Chronic Prostatitis - Antibiotic or other strategies
Posted , 9 users are following.
Had mild BPH diagnosed a few years back and was eventually prescribed Tamsulosin and later in combination with Finasteride. Been taking the combo therapy for about 2 years. Not seen any great improvement in symptoms which are - Frequency in the night, not totally voiding my bladder, dribbling.
However while all this was going on I had fairly regular bouts of what I and my doctor thought were UTI's. Samples taken generally did not show any major bacterial infection. Antibiotics thrown at the problem included Nitrofurantoin, Trimethoprim and Ciprofloxacin. The Cipro was a real killer for me with drastic side effects kicking in within a couple of days of starting the treatment. Joint aches, general muscle pain and lack of energy meant I had to stop treatment.
Skip forward to earlier this year when I had another UTI infection (or so I thought). This one was different and as well as the general ache in my bladder area with the urge to pee frequently, I also had pain and tenderness along my penis and also in the perineal area with occasional sharp pains around my anal sphincter. A urine sample did confirm a significant level of E coli and my doctor finally came round to the thought that I had prostatitis rather than a normal UTI.
I was put on a 4 week course of Cefalexin which seemed to help relieve the symptoms but in general within a few days of the end of the course my symptoms would come back to some degree but not to the full blown extent felt previously. This roller coaster continued for a couple of months of taking Cefalexin without it apparently clearing out the bacterial infection. At one point I agreed to try the Cipro again as it appears to be the "gold standard" for prostate infection. Again I had to stop taking it within a couple of days as the muscle and joint aches returned as before.
I have just seen a Urology Consultant and he is scratching his head a bit since a recent urine sample I provided is again showing significant E Coli contamination and the hospital Microbiologosts have confirmed that the bugs are resistant to most antibiotics except Ciprofloxacin. He is pondering what to suggest and might consider prescribing one of the other family of Floroquinolones eg Levofloxacin hoping that it has less drastic side effects.
The TL/DR point is:- Does anyone have any experience of successfully having chronic prostatitis cleared up and with what treatment - antibiotic or otherwise.
0 likes, 13 replies
roy80577 arlowood
Edited
Hi. I typed a long reply but it did not post, as I think it timed out.
In summary, try D-mannose. A game changer for me. I have had chronic bacterial prostatitis since 2019, caused by E. coli. It can help significantly with urethral symptoms by flushing out E. coli from the tract. It will not address root cause which is infection in the prostate, but can help make life tolerable if taken regularly, reducing urethra symptoms. It acts by interfering with E. coli's ability to bind to the tract, and hence it get flushed out with urination. It only works on E. coli. The science here is well verified.
Hope this helps.
65FBack arlowood
Posted
Arlowood - I just started a new discussion about my experience with prostatitis over the last year. There might be something useful in that post for you
-CT
arlowood 65FBack
Posted
Hi @65FBack
I've read your other post and found it very useful and informative.
To update my original post above, the Consultant finally decided to try a course of Levofloxacine to see if 1:- I could tolerate that drug without the side effects I experienced with Cipro. and 2:- whether the Levofloxacin, as another Floroquinolone, could eradicate the E Coli infection in my prostate.
I'm now 1 week into a 2 week course of the Levofloxacine and I'm not sure that it is really doing anything significant. I'm still having the discomfort in my penis which makes me feel that I have to pee on a regular basis while I'm sure my bladder is nowhere near capacity. This course runs until the end of this week when I have to submit another urine sample for testing to check if the infection is still detectable.
I'm not too confident that the oral antibiotic route is the way to go. The infection is clearly deep seated and probably difficult to access with oral antibiotics when they have to navigate the digestive tract before entering the bloodstream and then finding their way to a gland that does not appear to have a massive blood supply. That's just my thinking so I may be completely wrong on that.
From your comments it seems that other experts believe the IV route is best and that seems logical as it cuts out the digestive tract and would be a more direct route to the prostate.
I wait with interest to see what happens but I'm getting pretty fed up with the constant aches and just want this knocking on the head.
BTW I'm UK based and I'm not sure that a trip to Athens is really feasible for me.
65FBack arlowood
Posted
I think you are exactly right about oral being way less effective. I actually met a guy from London in the Greek Drs office. He is 27 years old and dealing with very similar symptoms - had several urologists tell him he is too young to have this - ha!! his prostate ultrasound was similar to mine - lots of inflammation.
I should get the microbio results from the prostatic fluid and sperm sample in a couple days. I have a Jan 5th appt with new urologist who has at least previously prescribed IV antibiotics so I'm hoping he offers me that chance. If that doesnt work then I'm probably off to Greece in February with much expense, and work/life disruption. One way or the other I have to get rid of this...
Not sure I mentioned this before but I met an Aussie guy who is at the end of his 10 week treatment in Athens with this Dr. He said the treatment has given him his life back. his symptoms including no energy were very bad - couldnt get out of bed some days. He is a writer and is planning to write a book to get the word out.
I might encourage him to post on here...
Good luck with the remaining Levofloxacine but I'm starting to believe it can only be eradicated with better penetration of the drug which may include daily prostate massage.
markswain 65FBack
Posted
G'day Chuck
It's Mark here we met in Athens. My experience is blood and urine tests simply do not work to find prostate bacteria. I wasted a year with these tests. All people who think they may have Chronic Prosatitis should insist on a strong prostate massage followed by sperm test. Re antibiotics only, my experience is its a waste of time as they cannot get past sclerotic hard prostate tissue caused by CP inflammation. Stay in touch mate. Mark
compiler arlowood
Edited
Take antibiotics, Rapaflo and Advil but the most importance is to decrease sexual activity. Your prostatitis can go away.
arlowood compiler
Posted
Hi
Thanks for the comment.
I'm already taking Tamsulosin (Flomax), which is a similar drug to Rapaflo, along with Finasteride and have taken Ibuprofen (Advil) regularly to alleviate some of the discomfort. I've also been on various courses of oral antibiotics since around February of this year and none of those strategies have been successful so far.
I live in hope that something will work eventually - maybe IV antibiotics in place of the oral ones.
compiler arlowood
Posted
Do you still have sexual activity during treatment?
cali-mike1970 arlowood
Posted
for the penile pain, do you feel there is a nerve involvement? if so, i would recommend gabapentin for that. I had a urethral sensation, not really a pain at the tip and in the bulbo spongioses and the gabapentin is deadening that for me. it relieves the urgency/frequency feeling. i could swear it was a UTI. i think that's on top of a bph type frequency feeling which feels different. when you have these syndromes, it's easy for things to get altered down there.
Remus arlowood
Posted
you probably have non bacterial protatitis . Most is ..cernilton bee pollen for imflamation . alternate Hot and cold water 50 sec each with flexable shower head on perinum for 6 times finishing on hot . Epilobium pavilium to shrink prostate.
arlowood
Posted
Hi Folks
Just thought I'd give an update on where I am currently in the saga of my prostate infection.
The levofloxacin did eventually clear out the bacteria in my bladder but I was still experiencing low level discomfort in my penis and perineal area.
The consultant had scheduled a series of tests to rule out any major physical reasons for my symptoms and since I last reported I have undergone an Ultrasound scan of my kidneys/bladder followed by a CT scan of the same area (they found some cysts on one kidney that have been ruled out as benign). That was followed by a cystoscopy which also showed no major issues other than a slight stricture at the neck of the bladder.
Basically the consultant has concluded that my problems are not due to anything physical in my urinary tract.
Due to my sensitivity to Ciprofloxacin he is now looking at a non-antibiotic strategy based on a drug called Methenamine hippurate. (Hiprex). This drug has been the subject of a trial in women with recurring UTI problems and has been found to be at least as good as standard antibiotic treatment.
The drug works by metabolising to produce formaldehyde in the urine which is supposed to kill off or inhibit the bacteria.. Since it is most effective in acidic conditions, the recommendation is to take it with Vitamin C which helps to produce acid conditions in the urine.
Have just started what will be a 3 month course and hoping this will be more successful. Due to revisit the consultant in early July.
First few days of the treatment have been characterised by some gastric issues. Wind, indigestion, slight nausea. Just hoping that these are not side effects that will continue otherwise I might have to pull the pin.
Anyone else had experience of Hiprex.
cali-mike1970 arlowood
Posted
If your last remaining issue is penile urethral irritation causing voiding frequency and urgency, i had that after several rounds of antibiotics had diminished it. the thing that cleared it finally was diflucan for 10 days. I was treating a gut inflammatory marker but noticed improvement in my urinary frequency. no tests had indicated i had a yeast issue.
arlowood
Posted
Hi Cali-Mike 1970
Very interesting observation and something that I am certainly going to follow up. Had never considered that fungi could be a vector in chronic prostatitis.
However a quick Google pulled up a report of a patient who had suffered symptoms of prostatitis for 20 years before he was eventually diagnosed with a Candida fungal infection. 2 months of Fluconazole did the trick without a recurrence of the symptoms.
Seems like the clinicians have focused on the regular bacterial bladder infections with the presumption that E coli was the basis of my problem. However in those cases the antibiotics (bactericides) successfully cleared the bugs from my bladder but the prostatitis symptoms have always persisted even after my urine was clear of infection.
Could well be that fungi are the issue and I will be raising that with the consultant. Unfortunately my next appointment is not until July but I might try to bring that forward once I've let the Methenamine treatment run for a couple of weeks just to see where we go with that.