacted stool can push on your urethra and prostate, giving symptoms you described, similar to BPH. 

    Hank

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    • Posted

      I asked the Uro. today and he didn't think so, which he rather quickly dismissed. I've heard both arguments, but this one didn't give any except for he didn't think so. After I do have a bowel movement wouldn't it quickly go back to normal relatively quickly or does that cause the irritate the prostate for days to weeks?

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    • Posted

      If you have chronic constipation, a bowel movement only pushes out a little bit near the rectum. Stool is still packed solid in the rest of the colon. Many people on this forum, including myself in the past,  had this problem and not every uro knows this (too bad). Only you can determine how serious a problem it is on you. If you have regular BM regularly than it's not it.

      Hank

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    • Posted

      That makes sense, unfortunatley I don't "know" if there is or not. I had a bowel movement on Wed. and then didn't have one until Sunday. Not to be gross, but Sunday had a good sized stool and two on Monday.  If I'm not empty then I've really got some problems. Question is, let's say I'm cleared out and no stool in the colon. Can the irritation from rubbing the prostate last days or weeks?  I know I've been cleaned out before and still had irritation afterwards. Of course then I've eaten again and probably been plugged up and started all over.

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    • Posted

      ..Can the irritation from rubbing the prostate last days or weeks? ..

      For days, sure. For weeks, maybe. All that poop going bad can cause irritation and even infections to many things nearby so it depends how blocked and how much. 

      No BM between Wed and Sun .... Yes, you have constipation. Try to fix it, you may find significant relief. It may take a while to really remedy the whole situation. The problem is that you think you are OK after a good BM, but the reality is that you quickly pack it in the other end. 

      Hank

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    • Posted

      I asked the Urologist that and he just shook his head and said "no, I don't think so".  Are you a Dr. by chance? I can't seem to get any of them to agree that this might cause it. Do you think that the constipation just causes irritation and inflammation or an actual infection?  My bowel movements (or lack of) has been pretty consistent for many years, however I've had extended periods where I didn't have any issues at all.  I just want to make sure I'm addressing the root cause. This Urologist wants me to take Flomax (and gave me a sample of Vesicare) with the hope that it will help prevent future flare-ups.  I don't want to be on a crap ton of medication.....any at all if I can help it.  What are your thoughts about having a terrible Saturday morning and then Saturday night all symptoms nearly disappeared until Sunday afternoon?  I asked him that and he just shrugged his shoulders and basically ended the visit.  This was truly the worst visit I've ever had with a Urologist, at least the others have given me more than 10 minutes to hear my concerns and history. I tried to ask him if it was Prostatitis why there is never any burning or pain. Irritation in the rectum and pressure on the bladder, but never sharp or burning pain.

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    • Posted

      Google "constipation" and "BPH" or "urinary retention". You know you have constipation. Treat it or not is up to you. I am not a doctor. I was a suffer. Many people on this forum know more and are more helpful than many doctors.

      Try Flomax, if it helps you significantly, then your problem is more prostate or bladder related. You can also stop any time.

      Good luck.

      Hank

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    • Posted

      Hank,

      Thanks for your responses and advice, please don't take my endless questions as me doubting you. I just feel that I am nearly at   the of my rope and am in desperation mode. My quality of   life  is terrible right now and am dragging my family and everyone else through it. I am pretty miserable to be around.

      Did you just have the consistent urge to urinate or the irritated rectum feeling to?  These flare-ups and that constant urge to pee are driving me nuts. The majority of my flare-ups are gone or greatly reduced within a week or so, but this one is 3 weeks in and showing little sign of letting up. I don't know if the Cipro is what has helped before, since my Primary Care Physician generally prescribes it (I told him that is what I had taken previously and seemed to work, so he went with that) whenever I begin to flare-up and call him. I haven't been to a Urologist in a couple of years, but when this flared up in June and then end of July had to do something different. This Urologist wants me to do a Flow Test and bladder ultrasound on Friday. He also wants me to go on a 500mg per day regime for 3 months, while on Flomax after I complete this 1,000mg per day course in about 10 days. I don't want to get all drugged up unless that is 100% the only recourse. They say that walking is great therapy, but for me just makes it worse. I don't know why they can't do any more than what they are, guess they think I am making it all up. I am coming to work, but get little done as my mind is constantly pre-occupied with this. Don't want to be here, but don't want to be at home sitting around either. 

      Thanks again

      Terry

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  • Posted

    If you are not prepared to do pelvic exercises (Yoga, squats,..) then be prepared to endure these types of flareups.

    Inactivity, excess weight, and / or sitting down all day will all combine to mess up your pelvic area, and cause you pain / discomfort.

    I went through 10 weeks of bacterial prostatitis, and can attest to the damage that the pelvic area can be exposed too, and also "cured" with yoga exercises within days.

    See my previous posts on Sitz baths as well, which gave me the greatest comfort in pain relief.

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    • Posted

      As long as you are doing Yoga Balasana, then it's all fine.

      My pain was cleared up in 3-4 days, and no problems.

      I still do it before a Jacuzzi at times, to keep up the benefits of pelvic exercises (plus squats).

      Every male should know how to do the Yoga Balasana, because it's free and pelvic exercises can keep you healthy and pain free.

      Hope that helps. 

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  • Posted

    i had the same for years on and off. its all about diet and exercise. I have a bout now and i know this will work. Don't continue the antibiotics. Its all about fixing your body. also stay away from masturbating or rough sex. Regular sex 2-3 times a week and a healthy diet cured me. Well i have a bout now so not cured but kept it away for years. I also wrote down everything that effected me.

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