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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
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

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

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

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.
Avatar universal
I have been on another dose of Leviquin now for two weeks. Symtoms are that i have to get up and urinate early in the morning ...otherwise flow is fair.

However i have been having extrene pain at the hip joints for about several weeks now and getting worse. And i think it maybe a reaction to the medication. I did do a search on Leviquin and side effects and found several patients having this reaction. Along with other reactions mention were pain or distress in the tendens???

I saw Dr. One today...and seems he was evasive or defensive in answering my questions. That and i quote...he didn't have the time to discuss it my questions or something like that.

He did say i had prostititus(sp) and said no urologist would ever consider surgery ...for that. Seems like finding a good doctor is just so hard these days.

My thoughts are discontinuing the Leviquin...as a result of reading up on it...any opinions appreciated...as always...Thankyou
Avatar universal
Opps...that was Dr. TWO and not Dr. One..... who lacks patience or good bed side ect.  The one who suggested i stay on antibiodics perninently...
180749 tn?1443598832
The Yoga Pranayam (breathing exercises) will  help you relax and also help with the prostatitis.You will start to notice benefits after 2 weeks and over long term the problem will disappear.
Build up your timing gradually. If you feel tired or dizzy, stop and resume after 1 minute.

Bhastrika - Take a long deep breath into the lungs(chest not tummy) via the nose and then completely breathe out through the nose. Duration upto 5 minutes.

Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Age over 15 years -Repeat this cycle for 20 to 30  minutes twice a day(maximum 60 minutes in one day).
Age under 15 years -Repeat this cycle for 5 to 10  minutes twice a day(maximum 20 minutes in one day).
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.

Bhramri Pranayam -Close eyes. Close ears with thumb, index finger on forehead, and rest three fingers on base of nose touching eyes. Breathe in through nose. And now breathe out through nose while humming like a bee.
Duration : 5 to 12  times

Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and hold your head steady. Not for pregnant women. Seriously ill people do it gently.
Age over 15 years -do this for 20 to 30  minutes twice a day(maximum 60 minutes in one day).
Age under 15 years -do this for 5 to 10  minutes twice a day(maximum 20 minutes in one day).

Once you are better, continue the pranayam once a day.
Be patient, as the benefits will show over a period of months.Only by doing you will benefit
and feel good because you are helping your body.Those who say I have tried everything....
will be amazed at the result of doing pranayam.

Avatar universal

The symptoms you described may represent a rare reaction to the drug, however, it may be more likely that it might be a different problem. The simplest scenario is that it is the infection getting worse. If the symptoms are pretty bad, then discontinuation of the antibiotics may indeed be in order. It would be better if you discussed this option specifically with your doctor.

Tou could also consider getting your urine analyzed to make sure that the drugs you are using will be able to control the infection. This is usually done with a culture of the urine.

While surgery is not the treatment for prostatitis, is it possible that you also have underlying BPH that is predisposing you to get recurrent infections? That may be something to discuss with your doctors.
Avatar universal

Update...I saw Dr. Three...my latest urologist...after one month of Levaquin. He examined the urine...and said it was clear. I told him about the feeling cold and thought it was a reaction to the drug. He agreed to allow me to stop taking the drug instead of the original two month course.

I don't ...however we will continue the drug for just one more week as i have some to make it a five week treatment. Just to allow the drug enough time to be effective.

Present condition...or symtoms: i am not feeling the cold as much. Although while still on Levaquin...for the past week i have had to get up at least three times during my sleep to urininate. The flow is generally easier...

Still on flomax and avodart...We are scheduled to see Dr. Three in 2 months for a follow-up.

Again thank you for your opinions as they are greatly appreciated.

ps...i did also inform my internist...although the Dr. was on leave ..s.the office ordered some blood culture be done. The urinalisis(sp) was normal. Although the blood work was pending ...i did give copies of the lab work to Dr. Three.

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