Prostatitis? Am I too young for prostate cancer?

[Dave74]

Let me just start by saying I am a 33 year old married male with no history of health problems.

Today the date is October 20/2008.
At the end of May I started having pain in my left testicle.

Over the next 2 months I was seen by 3 more doctors with similar issues and diagnosed with epididymitis and prescribed various doses of Cipro(10 days), Apo-Cephalexin (3 weeks) and Apo-oflox(1 week).
Then the pain spread to my right testicle and eventually I started feeling a lot of pressure on my prostate. I had an ultrasound of the testicles that showed apparently no problems.
My prostate was 'boggy' and very sore when digitally examined. There were no other side effects other than the pain, pressure and sore testicles in the spermatic cord/epididymis area.  The testicle ultrasound ruled out the epididymitis.

I was prescribed 6 weeks of vibra-tabs(doxycycline hyclate)
At the end of 6 weeks the symptoms had not changed. One urologist has scheduled me for a cystascope to see if there is a narrow urethra causing it and the other urologist scheduled me for a bladder ultrasound, transrectal and prostate at the same time which all showed nothing that abnormal according to the ultrasound technician but I have not seen the doctor yet. They both seem to be approaching it differently but believe it is some kind of prostatitis.


I feel like I need to urinate badly sometimes, it is very uncomfortable to sit, the prostate feels sore and I get pain sensations like a sciatic nerve pinch down my legs constantly when it is irritated. My testicles also feel sore up to the base of my penis sometimes but not as often as they used to. After ejaculation/sex sometimes the spermatic cord area can feel sore for a day.  Laying down or standing up seems to make no difference, however it seems less irritated in the morning.
I have tried all sorts of things such as Saw Palemetto, pumpkin seed oil, flax seed oil and a few pollen type pills that say they help non bacterial prostatitis.


Thanks

[Dave74]

Thank you Doctor, I still take the NSAIDS and they seem to get my prostate4 under control.  But what concerns me is that every few days, mostly the right side at the base of my penis/spermatic cord becomes very tender and sore and then I get spikes of pain that radiate at the top of my spermatic cord, especially if I sneeze or cough.  I have been checked several times for hernia with nothing found.  What is happening? What can I do, this has been 8 months now on and off and no sign of it easing up.

Thanks again

Dave

[Ash Tewari, MD, M.Ch.]

I am glad to hear the NSAIDS are helping.  It is common that the symptoms will persist for some time and you may find that you need to re-start medication to alleviate symptoms.  Hopefully the time between symptoms will gradually grow longer.
As far as the medication and the potential side effects, I suggest that you discuss these issues you’re your urologist and primary care physician.  Generally speaking, these medications are safe when used as prescribed but the physician who sees you on a regular basis can give information that would be more specific to your individual case.
Continue regular follow-up with your urologist to monitor your progress.
Best,
AT  

[Dave74]

Hi Dr.  The NSAIDs seem to work well.  I do not have any pain during ejaculation though.  When I go off the NSAIDs for so little as 24-36 hours the spermatic cord area becomes sore again.  Will this EVER go away?

Also, how long can I be on these drugs.  I have been taking meloxicam for 2 months on and off now, I understand there are issues with blood pressure?

Thanks

Dave

[Ash Tewari, MD, M.Ch.]

Prostatitis is the most common urologic diagnosis in men younger than 50 years and the third most common urologic diagnosis in men older than 50 years (after benign prostatic hyperplasia [BPH] and prostate cancer),

Prostatitis can range in its severity and level of bother to a patient.  Although prostatitis may have more than one etiology, it is often considered bacterial until proven otherwise.  There are three major categories of Prostatitis, but it is easier to think of them as two; acute and chronic.

Acute Bacterial Prostatitis
Acute Prostatitis is characterized by an acute onset of pain combined with frequent urination as well as difficulty in initiation of urination in a patient with fever/ chills and/ or achy joints. Patients typically complain of urinary frequency, urgency, and pain with urinating. Patients often also complain of pain in the groin, buttocks lower abdomen may have associated pain the genitalia.

Chronic bacterial prostatitis is characterized by repeated episodes similar to acute prostatitis that come and go.  Patients may be relatively asymptomatic between acute episodes pain, which was most commonly felt in the scrotum, buttocks and lower abdomen.  Pain can also be felt in penis, groin or low back. Pain during or after ejaculation is one of the most prominent, important, and bothersome features.  

Treatment for prostatitis involves antibiotic use, frequently for many weeks.  It can also be very difficult to treat and some men require multiple treatments with antibiotics.  NSAIDS are typically used to treat the symptoms of prostatitis but antibotics are key.

Unfortunately, your situation is not uncommon. I suggest that you continue to see your urologist for treatment.

Best
AT

[Dave74]

Yes I was also told that acupuncture could help, but I dont really believe in that kinda mumbo jumbo.  What kind of anti-inflamatories? That sounds like it may work because of proximity.  I have been taking Relexin but was told that something called 'Peenuts' is good too, but I am hesitant to buy things over the internet and I am a bit of a skeptic.  I have been taking Saw Palmetto, bee pollen, etc etc with no relief.  I think the alpha blockers may be helping but its only been 3 days on those.  7 Months total in pain.  *****.

;)

[jeffos95]

Dear Dave74

i have exactly the same symptom as you, urologist cannot give me any real explanation; except chronic prostatitis....without bacteria identified.

they give me antibiotics for weeks, all together alreary aound 8weeks....but no improvement of my symptoms.

they suggest me also accupuncture.

the things which work for me: hot sit bath, cushion donut sit, anti-inflamatory suppository, prosta-Q a little bit...

keep fighting it is not a easy disease..i carry this for 3 months, it seems like years for me!
regards

JFT

[Dave74]

Wow, I am just a layman here and thats alot of fancy terms I am not familiar with.  I am taking Meloxicam which is supposed to help a little bid.  My urologist basically wants me to take flower pollen pills and maybe acupuncture now that he is pretty sure it is not bacterial.  If it is non-infections prostatitis will it go away on its own and be helped by NSAIDS?  If it doesnt go away in a few weeks when I go back to see him I will ask him about that analysis.  I had a urine sample done after a prostate check and it yielded no bacteria growth.  IS it common to have some pain in the upper testicles/spermatic cord area with prostatitis?

Thanks

[swhurricane]

sounds like a hx of recrrrent prstatitis,might proceed to be  chronic if not correctly treated. i suggest you have your urologist perform a prostate massage and collect the prostatic fluid for analysis. need to rule out mycoplasma or chlamydia infection by serology. if still negative, the dx might be non-infectious inflammatory prostatitis,then use simple NSAID for symptom-control.