Do I have chronic prostatitis?

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Hi. I am 36. 

Around April this year, I had three episodes of gross hematuria. Scared, I went to a nephrologist & then another urologist. They conducted a number of tests on me including urinalysis, urine culture, X-ray and USG of KUB, phase contrast microscopy, lever and kidney function tests and a range of other blood tests. Almost everything came normal and the phase contrast microscopy found that the blood was coming from lower urinary tract. The doctors did not find any stones, lesions or tumors during the USG.

One morning in August, I passed a nearly 2mm stone through my urine. The urologist says I do not need to be scared anymore.

Now ever since then, I have been facing a number of issues:

1) Ever since, right after the hematuria episodes, at times, when I strain to pass a stool, drops of whitish semen-like substance comes out of my penis. In order to tackle this situation, I stopped straining at least a week back and it had nearly stopped. But over the past two weeks, I have noticed on one occasion, a small jelly-like transparent substance come out after I finish peeing. It usually sticks to the bowl and when I drop water on it, it rolls off into the water and sinks. Is this something to worry about?

FYI: My wife is pregnant. And I haven’t had sex or masturbated since September this year.

2) Often when I am sitting down, I feel a slight burning sensation near the head of my penis. 

3) Often I do feel some pain during ejaculation but not always.

Now I do not have extreme pain in my pelvic area, near the base of my penis or near my rectum. There is no fever or chills.

Also, my urinary urgency is nowhere close to when I had the stone. I now visit the bathroom at a 3-4 hour interval.

I have recently visited an urologist who without listening to me properly told me that I may have chronic prostatitis.  He gave me a bunch of tests again includign USG of KUB-PVR (60 ml pvr), Uroflowmetry, Urine profile and Uric acid (within range). Without even waiting for the results, he prescribed me three medicines including Finasteride 5mg, Flupentixol 0.5mg and Ofloxacin 200mg.

I waited for the tests. The urine profile did not have any RBC, WBC or anything else. Just 2-3 epithelial cells HPF and 0-1 pus cells.

Uric acid was within range.

Just to be safe, I also did a PSA test which came to 0.42 ng/ml, BUN and creatinine (1 ng/ml) . I have read in two different websites that prostatitis would usually yank up PSA level to over 1 ng/ml.

Uroflowmetry had an average flow of 29 ml/sec.

As the levels seemed okay, I went to a second urologist. He saw the prescription by the first guy, cancelled the three medicines the former doctor had prescribed and instead gave me Doxycycline 200mg, Suliandac and Bactrim. As I had an allergic reaction to Bactrim, I am now only on Doxycycline and Sulindac.

So, here is my question: Do you think this is chronic prostatitis?

Your answers would be appreciated. Thanks in advance.

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  • Posted

    I don't have answer for you regarding the prostatitis. Just curious, how long did the bleeding episodes last/ I had 2 episodes of gross hematuria. Both lasted 7 days. I had  2 CT scans and a cystoscopy. Nothing showed up but I had other prostatitis symptoms. Being 59  2 uros told me it was BPH and didn't prescribe any meds for prostatits. I've been on fernasteride and flomax since March 2016. 

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    • Posted

      The first instant happened in March of this year. I went to the bathroom and my pee was red. I drank a lot of water and the next time I peed it was back to normal. I later did an urine routine and culture. But that did not find any RBCs.

      The next time it happened exactly a month later in April. This was when I had it three times. As the uro did not believe me the last time, this time I took a photo of the urine with my phone and showed it to him. He acted rather indifferent. But the urine r/e did not find any RBC again.

      A few days later, i did the Urine R/E again and this time it was 'Numerous'. Over the next one month, I continued to do Urine R/E and the RBCs gradually came down.

      During this time, my urine frequency was around between an hour to one hour and half. I was drinking around 4 to 5 litres.

      I also had a heavy feeling near my left testicular region. I could not wear an underwear or lie down on that side for too long.

      Then it all kind of settled down. But there was a nagging pain of something crawling inside my abdomen and gradually coming downwards. 

      Finally, I passed the stone around first week of August. The pain was gone within a few days.

      My urinary frequency was up to three to four hour intervals.

       

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  • Posted

    A cystoscope is a thin tube with a camera and light on the end. During a cystoscopy, this tube is inserted through your urethra and into your bladder so the doctor can visualize the inside of your bladder. Your urethra is the tube that carries urine out of your bladder. He can also check the entire urethra to see if stones have damaged it in some

    way. I did not see it mentioned in the workup.

    Good Luck

     

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  • Posted

    Are you still bleeding? If so, have they done a cystoscopy? Did they culture your discharge? If not, I would ask them to. Is your current doctor a urologist? He should be. Yes, it sounds like prostatis but we're not doctors here.

    Jim

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    • Posted

      I have not bled since the stone passed in August. Hence, no cystoscopy was necessary.

      The discharge was cultured. Some epithelial and pus cells were found in it.

      My current doc is a urologist.

      Just tell me this, isn't there some pain associated with prostatitis?

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    • Posted

      Usually but not necessarily. Prostatitis is a basket of symptons that may be quite diffferent individual to individual or even with the same individual at different times. Issues 2 and 3 in your previous post, plus the pus cells in your discharge could suggest a mild prostatitis. Apparently your doctors thought so and that is why you are on a course of antibiotics although I hav some real reservations about your first doctor's advice. Are they fishing? Prostatitis is often that kind of nebulous thing, so they might be, but doesn't mean treating with antibiotics is wrong as antibiotics often work in these cases.  Did they do a digital exam? Did they mention if the prostate was inflamed? Did they do a prostatic massage and culture it? Not often done these days, not sure out of laziness or what, but can't hurt to ask and the actual act of the massage could even help.

      That said, based on your symptons I wouldn't be overly concerned and would not get hung up on the word "prostatits" as your symptons seem mild and most men (some say all) will have prostatitis in their lifetime. By the time I was your age I had at least a couple of bouts much worse than you describe. If things don't get better, getting another opinion is always an option as someone else suggested but with your symptons and the complexity of the urinary tract not sure anyone is going to give you 100% clarity. 

      Jim

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  • Posted

    The short answer is no. Nothing there that sounds like the prostatitis I or others report. Good that you passed the stone. Why strain on the toilet when there are plenty of stool softeners on the market.

    Why no sex since September?  Pregnacy is no barrier to it. Is one of you concerned that it will harm the baby? You can have sex until her waters break or she goes into labour.  

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    • Posted

      Hi Derek,

      Thank you for your answer. Really appreciate it.

      About not having sex, our first baby had some developmental delays.

      She passed away when she was eight months old. She had pneumonia but unlike other healthy children she could not recover from it.

      Also my wife has polycystic ovary syndrome.

      This is why the gynaecologist has asked us to be extra careful.

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    • Posted

      My wife was a nurse in maternity and understand all that.

      I feel for you as we lost our daughter to cancer when she was 22.

      Pneumonia almost killed me when I was 12 but fortunately one of the new drugs saved me.

      Report

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