Prostatitis or something else - how do I get a diagnosis?

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I have soreness in my penis, and between the legs, mainly on the left hand side. It is getting worse. First noticed about two months ago when it was intermittent. Now it is there almost all the time, even at night and when I wake up. The smallest movement is sore, sitting down is sore. It is ruining my life. Walking, coughing, anything … hurts. Painkillers don't seem to effect it.

The doctors have made no attempt to examine me and little attempt to do any serious consideration of a diagnosis. My GP appears not interested as I have previously been treated privately by a urologist.

One problem is that I have had a couple of Urolift operations for BPH so I am now 'type cast' as probably having prostatitis. In addition there is only one urologist who deals with this, so I go to see him (privately is the only way). He tends not to listen and lectures, and I have little confidence he has even listened properly to my symptoms.

I suggested an MRI scan. He said that I should have PSA test in a few months when my symptoms settle down (!), and then maybe an MRI scan. (Further background is that some years ago I have a PSA of about 11 and had MRI directed prostate biopsies which were negative).

I would like to be confident that it is not 'serious' and would like to have a diagnosis, and then I would like to know what treatment to take. But these apparently simple requests seem impossible to achieve.

Any helpful thoughts would be appreciated :-)

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  • Posted

    Well if the docs your seeing won't help, only other thing you can do is see a different doc. I know it doesn't sound helpfully but I think it's the only choice you have. If you know something is wrong and it's not going away, what else can you do. Sounds like ignoring it is not working. Find a doc who will listen to you. Good luck.

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    • Posted

      Urolift is not linked to prostatitis. If he has prostatitis aka CPPS, he could Google "prostatitis/CPPS tips"

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    • Posted

      How do you know that Urolift does not provoke prostatitis?  Urolift is very new, and prostatitis is just an easy 'catch all' diagnosis.

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  • Posted

    What coutry are you in? Find a different doc ASAP. 
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    • Posted

      Hi

      ​Thanks for you reply.  I am in the UK. It is not easy to get another GP here.  Also the Urologist is the main man.  Hence my dilema. But I will have to go back and see them anyway

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  • Posted

    Have you been back to see the Doc that done your urolift surgery? If he is not concerned, I would find another Doc ASAP. As new as Urolift is I am surprised that he does not want to know what is going on as well.

     

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    • Posted

      Hi Joe

      ?Thanks for your thoughts.  Yes, as I said I have been to see the urologist who did my Urolift - he is the one who hardly listens and is somewhat dismissive.  One issue is that he is the most experienced man in the UK for Urolift and others defer to him.  Perhaps I should take comfort in the fact that he didn't seem bothered :-)

      I may have to pay to go and see him again ...

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    • Posted

      Really sad that the Docs in the UK are the same as they are here in the U.S, and do not listen the thier patients,

      How long ago did you have your last urolift done? And if he said it was most likely prostatitis, did he five you antibiotics??

      If he did not,  get some from another doc ASAP. Take it from a guy who has had more than his share of prostatis, it is not gonna just settle down and go away on its on. You need to be on a long course of an antibiotic specifically that will get into the prostate such as Bactrim. And it would also be a good idea to take a round of an anti inflammatory.

      Best of luck buddy

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  • Posted

    It sounds like besides getting a new urologist, you need to see a good radiologist who will do (another) 3T MRI. That MRI can tell you if it's "anything serious ".

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    • Posted

      Hi Neal

      ​Yes I suggested an MRI to the consultant, who reckoned that I should have a PSA in a few months and only then consider and MRI. 

      ​Perhaps I will have to pay for an MRI myself (I have had to do that before I had prostate biopsies once).

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    • Posted

      I will bring my situation up to date.

      ​I have intermittent pains on the left hand side which seem often to extend from where I sit across to between my legs over to my penis itself.

      ​These can disappear but often reappear after exercise - even just walking can be painful.  And the slightest movement of my body can provoke pain down there.

      ​I have now had a PSA test which was ok in the sense that the value was the same as about 4 years ago before I ever had postate cancer biopsies.

      ​My GP has no idea what the problem is and is therefore (he says) unable to refer me to anyone.  I am wondering now whether the problem is indeed that one/some of the Urolift external tags are snagging and pulling through to the tags in my urethra giving these symptoms.

      ​Anyone relate to this please?

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  • Posted

    Hey Mike, I notice your initial thread was 5 moths ago. Did you do a good long round of antibiotics anytime during that time, and the sypmtoms improved?

    If so mostly likely you do have a serious case of prostatitis. That seems to be the way it works. Things get better, and then just slowly start to creep back up on you. And if you are like me when it starts you try and convince yourself that its not what it is again.

    I hadnt had any problems in over a year, so I was actually getting cocky and thinking about bike riding again lol (glad I didnt do that). So last week I done some extra lawn mowing, riding it for about 6 hours. Needless to say bad idea. I convinced myself for 3 days I had messed up my hemoroids. Gave up after that after 3 days, and started immediatly on 2 Clarythromycin 500 mg twice a day, and Prednisone. Within 3 days the pain is almost gone.

    I will do this regiment for 21 days.

    The bottom line is, I do not think you ever get rid of it, and if you do anything to aggravate it, the chances are  very good its gonna come back, and just get on it quickly with a good antibiotic that gets to the prostate(not all do).And do them for longer than the usual 7-10 days.

    Good luck Joe

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    • Posted

      Hey Joe

      Thanks for the thoughts.

      ?Actually this time I have not done the antibiotics.  

      After my first Urolift operation I had some issues, so I had a 5 week course of antibiotics but they did not do any good and it was concluded at the time that there was no infection.  ?Actually, it turned out that there were some problems with the Urolift tags and I paid for a second Urolift operation 18 months ago, where the problems seemed to have been resolved.

      ?But a year later, these pains started up and more associated with any sort of exercise.  Hence me now thinking it could well be due to those Urolift tags moving again (I have 9 of them) rather than prostatitis.  My feeling is that blaming prostatitis is 'the easy way out' as it is unprovable and untreatable (or just unresolvable).

      ?I am again going to press my Urologist on this matter (probably at more great expense)

      Cheers

      Mike

       

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  • Posted

    You could very well be correct, the tags possibly are just causing severe inflamation, Try a round of prednisone, and see if it improves, that will give you a good idea if that is what is. If it is inflamation, it will start to feel better within several hours.

    Its very hard to detect an infection in the prostate. But infection usually follows a case of inflamation. I knew I had just inflamed mine with the mower last week. But decided to go ahead and do the antibiotics just in case.

    What type antibiotic did you try before?

    I am seriously considiering having the new FLA done, which removes tissue, with the hope that might cure my prostatits for good,

     

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    • Posted

      Hi Joe (and everyone!)

      Just a quick note to bring this up to date.

      ​I eventually saw another urologist who found my prostate to be inflamed (of course).  Urine test negative for infection as usual.

      Despite my wishes he prescribed me 5 weeks of trimethoprim antibiotic.  I was sure it would do no good.

      ​But actually in the last of the 5 weeks things seem to have got much better!!

      ​So maybe it has been an infection after all!

      ​I will not be too optimistic yet, and see how things progress

      Best

      Mike

       

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