23 year old with prostate problems

[Jason__0]

  I am a 23 year old male, and I have been having problems urintating for several years.  I have had a lot of medical treatment, but none that has been absolutely effective.  I Originally went to the doctor because I constantly had to urinate, I never felt as though I could empty my bladder, and I had leakage.  The first doctor decided it was a stricture, which proved to not be the case.  I left the problem alone for several years, and then again went to a Urologist who checked for a stricture, STD's, and urine splashing back into my bladder before settling on Prostititis.  I had two bouts with medicine which helped but didn't fully cure the problem.  I would give a urine sample and then the doctor would "milk" my prostate and I would give another sample, and both times there was still infection.  I had x-rays and CAT scans, and it was discovered that I have a Horseshoe Kidney, but it was considered safe and irrelivant to my problem.  Finally, I was given Cipro for the max time (a month or six weeks, I think) but I wasn't given a check-up afterwards.  The doctor said that he had exhusted options and that if the Cipro didn't work he couldn't do anything else.  He said sometimes the Prostate stays chronically infected.  My symtoms did relent, but it has been several months and now they're returning.  I constantly have to urinate, etc.  My questions are;  How unusual is this for someone my age, and how will it effect me later on?  Is the Dr. right in that it may not be correctable?  Can Herbs such as Saw Palmetto really help?   What advice can you give?  Thank you in advance for any help you can offer.
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Thanks Jason for your questions.
Your symptoms may be related to a variety of urologic conditions including primary bladder neck contracture (PBNC).
A cystoscopic exam ( looking into your bladder with a lighted scope) can be the first step in diagnosing this rare condition.  Another test , which is more definitive, is called urodynamics. A small catheter  is placed into the bladder , the bladder is filled  and the pressures and flow rate is measured when you are asked to urinate.  A positive test for PBNC shows a obstruction to urine flow at the bladder neck.  Alpha blocker medmedicationsw like Hytrin, Cardura, Flowmax may help somewhat, but usually same day surgery is needed to open the bladder neck by making a cut in the narrowed area of the bladder neck.  This is accomplished by using a scope through the penis.   These patients have dramatic results with surgery.  Cystoscopy and urodynamics  are a  must for your work-up to be complete.   Drs. Ron Glinski and Hans Stricker have just reviewed Henry Ford Hospital experience of very young men who have this diagnosis.  About 5% presented in renal failure and required kidney transplantation because of the damaging back pressure put on the kidneys.    
If these test are normal and no obstruction is found, continue treatments for prostatitis.   Unproven herbs and home remedies may work for few. They have not undergone the rigorous testing of the FDA and probably will not hurt you besides in your wallet.  Remember about 30% of patients will report symptom improvement with just a placebo ( sugar pill) for urination problems.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians’ notes and lab test results that you  may be able to obtain. These will help us greatly.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
Sincerely;
HFHS-M.D. MS
* Keyword: bladder outlet obstruction, primary bladder neck contracture