need cure

[buzzy516]

I am 1.5 years in cccp/prostatitits and no cure in sight.Tried everything.

[MSKshelly]

Once tests rule out other issues,,, you might consider seeing a pelvic pain physical therapist!  These are trained to work with men and women!  My experience has been that they can often find many other issues that a URO may miss!  I have IC and suffered for many years!  MyPT helped me significantly finding musclura issue etc and that my pelvic region was in a constant state of spasm!  If you do not get relief from your uro soon it might be helpful to ask for a referral!  I found mine by calling several hospitals in our region and asking about it!

[Dr Smitha Mathews]

Hi,

Yes, you can suggest that you would prefer the less invasive procedure first.
A prostate ultrasound is done transrectally and the probe will be inserted through the anal opening.
Preparation includes an enema, but instructions about preparation would be provided by your urologist.
If you need any further info on it do post here.

A cystoscopy carries the risk of traumatizing the urethra. This can cause scarring or strictures which can further complicate your existing condition.

Have you tried any centrally acting agents for your pain?
These include amitryptiline and gabapentin.
You may also wnat to discuss treatment with hydroxyzine (Atarax).

Any treatment or investigation that is to be performed on you cannot be carried out without your concern. So it is always your call.
You do not have to agree to anything that you are not sure about.

Regards

[buzzy516]

Dr. can i suggest an ultra sound of the prostate first.Since it is less invasive and it could diagnose something, and save the cystosocpy for last if needed.Like I said the urodynimics test for me was very painful.Can I make that call?I know there are more risks with a cystocopy.

[Dr Smitha Mathews]

Hi,

I think you should also discuss the possibility of having a cystoscopy done.
This is to look at the inside of your urinary bladder to identify any growth or damage to the urothelial lining, which may be causing the inflammatory symptoms.

Another possibility is pudendal neuralgia - caused by pudendal nerve entrapment or compression.

Identification of the cause of your symptoms is crucial to right treatment.
However, you can try an IC diet to check for any mitigation in symptoms.

regards

[buzzy516]

Iam 46 years old.I had urodynimics testing done,test came out fine.iam at my wits end nothing helps.My psa is good.Ijust feel achey in my pelvis and it is constant.Idid see 2 urologist and both are doing the same thing. flomax,hot baths,etc. it wont go away.is this something i have to live with?

[Dr Smitha Mathews]

Hi,

How old are you?
Have you had a prostate ultrasound (done transrectally)?

A prostate massage is used to obtain a sample of the prostate gland secretions and does not have any therapeutic value.

It is done to obtain a fluid sample from the prostate to check for infection.
Should not be undertaken without proper guidance in view of the risk of perforation and prostate injury.

Do discuss the possibility of prostate ultrasound and cystoscopy with your urologist.

If you have any family history of cancer it would be a good idea to rule it out as well.

Regards

[buzzy516]

I've tried flomax,vesicare,elmirone,you name it nothing works.Where my discomfort is it is the prostate and the area around it.the mornings are the worst,the whole pelvic region aches.The urologist said my prostate is fine according to my frequent DRE's.I can't believe this condition can so chronic and difficult to cure.This is a terrible condition with no end in sight.Dr. please comment more this matter.Would prostate massage help or just make things worse?Thats the one thing i didn't try yet

[Dr Smitha Mathews]

Hi,

The symptoms you have described can occur with prostatitis as well as with interstitial cystitis or overactive bladder.

Interstitial cystitis is a disorder that can be due to genetic, neurologic, allergic, or autoimmune cause characterized by  damage to the urothelial lining of the bladder.

Cystoscopy with hydrodistention can be used to diagnose the condition and differentiate it from prostatitis.

An ultrasound of the prostate can also be done to check for inflammation within the prostate and to pick up prostate enlargement.

Slight changes in diet, such as avoiding caffeine and alcohol and citrus foods can help reduce symptoms.

Pain medication such as elmiron have been described as having good results in this condition.
Regards

[buzzy516]

My symptoms are lower back ache,testicals ache,slight discomfort in rectum.Frequent urination,urgency.Had urodynimics testing done,showed no blockage.Uro did not order other test.test very painful.this condition is 24/7.Wake up 2-3 times a night to urinate.If i had a obstruction would the urodynamics test pick up on that.Never had cycsoscopy.

[Dr Smitha Mathews]

Hi,

Could you please provide a few more details of our symptoms?
Have you been investigated for overactive bladder syndrome or interstitial cystitis?

Have you noticed any variation with any of the therapies you have tried?

Do post a few more details.

Regards