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Avatar universal

chronic prostatitis

Hello people...

I am a 60 year old male. For the last 6 months or more...wake up with all the classic symtoms of protatitis. Crampy bladder or adomin, weak first morning stream, back ache. Three cups of coffee primes the pump follow with lots of water...gets me going.

Actually i have been having this kind of problem for a longer than six months....it's just that it has gotten worse.

I have been taking levinquin 500 mg. Started six months ago with short 10 day doses. Symtoms would almost dramatically get better...However now it seems i am on it almost all the time and thesymtoms get better at first and then go back to worse even though i am still on Levinquin. I have had over six courses of Leviquin in the last six months...

Currently have been on Leviquin for three weeks now...planning to stretch it to five weeks. However i got up this morning ...same thing ...crampy feeling in the bladder.

The urologist say it is chronic prostatitis... inotherwords benign...Psa has always beem .5 or less than one. Other than a bladder x-ray nothing else has been done. The bladder image with contrast dye looked good.

And yes..i have been on flomax and avodart all this time too.

Any advice apreciated...Thanks!
11 Responses
Avatar universal
Hi
Acute prostatitis --
It is a quite severe disease characterized by high fever, chills, severe pain in the lower abdominal region and in the perineum, burning at voiding or difficulties to void.
Chronic Prostatitis ---
commonly used to describe a collection of symptoms characterized by the presence of pain or discomfort in the perigenital area (perineum, groin, testicular region) often radiating to the lower back or the inside of the thigh.

It would be better to have an ultrasound done (TRUS), as it would give an idea about your condition. Have an urine culture done as UTI can also lead to chronic prostatitis.  
Avatar universal
Hi folks...

Update...went and saw Dr.One...and asked about the trus suggestion. He opted for doing another psa which came out .5 or around there. And put me on another course of Leviquin...this time 4 weeks. That was over two months ago.

Since i commute and live in two cities...i have another urologist Dr. Two. His thoughts are that when i am on the Leviquin...i am fine and after i get off of it for a while ...i start having symtoms. Soooooooo he propose that i just stay on antibiotics period.

This seemed that i would eventually become to antibiodtcs altogether...however the pattern seems true...however i just am not so sure about his plan on being permenently on antibiodics?

Hence...have symtoms again...crampiness in the groin area in the morning ...weak morning stream until i drink a half pot of coffee to get the stream flowing. ......So i sought another opinion...Dr. Three. Saw him for the first time the other week. Gave him some basic lab info psa tests... He attempted to perform a prostate massage so as to examine with microscope the fluid ...however none came out. So he requested i urininate so as to seek residule prostate fluid to be examined...

At the end of the visit...Dr. Three prescribed another course of Leviquin (2 months)!?

So now once again i am back on antibiotics...Being a cardiac out patient...it seems the cardiology treatment and diagnosis is far more advance than urology???

Any enlightenment or suggestions appreciated ...Thanks
Avatar universal
Hi,

I understand the frustration with this condition, as it is chronic and relapsing by definition. The antibiotic treatment may indeed take several weeks and    extends more than a month for some cases. The advice to take the antibiotics without end sounds practical but doesn't sound rational as chances are its usefulness will be exhausted at some point.  You could send a sample and do a culture in order to direct the next course of anitibiotics that you need. The problem here is the additional cost and the waiting with this approach.

You could also discuss if the likely cause of repeated infection is obstruction due to the prostate size. If this is the case , it is likely that the definitive treatment would be to relieve the obstruction by undergoing an operation on the prostate.
Avatar universal
Thanks for your replies...Although i take them as opinions...they help educate me so i am better able to talk to the docs who would have the hands on position.

Talking to Dr. Two ...as far as surgery was concern...his comments where that if surgery on the prostate was done...the whole thing would have to be taken out as the prostate post surgery in order to prevent the remaining prostate post surgery from becomming infected again???

No i am not opting for any surgery...just confused as to what he might have ment? ...Also he did explained   what a turp was...as i understand...a kind of rotor rooter job through the ureatha...

Dr. One...said at the on set that i was too young to have the prostate removed...and that after some time ...hopefully the prostate would shrink as i got older.

So far now...have started 3 days on Leviquin again...and the symtoms dramatically improve,,,first morning stream is fuller and able to feel that i am complelely emptying the bladder. Perhaps ...just this should give a clue as to what might be going on???

Thanks...any other thoughts...enlightenment ...suggestions always aprreciated. As i said ...the hands on physician will have the last word...

Ps...is there any other less invasive way of x-raying or sonograms to show an obstruction? Cannot do an mri....
Avatar universal
Hi,

You could discuss the option of rotating antibiotics - that sounds like a better plan than an indefinite intake of the same drugs.

Of course, surgery is not the only means to achieve a reduction in prostate size. There are drugs that you can use to decrease the prostate size and hence may provide better symptom control.
Avatar universal
Dr.Heinrik...

Thankyou for your suggestion...I did mention to the last Dr.Three about changing to cephilexin(sp). However he wanted go with leviquin and said that they were both in the same family.

I have been on flomax .4mg and avodart .5mg daily almost from the get go.
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