Prostatitis Urgency to Urinate

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Hi I am 25 year old diagnosed with bacterial prostatitis after the doctor took a semen culture. I have no pain in the pelvis, no pain during ejaculation. However, I have this issue of frequent urination that is really troubling. Sometimes I would be there on the toiler constantly peeing and dribbling for 10 minutes. During good times I have to pee every 1 hour. I does not let me sleep either. It waking me up every 2 hours.

I also have weak and split stream. Doctor said all of my symptoms can be explained through prostatitis. I have been on ciprofloxacin for 10 days now. It has helped a bit with the irritation that i used to have in the bladder and also around the rectum, but my frequency has only gone worse.

Any advice on how to deal with this would be much appreciated. Is there hope that this go away? 

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  • Posted

    There is other medication that is specifically made to slow down periods of urination.
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  • Posted

    In my opinion, you would be halped by being taught how to catheterise yourself. This is called CIC (clean intermittent catheterisation). You can find a lot about it on this site. It is usually very quick and easy to learn, but rarely used in a clinical setting outside cases of Benign Prostatic Hyperplasia. Many doctors may not be familiar with it.

    Why I am suggesting this for you as a temporary measure is because it would enable you to completely empty your bladder every time you wanted to, all in one go, over a few seconds.

    Because your prostate is inflamed, CIC might be a little painful at first, but that should quickly subside. You might also find a simple painkiller, such as paracetemol might help.

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  • Posted

    My only concern is: is this normal part of prostatitis and is it going to go away with antibiotics in time? 
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  • Posted

    Hi,

    I have prostatitis. My symptoms, pain in the pubic area and lower back sometimes in the shaft of my penis disapear for a couple of weeks and then slowly return for several days. As daft as it may sound going for a walk seems to help apart from the frequent need to pee. My worst day 14 times in 10 hours.

    My Gp says it will certainly clear up for good , had this problem for several months and to be honest each episode is less of a problem.

    Hope you soon feel better.

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  • Posted

    I had your symptoms and on and off cloudiness in the urine. Stinging nettle root extract softgel which also contain Saw Palmetto oil and Pumpkin Seed Oil helped here.

    However, in preparation for a PAE, I had a MRI. This showed a one inch calcification in the base of the bladder. My urologist says this is what is causing Stinging, urgency etc. I am soon to have that blasted with ultrasound.

    Where my GP's anal probe told him I had a 'moderately' enlarged prostate, the MRI showed only a mildly enlarged prostate of some 45 CC.

    There is more, but the point I am making is that GPs do not have specialised knowledge. Specialists do, and it is wise to compare the vlinicians' views.

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  • Posted

    First off, I am not a doctor.. I simply suffered with bacterial prostatitis for maybe 20 years of my life (I'm almost 50). It is a horrible disease and not a lot of research has gone into it.

    Was it your urologist or primary care doctor that took the semen culture? Did he do an antibiotic sensitivity analysis on it and talk to you about what different antibiotics are available to treat your disease?  If not, I would push  the issue hard to have it done, even if you have to give another sample.  Here's why:

    The prostate unfortunately is not easily penetrated by most  antibiotics. Additionally, the prostate will attempt to preserve healthy tissue by calcifying the area that is infected leaving a very large calcium seal around the enlarged infected part of the prostate.  Cipro has been the drug of choice in the past because it does penetrate the prostate well and it used to be very effective against most bacteria that tended to infect the prostate. Unfortunately, with the growing resistance of many pathogens, it is not nearly as effective as it used to be. So getting the right antibiotic for what you have is essential. Cipro is so overused in other countries that it is partially to fully resistant to 50% of the bacteria it could fully treat when it first came out.

    Another fact. It could take weeks to months to even years to clear out a really bad prostate infection, even under perfect conditions..  Sorry for the bad news. That is from experience and talking with dozens of people that had bacterial prostatitis. But the best thing you can do is (1) make sure the antibiotic they are giving you is effective against the bacteria...and (2) Make sure that antibiotic has good penetration into the prostate.  For example Doctors can be lazy and just play Russian roulette by giving you antibiotics that you have no way of knowing if they will be effective.

    There are some things you can try before starting something like self catherization.  If you can find a doctor that specifies in prostate diseases, or at least a knowledgeable urologist, he may give a prostate massage, and if you have a significant other, they can be taught to do it. If you are in shape and limber you can even do it yourself. I did when I was 29 and it made all the difference in my treatment. I could both feel and  hear the calcium breaking apart and after 6 months of antibiotics with little luck, in a  little more that 2 weeks, the entire left side of my prostate had returned to normal and the right side had decreased by 10 to 15% and my urine flow still wasn't normal, but it was WAY increased.

    Did the doctor give you a reason for your prostatitis? You don't have to go into details, but the reason I ask is because I had urethral strictures. The strictures increased the pressure of urine and allowed it to overwhelm the check valves that prevent urine from backing back into the prostate.  I would definitely have a look for structural issues if you are having these symptoms, 

    If you do decide to self catheterize yourself. Have a doctor or a nurse show you how. It is not difficult, but a urologist showed me how to do it and it is much less painful. Also, realize that using a larger catheter (20fr) is much easier to get through the prostate than a small one like a 16Fr, 14Fr, or smaller.  It has to do with how the urethra and prostate meet and how it is pushed open by the urethra.  A larger catheter will open that area fairly easily. I used a very small 8Fr and it actually tore some prostate tissue up requiring repair. 

    I have had 7 surgeries because of urinary issues.  IF you have an questions, go ahead and ask.  

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    • Posted

      Thanks alot for the detailed reply and thanks for showing concern. It really is a tough condition to deal with, my only biggest problem is the frequency of urination.

      Anyhow, yes the doctor who carried the semen test was a urologist and yes he did both culture and senstivity. The semen culture showed moderate growth of some sort of staph infection and the senstitivity to antibiotics was also carried out. The urologist said almost the same thing regarding cipro as you did that it has the best prostate penetration. He also said if the symptoms do not start to feel better in about a month then we will do the semen culture and sensitivity test again because apparently the bacteria can grow resistance over time to a certain antibiotic. 

      I am going to see the doctor this friday or saturday and I will ask him about the cause with specifically mentioning three things as you pointed out: calcification, urethral strictures and prostate massage. 

      The idea of self catheterization really scares but I will try to bring it up with my doctor. I am not sure why I would need it? Why did you catheterize yourself? I mean what condition lead you to do it?

      Can you also tell me why you had go through 7 surgeries? was it due to prostatitis? You said you HAD suffered for 20 years from this problem, so I take it that you are now cured, can you tell me what healed you? Any breakthrough or did you just let antibiotics run their course? Is there anything else you can tell me for the frequency of urination that I have. What were your major symptoms?

      I really really appreciate your detailed feedback and it would really help if you can guide be through this debilitating condition. Having to deal with prostate issues in this young age is literally like living a nightmare. 

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    • Posted

      It's no big deal to reply. If I can offer any help at all to someone it would make my day. People who have never had prostatitis can't imagine how painful it can be as well as affecting your daily life.

      I went through the 7 surgeries due to urethral strictures. The very first urethral stricture developed due to being kicked in the groin playing soccer. I knew I had been hurt more than the standard kick to the junk because I was peeing blood after the game. I was a stupid kid in puberty so I waited a day or so to tell my parents. Then I noticed the blood going away, but my stream was reduced. I decided to tell my parents, but the morning I made the decision, I went downstairs to find them crying as my grandfather had just passed away and they were already making flight plans to leave that night. I hoped that maybe it would just get better, and in a way it did. After a week or so, my stream started to return, not to the level it was before but enough that I wasn't worried like I should have been. Because once you get one, you open yourself up to getting more very easily..

      To see the strictures the doc does a cytoscopy. Basically it's just a small fiberoptic cable that goes in and can go all the way to your bladder to check for problems. A stricture looks just like a little ring of skin like a really thin doughnut that reduces the size, and they can very in how much they close the tube as well as how long the restriction is for. It's just scar tissue. My first one closed the tube down almost completely, but it was like 0.1 mm in length.

      The surgery is outpatient, and doesn't take very long. The doctor usually gives you an option for the type of anesthetic they use. I chose to have an epidural and then another IV drug to put me to sleep. On my complete urethral reconstruction I had to have general anesthesia as the operation takes like 8 hours. The doctor goes in and removes the scarred tissue with a endoscopic blade (as in my first couple) and later with a laser. I was awake for part of the 6th surgery (not intentional) but it looked almost like an old video game where he would move the crosshairs and set a radius for the laser and hit a button and poof there was a small hole there. He continued around until he got as much of the stricture as he wanted. They also do some other tricks to try to prevent regrowth, like cutting channels and stuff, but I don't remember it well enough.

      Anyway, the reason I had so many surgeries is multiple reasons. (1) Once you get one, the pressure behind the first stricture builds up higher than the urethra was designed for and it stretches far enough for a small tear and then scar tissue starts to form around it. (2) I was a fighter pilot. I was routinely pulling 9g's and having to strain my lower abdomen to remain conscious during hard turns. It was the funnest job in the world but your body pays for it over a career. (3) I didn't know at the time, but I had a genetic abnormality passed down on my mother's side. It's called CVID, or Common Variable Immune Deficiency. Mine has to do with antibody production. Today I make absolutely zero antibodies (or should I say correct antibodies) and have to get infusions of blood plasma with a mixture of antibodies from healthy people to stay alive. Back then, my immune system was still functioning, but was weakening every year. It caused a lot of urinary tract infections that would often reinfect my prostate after spending months on antibiotics to get rid of it.

      Anyway, back to your post and some other questions:

      - Did your urologist do a bladder emptying check? It takes like 2 minutes after you go to the bathroom and tells you how much urine you retain after you think you've emptied it. Simple ultrasound device.

      Also, I would talk about a uroflowmeter test. It too is quite simple. Just pee into a special toilet that is really nothing more than a beaker on a scale. But they can see how long it takes to get up to full flow, what your peak flow rate is, etc. If they haven't done this, and you've discussed your flow issues I would look for a second opinion. Usually when someone is in pain for this long, they do these tests as they can all be done in one visit and give a lot of diagnostic info.

      As far as how I'm doing now, well fantastic... relatively. This last year my prostate began swelling with symptoms of prostatitis around June. I couldn't feel it, just went to bed one night and could not urinate at all. I had catheters because after a urethral stricture surgery depending on where and the size of the stricture, the doc may want you to self catheterize yourself simply to keep scar tissue from accumulating. Anyway, I was familiar enough and knew that this would happen one day as my flow had been weak again since my last surgery 5 years ago which was the complete reconstruction. It went terribly wrong and really messed me up.

      I used the catheters, but my prostate swelling wouldn't go down, even after it seems we got the bacteria. So on the 31st of Dec had a Urolift procedure and I can go better than I have since I was 16. I'm still having to retrain my bladder and have some incontinence issues, but they all seem to be improving.

      As far as my prostatitis, non-surgical solutions, I would say the best improvement came with the combination of the right antibiotic, frequent ejaculation, and I had to do prostate massages. My doctor did a few and actually taught my wife how to do them. With just the right antibiotic, I seemed to just stabilize. The massage did the trick. You can search for prostate massage devices online as I got to where I would do it myself at times. (You just pray the credit card receipt and the box are discreet!) Just add medical to the search terms and you can find what they have nowadays.

       

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  • Posted

    Simroo.  I am sorry that you are having a problem at your age.  You need that prostate for a good many years.  The infection will go away in time I read that it could take up to 3 month.  I have the same thing I had a infection of the kidney and found out this time it hit my prostate.  I had a orgasm and it hurt so bad I try to stop it but could not.  Did not feel good Pain almost a hour later.  I told my urologist and I am on Ciprofloxacn 500mg 2 time a day for a month.  I see him on the 11.  Just drink alot of water and take it easy   Ken
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    • Posted

      Thanks for the reply, yes it is sad and I have no idea how i got it in the first place. It was just so random. I do not have any pain of any sort, No pain during ejaculation either. I have urinary frequency and urgency, decreased libido, weak and split stream. 

      My uro also told me to ejaculate very often. He asked me not to let the semen accumulate for than 2 days, i believe thats when the bacteria starts to incubate. So I have been ejaculating everyday almost. I have also read that it is best to ejaculate within half an hour to an hour after taking the antibiotic dose because thats when the level of antibiotics is highest in the blood. And when you excite yourself, thats the time when blood rushes to the prostate region, thus supplying it with antibiotic rich blood to clear the bacteria. There is no medical evidence behind this theory though. 

      I hope you get well soon. Do you have pain just during orgasm or also during urination? How long have you been taking cipro for and has it helped thus far.  Today is my day 11 on cipro, I feel that the irritation in my bladder area is a notch better, but I am far from feeling alrite. Btw do you also get fatigued? keep in touch!

      Thanks man

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    • Posted

      I have a stricture that is what is causeing my infection.  I have takin Cipro many times.  This time I have to take it for 30 day have 4 days to go .  I do get tired. My libido is doing good I try to do it 2 or 3 times a day.  I think at my age I'm afaid of loseing my prostate.  But I will not give it up without a fight.  I still enjoy sex and without ejaculation I would feel like a broken toy.  Dry orgasm are the pits.  Take care Keep in touch Ken  
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    • Posted

      I also think that I might be suffering from a stricture, I will talk to my uro regarding this because I have split, and weak stream. It also tends to spray sometimes. Have you tried to get your stricture fixed? how is the procedure? Thanks!
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    • Posted

      Yes I was going to ask you that.  Do you ride a bike or have you hit youself down there.  It very easy to get one if your not careful I got mine from kidney stones surgery never know I had it. Was in the hospital Thats a horror story.  I will tell you about it maybe later Yes have the same sometime I just sit to pee because it sprays or splits.  My doctor told be it was because of the stricture.  My is a short one in the Bulbar urethra.  It's about less then a 1/4 long and about the inside is about 12 to 14 cm  I can't have a catheter no bigger then a 10 or 12 fr conde catheter.  To have it fix my doctor has talk to me about 2 options.  The first one is a balloon dilation.  That is where they put in a catheter with a balloon on it and they go in and blow up the balloon  and break it up.  The only problem is that it can come back in 6 month or a year then you have to have it again.  You go home the same day and have a catheter for 2 days.  The other is a end to end urethroplasty surgery.  They would cut the perineum that is the space between the legs from your balls and anus. They would cut through the musles to get to the urethra and they cut the stricture out and they sew the 2 ends together  This is major surgery and thats takes 2 to 4 hours or more to do.  You have to stay in the hospital for about 4 to 5 days and you have a catheter for up to 4 weeks.  I will find out on the 11th to see what we are going to do.  It's alot to think about.  Talk later Send a private chat if you like  Ken  
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    • Posted

      Hi Ken, wow this forum certainly give you food for thought. I have never had a strong stream and its split for as long as i can remember. ever thought about an accident causing a stricture, uro never suggested the possibility either. had an accident between the legs sledging when about 11 yrs old. end of my penis split open and bleeding. Sore for a few days and that seemed to be it.( late 1950s we didnt go bothering the doc then) always had discomfort in the shaft of my penis starting about 15 mins after ejaculation, a sort of burning feeling untill the next time i went to pee. this stayed like this till my late 20s then just cleared up. Still have scar at the opening of my urethra just wonder now if i have damage inside. Thanks again to this forum.
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