Do I have chronic prostatitis?
Posted , 8 users are following.
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.
0 likes, 53 replies
mark23925 Distressed1011
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lester90053 Distressed1011
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You've got to see as many urologists as you can before you can find one to give you the right treatment. Your state's urology association can help you find one or more.
gbhall Distressed1011
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uncklefester gbhall
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martin80457 Distressed1011
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Hi,
I din't think that you have prostatitis!. There are 2 kind of prostatitis:
1. chronic- without any pain
2. acute- with severe pelvic pain
You have hematuria that is blood in your urine and stones, probably kidney stones.
Hematuria without any pain is considered dangerous because it be caused by cancer. In your case you have pain.So there is no cancer.
I think you have only kidney stones with uneven surface causing you bleeding when they move in your urinary tract. Maybe you have chronic prostatitis, too. Many men have it even at your age.
Don't worry. Chronic prostatitis is almost not curable. Don't believe the doctors if they say it is easily curable!. But if you want to minimise the damage of chronic prostatitis have a sex with your wife as often as you can: It will empty your prostate juices and filtrate all kind of bacteria in it. Sex is very beneficial for your pregnant wife, too. For first 3-4 monthe the libido in pregnant women is increased! Because they need testesterone to make powerful their lower abdomen and progesterone to prevent miscarrage. So dont worry, if you think that you can harm your pregnant wife!
For kidney stones there is no threatment too, believe me. Your metabolism is not normal. To normalize it, you need more spicey food, in order to drink more water. For example you can eat pickles during the dinner every day. Don't drink water more than 3 liters a day. 3 liters warter is quite enough!
derek76 martin80457
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Two of my long term bouts of prosatitis started with passing blood but I had a very large prostate and it was thought that blood vessels had burst. I'm not sure how that was connected to the prostatitis.
uncklefester derek76
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How long did you bleed for? So, you don't have a definite answer where the blood came from? I'm sure its been discussed in another thread but how did you fix the problem of enlarged prostate? How did you treat your prostatitis
derek76 uncklefester
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Cipro etc for prostatitis but I have been clear of it for well over a year now.
Prostate, GL in 2004 and Thulium/Holmium laser in 2013. All symptoms now gone but not as good a flow as I hoped for and PSA down to 0.74. Prostate now 55grm from high of 135grm but a nodule on the median lobe that is not a problem at the present time.
Distressed1011
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So this morning I woke up and went to pee. After finishing, I looked at the pee and found a small brown sediment at the bottom of the urine. Almost looked like a dried clot or something. When I flushed it just bounced up and then went away. Most likely, it was not jelly-like. Not exactly sure.
After that I went to pee again four hours later. I felt a slight pain and thought that I may see blood again. But it was normal this time.
Could it be that this is the blood clot finally come out from the episodes of hematuria I had faced till July?
Or do you think this is due to the Doxycycline taking effect on my possible problem?
I am so worried now. My fears of cancer are resurfacing.
uncklefester Distressed1011
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After my bleeding episodes I peed a few scabs that looked like what you described. I've peed those clots months after a bleeding episode. I am on fernasteride which can shrink the prostate. I surmise the bleeding came from dieing prostate tissue
Distressed1011
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Btw, I felt a mild burning sensation on and off the entire day yesterday. That seems to be gone after this morning's urine with the brown sediment.
So do you think this was another stone-type thing?
jimjames Distressed1011
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Sediment is fairly common. I've seen it myself. It doesn't in and of itself mean cancer. If your seeing a good urologist, they should know when to probe farther with either more tests or procedures. Personally I'm not a fan of looking too hard for trouble when the facts don't really warrant it (just too much stress) but others may disagree.
Jim
Distressed1011 jimjames
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derek76 jimjames
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Could the brown sediment be old blood?
jimjames derek76
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Sure. And I don't want to leave the impression he shouldn't mention it to his urologist for a look under the microscope, etc., I just didn't think it was something to get alarmed about given his psa, age and history. I use Multistix at home that check for a number of things in the urine, including blood. Not sure if it would pick up on dry/undisolved blood but I find them as a useful pre-screen before I see a doctor. There are also presumptive blood tests you can buy on the internet using phenolphthalein if you really want to play home detective!
Jim
Distressed1011 jimjames
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I went to my urologist. I had taken a photo of the sediment. Showed it to him. He told me there is nothing to worry about. That it can be blood from previous episodes. Or it may be stone forming element, since it was dry. I am guessing he meant oxalate by that.
He asked me to finish the Doxycycline and not worry about this.
jimjames Distressed1011
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Sounds like a good plan
Distressed1011 jimjames
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Ohh, and I have also asked him why they think this is prostatitis when I have just one or two symptoms that coincide with it.
He said, 'It could be. Acute prostatitis has severe symptoms- pain, swinging temperatures etc. But chronic does not. Since it takes a while for the antibiotic to reach the prostate, that is why I prescribed Doxycycline for a month. Hopefully it will work.'
From the way these uros in my country think, chronic prostatitis is something that can be cured. It is being called chronic just because there is no pain.
Do they mean 'Chronic bacterial prostatitis' then? So, to answer your previous question, Jim, yes, they're fishing.
I've found the contacts of another urologist. Planning to visit him next week
jimjames Distressed1011
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I'm assuming his dx is "chronic non-bacterial prostatitis" unless he is treating based on a positive urine culture. Even though no bacteria is found, antibiotics often seem to work for reasons not fully understood. Two possibilities thrown out are the anti-inflammatory properties of antibiotics and the possiblity that there is some bacteria involved but it just isn't being picked up by the tests. It's a very common diagnosis and can be very frustrating. I've had prostatitis on and off for as long as I can remember and FWIW it seems to get much better with age.
Jim
jimjames
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Just wanted to add that while there's nothing wrong with seeing another urologist for input, I doubt they will do or offer much diffferent advice given your symptons and history. They will most probably tell you what he did to finish the course of your antibiotics, not to worry and to come back and to come back and see him for follow up.
Jim
Distressed1011 jimjames
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Thank you Jim.
I remember someone asking this in a previous comment. None of the two urologists carried out a DRE or even gave me a physical examination.
They just heard bits and pieces from me, looked at one or two of the medical reports and went ahead with the broad category of 'Prostatitis'.
Even the current uro is the one I had been going to since April. He had gone to some workshop or something which is why I went to the second one. The second one looked at the first one's prescription, saw another prescription by another GP that said simply 'pain in pelvic and abdominal area'. That GP had prescribed me Diazepam to help me sleep and battle my anxiety. Two days after, I had passed the stone.
So, the second uro saw the prescription of the GP and wrote 'symptoms suggesting chronic prostatitis'.
And to tell you the truth, I had even asked the first uro in May (during hematuria and before passing the stone) whether this is prostatitis.
He had replied with a vehement no. Almost like a rebuke.
So when I went back with the diagnostic test results from the second guy and the first uro read that prescription, he cancelled his prescription but stuck to the diagnosis.
This is the reason I feel I am misdiagnosed. The two of them are just running after each other's tails, it seems.
Earlier, in May, I had gone to a nephrologist as well. He was the only person who had predicted that it may be 'a small stone stuck somewhere'. He had given me a bunch of tests including phase contrast microscopy. That found that the bleeding is happening somewhere in the LUTS.
He had also asked me to do a CT Urogram. But this particular test is very rare and unpopular and so I couldn't do it. If I would have done it, maybe I wouldn't have had to spend so many sleepless nights thinking I have bladder cancer.
Anyways, so I had gone to him yesterday. Told him that he was right. He gave me some dietary changes and also said that this may be a UTI or something similar. That I may still be passing clots and o
jimjames Distressed1011
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I thought the DRE was pretty standard. Maybe another opinion is warranted. Not sure if the two urologists share the same hopsital or know each other but I've found it best to seek a second opinion from a doctor who doesn't have any hospital or other affiliation with the first doctor. If not, they sometimes tend to support each other. Also, "sticking to a diagnosis" in spite of new evidene is very problematic of doctors in general. Sometimes I don't even share the first diagnosis with the second doctor as I do not want to bias his opinion. A similar problem exists with imaging labs where the second time you get a test the imaging is compared to the first test. While in theory that makes a lot of sense, you sometimes wonder how hard they look at things the second time as opposed to just echoing what the first doctor said.
Jim
uncklefester Distressed1011
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uncklefester jimjames
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My first appointment at my first urologist he literaly walked in the room, I told him I had heavy bleeding for 7 days. He did nothing. No DRE. He scheduled me for a cystoscope, CT scan and walked out of the room. He did not lay a hand on me. At that point I felt a little bit let down. And during that 5 minute appointment he assured me I didn't have cancer. I was releaved but kind of doubted his diagnosis.
jimjames Distressed1011
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If it makes you feel any better, bladder cancer is uncommon if you're under 60 years old. That said, they will often do a cytology urine study and cystoscopy if they cannot find other causes for blood in the urine.
Jim
Distressed1011 jimjames
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Fester, the only doctor who gave me a physical examination was the nephrologist. And he was quite thorough. He had even examined my testicles to rule out lumps. Then he gave a whole list of tests as a workup to rule out other probable conditions.
Jim: Early this morning I woke up once after having a wet dream. I woke up exactly before I was about to cum. So I realized that there was no pain during ejaculation.
I hope that is a good sign.
Those are the only two issues that I seemed to have on and off that coincides with prostatitis:
1) At times painful ejaculation. This was so much worse before the stone had passed. I remember I used to feel like my veins were going to burst while ejaculating earlier.
But when my wife and I were having sex around September, this pain was no longer there. (I passed the stone around first week of August.)
2) whitish semen-like substance in penis if I strained during bowel movement. The few days I had sex in September, this had entirely disappeared. But came back a week after I stopped having sex.