Chronic Prostatitis

[cavi77]

About a year ago I started felling some itching and burning sensation in my urethra, left testicle and also in the rectum. These symptoms showed up after having intercourse with my partner/woman at that moment. Since then I have seen 4 different MDs and they have not been able to identify the cause of the symptoms and provide the right treatment. The first doctor was a general physicist and he did a urine test that turned out negative. Anyways he treated me with Vibramicin for 10 days and Fluconazole (Diflucan) for 2 days right after the antibiotic. The antibiotic did not make any effect and the Fluconazole actually made me feel better but not a 100%. So the doctor sent me over to an Urologist. This Urologist did urine test (negative again) and looked into my urethra and realized that there was an irritation and inflammation by the prostate. And he prescribed Cyprofloxaxine, for 15 days. It did not work, actually it made me feel worse. He recommended to do some sonogram and I decided to see a different doctor. I spent some time in Caracas-Venezuela I found out about a very good Urologist. I went to see this doctor and he decided to do a urine test where he takes three different samples and one of those three is after massaging the prostate for a little while. In this test he found E. Coli and it is supposed to be in the prostate. He prescribed to me Cyprofloxaxine again but this time for 28 days. The antibiotic did not work and this time I could feel how the antibiotic was actually worsening up the symptoms big time. He suggested me to do the same three-sample urine test here in the US so I did some research and I found another Urologist, I explained the history to him but he would not suggest the three-sample test, instead he did a regular urine test that turned out negative. He decided to try with some antacid for one week, there was not improvement, so he decided to try with a different antibiotic, this time Sulfa. By the end of the first week of treatment I could not stand the symptoms so I called him up and he suspended the antibiotic. We started analyzing what had made me feel better in the past so he tried with Fluconazole and it made me feel a lot better, but the symptoms did not totally disappear, so the conclusion we could take is that there was a yeast infection being agitated by the antibiotics and there was also a bacteria (E. Coli) as it came out in the test but we are not sure if it is gone yet. So the doctor decided to try with antibiotic again (Vibramicin), assuming that the yeast infection was cured, but it won’t make me feel better, actually it worsens up the symptoms again and this time over the first 4 or 5 days. I had some Fluconazole again and I am not 100% ok but much better than when taking antibiotic. Right now I believe that I have a yeast infection that has not been treated in the proper way. Any comments or suggestion? I really appreciate your help in this matter.

[Kevin Pho, MD]

You have had a comprehensive evaluation, including evaluation by several urologists.

At this time, you can consider further imaging of the prostate.  This can be done with a transrectal ultrasound to evaluate for any prostatic abscesses.  

The prostatic massage that was done is a good idea.  Ensure that the fluid has also been sent off for a fungal culture, given your response to fluconazole.  

Prostatitis can be difficult to treat - sometimes requiring several months of therapy.

Another urological opinion can be considered - preferably at a major academic medical center.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[JDHAWK]

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[kapitan_problemado2006]

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[shawnime]

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