Other avenues for Prostatitis Treatment

[weston89]

I am a 36 year old male. I was diagnosed with Chonic Prostatitis a year ago.  I have had X-rays (a year ago)CT's (a year ago), DRE's, CBCs w/differential, an AFBG, and B-HCG testing.  The blood work has all been negative and the urinalysis (too many to count) show no bacterial infections.  X-rays show no problems with my discs.  Also the CT was clear (it showed minor pelvic lymph node swelling, but the AFBG and B-HCG and CBC were clear).  There was a period of time I was in constant pain (pain in the penis (tip), burning while I urinted, constant feeling that I had to urinate, golfball feeling, inner thigh pain, and lower back pain).  At this point, the pain has lessened about 70%, but I still get a feeling of pain in the penis (burning in the head), urgency to urinate, pain while and after urination and ejactulation, inner thigh pain (almost like a stretching) and now the lower right back pain has returned.  At this point I have been examined every which way I can imagine.  I have been on and off doxycyclene for the past year, was on Elmiron, but due to an allergic reation I am now off of that.  My urologist sees me every six months, tells me to use warm baths, advil, etc.  Wants me to continue to get CT's.  But nothing is really working. It is important to note, that this all started after I sustained a severe groin pull while working out.  My primary care doctor, told me to take saw palmetto and that this will last a while. What more can I do?  Have I missed something?  I have read about the Stanford Protocol.  is that something to try?  I am definitely frustrated especially since my wife and I are trying to start a family and this is not helping matters.

[Kevin Pho, MD]

Chronic prostatitis can be difficult to treat.  

Regarding the workup - you have had a pretty good evaluation.  You can consider a transrectal ultrasound (to image the prostate for any abscesses) or a cystoscopy to ensure there are no anatomical issues leading to your discomfort.  

The Stanford Protocol approaches cases of chronic pelvic pain from a tension disorders, rather than an infection.  I am not very familiar with the protocol, but this is certainly an avenue you can persue should antibiotics continue to fail.  

Another option would be a referral to a chronic pain specialist.  Although this won't be curative, a specialist to manage the pain can greatly improve the quality of life.

These options can be discussed with your personal physician or urologist.

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_b

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