Do I have chronic prostatitis?

Men's health
1

Hi. I am 36. 

Around April this year, I had three episodes of gross hematuria. Scared, I went to a nephrologist & then another urologist. They conducted a number of tests on me including urinalysis, urine culture, X-ray and USG of KUB, phase contrast microscopy, lever and kidney function tests and a range of other blood tests. Almost everything came normal and the phase contrast microscopy found that the blood was coming from lower urinary tract. The doctors did not find any stones, lesions or tumors during the USG.

One morning in August, I passed a nearly 2mm stone through my urine. The urologist says I do not need to be scared anymore.

Now ever since then, I have been facing a number of issues:

1) Ever since, right after the hematuria episodes, at times, when I strain to pass a stool, drops of whitish semen-like substance comes out of my penis. In order to tackle this situation, I stopped straining at least a week back and it had nearly stopped. But over the past two weeks, I have noticed on one occasion, a small jelly-like transparent substance come out after I finish peeing. It usually sticks to the bowl and when I drop water on it, it rolls off into the water and sinks. Is this something to worry about?

FYI: My wife is pregnant. And I haven’t had sex or masturbated since September this year.

2) Often when I am sitting down, I feel a slight burning sensation near the head of my penis. 

3) Often I do feel some pain during ejaculation but not always.

Now I do not have extreme pain in my pelvic area, near the base of my penis or near my rectum. There is no fever or chills.

Also, my urinary urgency is nowhere close to when I had the stone. I now visit the bathroom at a 3-4 hour interval.

I have recently visited an urologist who without listening to me properly told me that I may have chronic prostatitis.  He gave me a bunch of tests again includign USG of KUB-PVR (60 ml pvr), Uroflowmetry, Urine profile and Uric acid (within range). Without even waiting for the results, he prescribed me three medicines including Finasteride 5mg, Flupentixol 0.5mg and Ofloxacin 200mg.

I waited for the tests. The urine profile did not have any RBC, WBC or anything else. Just 2-3 epithelial cells HPF and 0-1 pus cells.

Uric acid was within range.

Just to be safe, I also did a PSA test which came to 0.42 ng/ml, BUN and creatinine (1 ng/ml) . I have read in two different websites that prostatitis would usually yank up PSA level to over 1 ng/ml.

Uroflowmetry had an average flow of 29 ml/sec.

As the levels seemed okay, I went to a second urologist. He saw the prescription by the first guy, cancelled the three medicines the former doctor had prescribed and instead gave me Doxycycline 200mg, Suliandac and Bactrim. As I had an allergic reaction to Bactrim, I am now only on Doxycycline and Sulindac.

So, here is my question: Do you think this is chronic prostatitis?

Your answers would be appreciated. Thanks in advance.

2

I don't have answer for you regarding the prostatitis. Just curious, how long did the bleeding episodes last/ I had 2 episodes of gross hematuria. Both lasted 7 days. I had  2 CT scans and a cystoscopy. Nothing showed up but I had other prostatitis symptoms. Being 59  2 uros told me it was BPH and didn't prescribe any meds for prostatits. I've been on fernasteride and flomax since March 2016. 

3

A cystoscope is a thin tube with a camera and light on the end. During a cystoscopy, this tube is inserted through your urethra and into your bladder so the doctor can visualize the inside of your bladder. Your urethra is the tube that carries urine out of your bladder. He can also check the entire urethra to see if stones have damaged it in some

way. I did not see it mentioned in the workup.

Good Luck

 

4

The first instant happened in March of this year. I went to the bathroom and my pee was red. I drank a lot of water and the next time I peed it was back to normal. I later did an urine routine and culture. But that did not find any RBCs.

The next time it happened exactly a month later in April. This was when I had it three times. As the uro did not believe me the last time, this time I took a photo of the urine with my phone and showed it to him. He acted rather indifferent. But the urine r/e did not find any RBC again.

A few days later, i did the Urine R/E again and this time it was 'Numerous'. Over the next one month, I continued to do Urine R/E and the RBCs gradually came down.

During this time, my urine frequency was around between an hour to one hour and half. I was drinking around 4 to 5 litres.

I also had a heavy feeling near my left testicular region. I could not wear an underwear or lie down on that side for too long.

Then it all kind of settled down. But there was a nagging pain of something crawling inside my abdomen and gradually coming downwards. 

Finally, I passed the stone around first week of August. The pain was gone within a few days.

My urinary frequency was up to three to four hour intervals.

 

5

Yes...the cystoscopy was the only thing that was not done. 

6

What is urine r/e? 

7

Are you still bleeding? If so, have they done a cystoscopy? Did they culture your discharge? If not, I would ask them to. Is your current doctor a urologist? He should be. Yes, it sounds like prostatis but we're not doctors here.

Jim

8

As usual jimjames asks the right questions, and gives sound advice 

9

I have not bled since the stone passed in August. Hence, no cystoscopy was necessary.

The discharge was cultured. Some epithelial and pus cells were found in it.

My current doc is a urologist.

Just tell me this, isn't there some pain associated with prostatitis?

10

Urine routine examination

11

The short answer is no. Nothing there that sounds like the prostatitis I or others report. Good that you passed the stone. Why strain on the toilet when there are plenty of stool softeners on the market.

Why no sex since September?  Pregnacy is no barrier to it. Is one of you concerned that it will harm the baby? You can have sex until her waters break or she goes into labour.  

12

Hi Derek,

Thank you for your answer. Really appreciate it.

About not having sex, our first baby had some developmental delays.

She passed away when she was eight months old. She had pneumonia but unlike other healthy children she could not recover from it.

Also my wife has polycystic ovary syndrome.

This is why the gynaecologist has asked us to be extra careful.

13

Forget the Sulindac it is not doing a thing for you, its like ibuprofen. But the question is whether the doxycycline is helping you any, and have you noticed diminished symptoms, If not, the doctor is on the wrong track, either with regard to the antibiotic or with the whole problem. It appears that your condition is profiting both physican. No I do not think you have chronic prostatits, because it came on suddenly and it has not been present for years. It is something else,they  are misdiagnosing you, but I do not know what it is. Just intuition.  Change urologists again.

14

You've got to see as many urologists as you can before you can find one to give you the right treatment. Your state's urology association can help you find one or more.

15

A lot of your story seems to me down to a single thing which is the passing of the stone. I dont know if the stone formed in your kidney or prostate but the more recent symptoms are a little difficult to disentangle and may not amount to anything. The jelly-like material could be a part of the urethral lining torn by the passage of the stone or the peeling off of a kind of healing scab. The white substance is probably just overflow semen due to lack of action. On the whole I dont think you have prostatisis now and do not need any medication. You might look into dietary matters with respect to avoiding any further stone formation, but I am not a doctor.

16

Usually but not necessarily. Prostatitis is a basket of symptons that may be quite diffferent individual to individual or even with the same individual at different times. Issues 2 and 3 in your previous post, plus the pus cells in your discharge could suggest a mild prostatitis. Apparently your doctors thought so and that is why you are on a course of antibiotics although I hav some real reservations about your first doctor's advice. Are they fishing? Prostatitis is often that kind of nebulous thing, so they might be, but doesn't mean treating with antibiotics is wrong as antibiotics often work in these cases.  Did they do a digital exam? Did they mention if the prostate was inflamed? Did they do a prostatic massage and culture it? Not often done these days, not sure out of laziness or what, but can't hurt to ask and the actual act of the massage could even help.

That said, based on your symptons I wouldn't be overly concerned and would not get hung up on the word "prostatits" as your symptons seem mild and most men (some say all) will have prostatitis in their lifetime. By the time I was your age I had at least a couple of bouts much worse than you describe. If things don't get better, getting another opinion is always an option as someone else suggested but with your symptons and the complexity of the urinary tract not sure anyone is going to give you 100% clarity. 

Jim

17

Hi, 

I din't think that you have prostatitis!. There are 2 kind of prostatitis:

1. chronic- without any pain

2. acute- with severe pelvic pain

You have hematuria that is blood in your urine and stones, probably kidney stones. 

Hematuria without any pain is considered dangerous because it be caused by cancer. In your case you have pain.So there is no cancer.

I think you have only kidney stones with uneven surface causing you bleeding when they move in your urinary tract. Maybe you have chronic prostatitis, too. Many men have it even at your age.

Don't worry. Chronic prostatitis is almost not curable. Don't believe the doctors if they say it is easily curable!. But if you want to minimise the damage of chronic prostatitis have a sex with your wife as often as you can: It will empty your prostate juices and filtrate all kind of bacteria in it. Sex is very beneficial for your pregnant wife, too. For first 3-4 monthe the libido in pregnant women is increased! Because they need testesterone to make powerful their lower abdomen and progesterone to prevent miscarrage. So dont worry, if you think that you can harm your pregnant wife!

For kidney stones there is no threatment too, believe me. Your metabolism is not normal. To normalize it, you need more spicey food, in order to drink more water. For example you can eat pickles during the dinner every day. Don't drink water more than 3 liters a day. 3 liters warter is quite enough! 

 

18

My wife was a nurse in maternity and understand all that.

I feel for you as we lost our daughter to cancer when she was 22.

Pneumonia almost killed me when I was 12 but fortunately one of the new drugs saved me.

19

Two of my long term bouts of prosatitis started with passing blood but I had a very large prostate and it was thought that blood vessels had burst. I'm not sure how that was connected to the prostatitis.

20

How long did you bleed for? So, you don't have a definite answer where  the blood came from? I'm sure its been discussed in another thread but how did you fix the problem of enlarged prostate? How did you treat your prostatitis