Prostatitis

Randy,

My condition was caused, apparently, by Green Laser surgery.  I'm not sure now how experienced my doctor was.  I would consider learning how to do the intermittant self catheter...probably #14 size..until you can sort this out.  You would have to do maybe 4 of them per day.  Depending on your situation, I would look at the possibility of having the BAE procedure done.   Google UNC Urology BAE to find a link describing that procedure.  It's not done by a urologist, so I suspect urologists are getting nervous about this procedure that is having a high rate of success.

If it turns out that you really must have TURP, ask how many procedures your doctor have done, and how many has he done this year.   And from what I hear, the Holep laser is a lower power laser that may be a better option for some.  (My doctor said that the Green Laser was too powerful for me! after things started going wrong.

Also, keep in mind that a lot of people do have TURP and have things work out just fine.  My dad did, apparently.

Randy,

  You have to do whatever in your heart you think is right. If it were me, I would definetely self-catheter. ( I wish I was given that option !!, but the dr. never even told me you could do such a thing. I didn't know much about the prostate till I started having real bad problems urinating ).

    Good Luck,

     Steve

    

Thanks. Glenn...Good Luck!...

So far I've been on a "direct leg bag catheter" for ~ 1 month....I've become accustomed to it...I have to empty the bag 3-5 times per day...I've heard that if I stay on the "bag", I could get "infections"...I'm a widow, 72 years old, and am not sexally active...If necessary, I could "live with the bag" better than TURP Incontinance, leakage, bleeding, etc......Yourthoughts?....

Randy,

I'm assuming that you have a Foley catheter with a tube into the bladder?  If so, there is a possibility of infections.  (I've had Foley catheters for short periods after my two procedures.  I found that the tubing was very irritating where it exited the meatus of the penis.

I have occasionally used a "condom catheter", also called a Texas catheter, and a couple of months ago, I had a UTI.   I had relaxed in a recliner chair that probably put the bag a little higher than the condom on the penis, and some contamination "back flowed."

I'm not sure about the name, "Texas Condom", but I am guessing that it comes from the fact that long distance truck drivers sometimes use them where toilets are  not available on their route.  So maybe one with a larger capacity bag would allow you to drive across Texas without stopping?

I found this on a website at http://emedicine.medscape.com/article/2040035-overview:

"Once a catheter is placed, the daily incidence of bacteriuria is 3-10%. Between 10% and 30% of patients who undergo short-term catheterization (ie, 2-4 days) develop bacteriuria and are asymptomatic. Between 90% and 100% of patients who undergo long-term catheterization develop bacteriuria. About 80% of nosocomial UTIs are related to urethral catheterization; only 5-10% are related to genitourinary manipulation."

(Bacturia is defined as the presence of bacteria in the urine, which is normally sterile.)

 

I posted a longer reply that is being moderated, meaning you will never see it.  So here's the meat of what I posted.  Its cut and pasted from a medscape article, and I'm leaving off quotation marks as they may trigger moderation.

Once a catheter is placed, the daily incidence of bacteriuria is 3-10%. Between 10% and 30% of patients who undergo short-term catheterization (ie, 2-4 days) develop bacteriuria and are asymptomatic. Between 90% and 100% of patients who undergo long-term catheterization develop bacteriuria. About 80% of nosocomial UTIs are related to urethral catheterization; only 5-10% are related to genitourinary manipulation.

(bacteria is the presence in the urine.)

Sorry, bacturia means the presence of bacteria in urine.

Was unable to go to my appointment today. My prostate is swollen and I can't sit down., Continueal Spasms. I left a message for my Dr and he called me back and said there is nothing he can do. I don't know where to turn to next. Am finally running out of hope. It seems like such a cold world. Prostatitis ( if that is what it is ), what a nasty disease.

   Steve

I had a lot of swelling after the Green Laser surgery.  I used a cushion with a long slit opening to sit on.  Got it at a medical supply place.  I even used it while driving the car.  I took Ibuprofen to reduce the inflammation.  I hope you find some help soon.

For heaven's sake, stop and consider other options. Learn to self cath to get some time to sort this out. Look on the Web, and on this site for information on self catherization, PAE (not "BAE". BAE IS AN AIRLINE OR SOMETHING ), and Urolift.

The horror stories you read right here about TURP should be enough to put you off that. Take your time, and do your research.

And one more thing. The PAE is done by an interventional radiologist, not a urologist, so you will never have it recommended by a urologist because they make no money on it.

Neal

Hi Glenn,

"I posted a longer reply that is being moderated, meaning you will never see it."

This is not true. Posts with links in will go for moderation but will be approved if they are to reputable sites. I have inserted the full url in your initial post. Medscape links will always be approved.

Regards,

Alan

Thank Alan,

Glenn

I do have the Foley Catheter inserted into the end of my penis and, yes, I have developed some inflamation and bacteria and the URO has put me on a antibiotic.....The "bag" is easy to use, but causes discomfort and penis pain at times, especially, when I turn while I'm trying to sleep or stand-up after being seated.. I wake-up several times during the night in pain....******** Suggestions-Advice ******* - The Second Uro Doc I saw last week performed a Digital Prostate Exam and, by his experience, believes I have Prostate Cancer...He has set-up a Cystoscopy, Flow Rate, and Bladder Scan Tests for this upcoming Wednesday, August 3rd..The prior Uro Doc had performed a Uro Dynamics Test. ...The 1st Doc does TURP Only and stated It Was Necessary..The 2nd Doc had talked about a Resen ? which is suppose to be the latest least invasive TUIP procedure...Does anyone know about the Resen Procedure?...The Best Treatment Recommendation seem to be the PAE Radiation...Can anyone refer me to a Radiologist who has been successful in performing these?....Also, the 2nd Uro Doc will try another TRIAL VOID Wednesday before he starts the test series.........I Don't Know Which Doctor To Believe or Trust!.....Or How to Select Any Doctor......I feel I need to pursue the PAE. If these tests indicate a possible cancer, the 2nd Doc. then, plans to do a Biopsy, and if cancer, then treat with Radiation Pellets/Seeds.....How Does All This Sound?, Suggestions?, Advice?...THANKS....   

The Foley catheter is painful at best when you move.   I found that the stretchy mens athletic shorts that fit snugly helped keep the penis and tubing in better alignment.  I also used a velcro strap around the thigh.  You might tru this, with an outer wrap of an elastic tape, such as used for ankle sprains.

Re PAE, Inova in Alexander, Va.  Contact # for questions 703-504.7950, and in Mt. Vernon Va, 703-664-7462.  Google UNC urology for a teaching hospital doing PAE.

In another post on a different board, I found this:

"Other US sites currently enrolling patients, according to clinicaltrials dot gov, include Northwestern University, University of Miami, and Tampa General Hospital. Merit Medical, which develops IR and endovascular products, is also sponsoring a prospective multisite clinical trial comparing PAE and TURP. As of April 2015, the study was still enrolling candidates to reach its target of 186 patients, according to clinicaltrials dot gov."

 

1. Don't let anyone do a biopsy until you have an MRI which will be used to guide the biopsy to suspicious areas rather than just shooting in the dark.

2. Most prostate cancer is very slow growing. You have time to take your time and do your research on all of your options. Don't let anyone rush you into anything. If you make the wrong decision, you can end up impotent and/or incontinent for no good reason.

3. Research PAE, and Urolift on this site, and on the web.

4. Also look at Frank Talk, and other Web resources.

Others will also be helpful.

PAE IS DONE BY AN INTERVENTIONAL RADIOLOGIST, NOT A UROLOGIST, SO IT WILL NEVER BE RECOMMENDED BY A UROLOGIST BECAUSE THEY MAKE NO MONEY ON IT.

Please let us know how you progress and continue to post questions.

Neal

I would second that.  Just talked to a good friend whose doctor thought his prostate was a bit asymmetric.  Had a biopsy done with 15 cores taken.  Put him out of work for 3 weeks to recover from that.  There's a bit of cancer in 1 of the 15 samples they said.  Doc says maybe watchful waiting will be advised.  

Thanks so much for your thorough response!..I'll heed your recommendations....I'll keep everyone posted regards my progress...

The urologist I'm  seeing now has set-up a series of tests for this Wednesday....Please let me know if these are necessary to determine treatment for my prostatis and possible prostate cancer...1) Cystoscopy, 2) Flow Rate, 3) Trial Void, and 4) Bladder Scan....A Urodynamics test has already been done and my current urologist has the results....There have been ~ 7 Trial Voids performed within 6 weeks and None have been successful so the Uro Doc put me back-on the "direct catheter with a bag"...The current Uro Doc performed a "digital prostate examination"and states per his ~ 35 years experience, I have "prostate cancer"..And, thus,  ordered the "above tests"..This Uro Doc would like to treat my prostatitus with the least non-invasive treatment option...(?) which one is that?....Please Advise Answers to My Questions ASAP...

Very Good Information!!.....Thanks, Glenn.....

That would be antibiotics, but it would need to be long term because the prostate is a fatty organ and it's difficult to get an antibiotic in there. Prostititus means "prostate inflammation ", so that doesn't call for ANY surgical procedure.

Neal

Glenn,    Seems like "You've Been There Done That" so your  experience and advice is very valuable....What were your prostate problems, diagnosis, successful treatment, length to recover, pain medication, other medication, ie. antibiotiics, etc..I hope you don't mind sharing...Thanks..

I was diagosed with BPH about 12-15 years ago.  IMy blood pressure crashed from first dose of Flomax sending me to the hospital in an ambulance, so I never tried that again.  For years, I was up 3-5 times per night, and had a slow stream, but never had an acute retention event.  Also, I'd never had incontinence of any sort.  Finally, another doctor felt I was sleep deprived and wanted me to go to a sleep lab and to see a urologist.  

I went first to to the urologist, they did the standard assessment, tests, which showed prostate enlargement in the median lobe.  The urologist was concerned that I could end up in acute retention with bladder and kidney damage.  Although I was almost 77, he thought my over all good health and fitness was such that I could live for another 15 or 20, and that I should consider having TURP procedure.  I had Green Laser procedure to open a channel in the median lobe in early March.  It didn't heal by 6 weeks and I was totally incontinent.  A second cystoscopy showed lots of hanging debris and inflammation.  A second procedure, Gyrus TURP, was done on May 13.  I'm still totally incontinent today on 1 August.  I've gone to special physical therapists, doing Kegels, etc.  Just started a new procedure which does electrical stimulation of the pelvic floor using a probe that gets inserted "where the sun doesn't shine."   A wire runs from the probe to an external controller.  30 minutes twice a day of this, so since I'm just on day 4, it's too early to tell I guess.

Now, I'm changing Depends pull and pads ups day, and sometimes in the middle of the night. Changing multiple times during the day and night is restrictive and exhausting, largely psychologically.  My fitness is declining as I'm doing a fraction of what I did before.   I'm told it's too early to give up and go for the artificial sphincter surgery.  (I do have conscious of the external sphincter to the point I can stop urination briefly.)   So, that's the story. ( Needless-to-say, I havent' been to the sleep lab yet.)

Fixing typo in last paragraph

Now, I'm changing Depends pull and pads throughout the day, and sometimes in the middle of the night. Changing multiple times during the day and night is restrictive and exhausting, largely psychologically.  My fitness is declining as I'm doing a fraction of what I did before.   I'm told it's too early to give up and go for the artificial sphincter surgery.  (I do have conscious of the external sphincter to the point I can stop urination briefly.)   So, that's the story. ( Needless-to-say, I havent' been to the sleep lab yet.)

 

Glenn, Thanks for sharing your experience and treatments so far..I'm sorry to hear that the treatments didn't work and you're still having problems....I don't trust uologists nor the treatment options  due to all the ALL the Problems the Patients on this Blog have experienced....I though PAE had the least complication, but after reading QEST 2016, PAE can cause plenty of complications too...Thus, there appears to be NO BEST TREATMENT OPTION....It appears a chance of success depends on the many years of successful experience of the urologist and/or radiologist, as well as, the patient's individual reaction to the various treatment options which is impossible to predict...Thus, there's No Good Perfect Treatment Options nor Reliable Results/Cures, etc. .It's Depressing considering the life long risks involved.....I certainly hope you can find some relief soon.....I've had several medical problem close calls that were life threatening in the last 5 years.. I feel I was Blessed to be cured of those... I Pray a Lot for Me and Others which I feel helped in my Cure...I will Pray for a cure for you....Please keep me advised of your progress....

Thanks Randy, I appreciate that.