prostatitis

[pokerprostate]

Hi, im a 23 year old male, about two years ago, i had pain in my pelvic region which was sharp for about 2 weeks, came on suddenly while laying in bed, and then went away slowly only to leave a mild pain on the right side of perineum lasting a year and a half now. The mild pain is on and off throughout the day usually worsens when i have to BM, and can be worse when sitting down. Doctor says its prostatitis after doing a (syscoscopy?), saying the prostate was a bit swollen.I have done a lot of sitting at the computer for work the past 4-5 years, and wonder if this could be one of the reasons for this. I have not had caffeine, spicy foods,alcohol,  and have been taking baths everyday but with no real improvement. Urination hasnt been much of a problem, sometimes a bit of a little pressure. The mild pain doesnt really bother me at all, but it is also resulting in difficulty with arrousal, and little pleasure when ejaculating. Does anyone know what could be going on with this, as most cases i have read about prostatitis usually deal with severe pain, and not so much resulting in ED. Could my acute case in the beginning have left some permanent damage to the prostate? Are there any suggestions on how i can help get rid of this? could a long period of no sitting down help? Thanks for any suggestions or analysis. :/

[pokerprostate]

i also dont have prickling, burning, etc... just a slight mild pain on the right side of the perineum and a bit of ED, which is my main concern as the pain doesnt bother me much. when i strectch the area out bringing my knee to my chest, it does seem like pressure is being taken off the area. The pain is also as bad as it will get when i have to make a bowel movement, more of an ache then a pain though, very mild. Do you still feel that this can be a nerve issue? thanks for your time once again, and please respond. is it also normal to have a urologist who thinks that the only possible thing to do is stay away from caffeine, spicy foods, and take hot baths..even though my situation has been stagnant for the past year and a half. He doesnt seem to want to explore any other causes of this except that it is prostate inflammation. Sorry for the rant, its just frustrating.

[pokerprostate]

Do you think that because antibiotics didnt relieve the mild pain at all, that there is little chance that this can all be caused by bacteria in the prostate?
Thanks for your time again, i've begun stretching throughout the day, and will talk to my doctor soon.

[Dr. Kokil Mathur]

Hi
No, your cystoscopy is right. There is evidence of prostatitis like picture in such cases without there being any bacterial prostatitis. These conditions are broadly classified as chronic pelvic pain syndrome. The intensity of pain depends on the degree of inflammation and thus compression. This can vary.
Please let me know if there is any thing else and do keep me posted. Take care!

[pokerprostate]

Thank you for taking time to respond to my post, i appreciate it a lot and have restored some hope. I just have a couple of questions. Does it make sense that this came on suddenly and was very painful for a couple of weeks, and then became very mild for the next year or so? And could the prostate be inflamed because of this as shown in the syscoscopy (sp?)?  thanks for responding again

[Dr. Kokil Mathur]

Hi
I just came across this because of a related thread update in my mail. Since I feel I can probably answer your question I am posting this. Hope this will be useful in diagnosing your problem.
Your problem looks more like Pudendal nerve entrapment (PNE). PNE “ is a source of chronic pain, in which the pudendal nerve (located in the pelvis) is entrapped or compressed. Pain is worsened by sitting, and can include prickling, stabbing, burning, numbness, and the sense of a foreign object in the urethra, ----- or rectum. In addition to pain, symptoms can include sexual dysfunction, impotence, anal and urinary incontinence.” You can refer to this link for further information and treatment options: http://en.wikipedia.org/wiki/Pudendal_nerve_entrapment
“Prostatitis-like urogenital pain and voiding and sexual dysfunction (like the ones you are facing) are the hallmark of pudendal neuropathy. Symptoms of prostatitis-like pain occur in 11% of American men, and approximately 95% of the men whose conditions are diagnosed as chronic prostatitis have no evidence of bacterial infection or inflammatory cells in the prostatic fluid.” Finding of skin bacteria in your case merely indicates a contamination from the skin. This is the reason you are not responding to antibiotics. Refer: http://www.chronicprostatitis.com/pne.html
Maybe you can discuss this with your urologist or even a neurologist can help you out with this.
Hope this helps. Do let me know if there is any thing else and keep me posted. Take care!

[pokerprostate]

I have been to the urologist many times, and he basically just says to take hot baths and stay away from caffeine etc, urine tests have come back with no infection, and like i said, i had the culture done where they found a common skin bacteria. all doses of antibiotics have not brought any relief, so does that mean its probably not bacteria.... in most cases ive heard that antibiotics help immediately, but dont always keep it away... im basically writing here because my urologist has offered little help. either that, or what hes tellign me to do in hot baths and discipline is what he thinks is the only thing i can do. was that an automated response?

[Dr J Singh]

Hello,
Prostatitis is an inflammation of the prostate gland, in men.It can be chronic bacterial prostatitis in your case. Chronic bacterial prostatitis is a relatively rare condition that usually presents as intermittent urinary tract infections.It presents with little pain and bacterial infection may also be present.

I sincerely advise you to consult a urologist and get yourself evaluated so that a confirmatory diagnosis can be made.Treatment will depend on the same.

Hope it helps.Take care and pls do keep me posted on how you are doing.Kind regards.

[pokerprostate]

some things i forgot to mention, i sometimes have small painless spasms in the perineum area, also had seamon culture done and they found common skin bacteria, antibiotics havent improved anything 3 different times, so im assuming its probably not bacterial?? is it possible this skin bacteria could actually be causing this in the prostate?