Prostatitis

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Hi Guys, just joined this site, wondered if theres any advice out there. Had urethral stricture back in 1996 and was in hospital for 1 week think it was passing kidney stone, everything was dandy for a few of years and then problems again with split / weak stream, had a urinary infection last year and cleared up with a 2nd course of antibiotics but now thought i had another but doc gave me a digital examination and turns out i have a enlarged prostate, had the usual bloods and urine test and bloods all fine with low PSA but infection in urine, now given another course of antibiotics ciprofloxaxin on my 4th day now and no improvement, pain passing urine especially at the begining, very weak stop start stream can take me 5 minutes to try and empty my bladder, although i can go through the night for about 5 hours or so without going to the bathroom. Doctor has referred me to local uriology dept but could be several weeks! help!

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  • Posted

    Hi Phil, seems you are in discomfort eh. I´m not a medical man by any means but I am aware that Urology covers many things; kidneys, bladder, uretha, prostrate, reproductive organs and so on. Other than trawling the internet, If I were you I would tell your doc that you simply cannot wait (pain- discomfort when peeing), don´t have the cash to go private, and WOULD HE, therefore, mark your referral as very urgent due to your intolerable pain and suffering not to mention having to get up every night for a wee. Maybe tell him it is stressing you out - "play on the emotions". The only problem I have had  "down there" was that after a very incompetent hernia op on my groin,I have erection problems. Best of luck, always here if you want to chat. Best of luck, Mike. (English) living in Spain.

     

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    • Posted

      Thanks Mike nice to have people to talk to about it also, he did mark it urgent but think if things havent improved by this week will go back to him and try and hurry things along iam 49 btw not sure if that makes any difference to the urgency but he did say i was young to have an enlarged prostate but not unheard of......
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    • Posted

      Hi Phil, just in 10.30pm. If I were you I would go back and speak to your doc laying it on the line that you just must be seen - as  your not getting proper sleep obviously and it is playing on your mind etc etc. If the latter is a white lie he is not to know is he.. Similar here here in Spain re "waiting" well I live in Gran Canaria actually, but I have found if you want something done you have just got to speak up and be persistent without becoming a pain in the a... for the medical profession. By the way you lost me on "I am 49btw" - don´t know what you mean. Very interested as to how you get on with this. Mike.
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  • Posted

    They have to see you within 18 weeks . but as for surgery should it come to that its a long wait. I would have thought your Doctor would have put you on Tamsulosin,

    that helps a lot with the stream and the getting up in the night.

    I hope you don't have to long a wait until you get sorted.

    kind regards 

    Howard

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  • Posted

    Hi Phil, Could be wrong but I think doctors have concluded PSA # is a meaningless, but free PSA may be a metric they track. I had an enlarged prostate and bladder infections which combined to create ongoing problems.

    I would get to a urologist who performs HoLEP (travel if you have to, just do it) and let them assess and recommend what to do. If HoLEP is right for you (probably), it will take a while to get checked and scheduled. If you can cath yourself it might help a lot in the near term till you get taken care of. Just watch out for the cath causing infections.

    I should add that I waited ~ 3 months, my surgery happened ~ 1 month sooner, and I wore a cath 2-3 months to get by. You can do it too. Good luck!

     

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    • Posted

      Phil, to be more specific in hopes it will help you:

      1) You may want to try to cath yourself if it is a fairly bad situation

      2) If you do, no need to use a fley bag in day, just use the plug, and pop it when you need to urinate. But prob use the bag at nite.

      3) Forget the doc you are going to and forget getting a referral from him. Call Lingemans office and that woman at Mayo and 1 other you can find and take the next appointment you can

      4) They will prbably recommend HoLEP. Get it scheduled, and emphasize you want the first surgery cancellation slot should any open up.

      Lastly, for everyone, I am hearing people say they cannot find HoLEP doctors out there. My dad who lives in Maine (not a major metropolitan medical center!) went to a urologist last month and the guy has done about 100 procedures. Lingeman who is the top guy in the US says any urologist who has done 30 or more should be over the learning curve. So look around, HoLEP doctors exist. Good luck!

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    • Posted

      Phil,  I have studied options for my prostate problem almost daily for the past six months. I have seen a urologist for at least ten years. he put me on the various meds tp shrink the prostate and I have had them all. They destroy your masculinity about like castration but only over time. If you can get a prescription for Jalyn, a combination of two different drugs, and if your problem is just an enlarged prostate blocking the flow, this will give you almost immediate relief. But be aware of the side effects and that the meds lose their effectiveness eventually. If you chicken out of surgery as I did you will find yourself with ED and loss of libido and needing surgery because the pills don't work anymore,

      Bill20925 above has given you the best possible advice, assuming a simple enlarged prostate, Holep is the best solution if you can find a way to get the procedure done.  It does not destroy your sex life as most of the surgical solutions may as the surgeon hollows out the prostate completely from the inside only,  leaving the nerves on the outside intact. Since only the enclosure remains it will not regrow causing more surgery at a later date. Don't let anyone tell you that Holep is like any other laser technique, it's completely different from Green light for example.

      At your age I expect your sex life is important to you. If so, Holep is the most likely to preserve that function and be a permanent solution.

      I discovered Holep and began looking for a surgeon only last week and I will continue until I find one. I strongly reccommend that you do the same. If you have not taken any of the meds then you should be able to take them without permanent harm for a few months, long enough to find a Holep surgeon, meet the criteria, get on his list and have the procedure done. You are lucky, I'm not sure I can make it through the routine. I am going to try, though.    .Best of luck and keep us posted. 

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    • Posted

      Thanks Bill and Ron for all your advice on my issues, its still fairly early days in me being under the doc but will take everything you say on board especially HoLEP procedure, not sure how readily that is available here in the UK but will investigate it fully. I did toy with the idea of taking anti inflamatorys like ibruprofen but the ciprofloxaxin iam not at the moment is not a good combination don't know if anyone out there has any experience or relief from taking anti inflamatorys?
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    • Posted

      Ron:

       Google the long Mayo Clinic article on HoLep.

      It says on retro:

      Some studies have shown that patients who underwent HoLEP actually had improved erectile function after surgery, but almost all had retrograde ejaculation. All patients experience hematuria for one to two weeks after the procedure, but the need for blood transfusion is low, around 1 percent. Since normal saline irrigation is used for the procedure, there is no risk of hyponatremia, regardless of prostate size. Transient urinary incontinence is common, but permanent incontinence at one year after the procedure occurs in approximately 1 to 2 percent of patients, depending on the definition and type of incontinence.

       

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    • Posted

      I saw that but there's a good reason not to consider the Mayo Clinic. I'm working on the problem and I have a great solution if I can last a few months. Going to see my long-time uro tomorrow to enlist his aid in using a catheter or some med I don't know about, diapers or whatever will keep me respectable enough to last until the end of December. That's the earliest I have found to do Holep. I am going to have the Holep procedure done, there's just no comparable method available. We'll see what my uro says tomorrow. I'll report here. 
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    • Posted

      What's your location? I may have found a Holep surgeon in your area. There's also urolift, I know where a lot of those guys are also. I should have thought about the cost of the procedure when I replied. You aren't old enough for Medicare so it's either private insurance or out of pocket. Urolift is much cheaper than Holep and if you have the right size and type of prostate Urolift could be the best for you, at least for the next 3-5 years, maybe a lot longer.  Let me know if I can help in some way.  
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    • Posted

      Bill, I've been on the phone all day since 8:30. i have talked to the staff of 4 or 5 Holep uros, all in the Northern tier of states and all booked until December or Jan.  So, now it's on me to find a way to hold out until then. Going to see my long-term uro tomorrow for help.
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    • Posted

      All of you who are struggling to get an appointment should just focus on securing the exam appointment regardless of how far out the doc is on surgery. When they realize your condition they will do their best to give you first shot at a cancellation. I was orignally promised 3-4 months but got it done in 2 when a cancellation opened up.
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    • Posted

      I don't know about urolift, but HoLEP should be 1 and done.

      It seems like a good note would be for all of us to post doctors and their locations who are experienced HoLEP practitioners.

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    • Posted

      I went 2 months with a cath, so you can too! I really liked just using the plug and no bag in the day, and going to the urinal, aiming the cath end into the urinal like normally peeing, popping the plug, unloading, popoing it back in, and done! Just tape properly to miimize puling. I recall using the bag ~50% of the time at night. But you really don't need to with the unplug and pee method. And in the daytime you feel so much more in control of your life. Just remember to watch out for pangs in that area, it culd indicate an infection to address.
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    • Posted

      Well, here's a start; I believe that every one of the Mayo clinics around the country have a Holep surgeon on the staff. There's also one in Nashville, one at Indiana University, one in Ohio, one in Maine, one in Philadelphia. No doubt some others. There's Drs, Knutsen, Knowles, Dusing, Lingeman, Humphries, Nicole Miller,  etc. I think a google search for Holep will turn them up. 
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    • Posted

      I did see my uro last week and he is dubious about HOleb of course as he was about Urolift. He recommended "Simple" prostatectomy instead. He advised that there are no new drugs to improve on Jaylin and he recommended a thinner catheter with a bent tip to be easier to insert as I couldn't get a larger, straight one past the prostate. I haven't tried it yet but I'll do so today. I'm retaining too much I know. I just need a combination of aids to help me last until i can get HOleb done in late December.  I think I'll make it ok if the catheter works. 
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    • Posted

      My Uro told me that a regular catheter would fall out and I would have to use a Foley type with a little balloon to hold the catheter in the bladder. What is your experience? 
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