Radical Prostatectomy - or not?

Men's health
1

I've been suffering for 15 awful months now with prostatitis - burning urination, bowel movements, scrotal inflammation and irritation, constipation. I can't go anywhere,,, I can't sleep - I'm wrecked; I'm broken- recent course of Amoxicillin for a supposed and probably non-existent bacterial infection has just made things much much worse Consultant Urologist has advised me to have the prostate removed - he has a good track record in this. He says that there is a good chance it will relieve my pains; on the other hand there's a possibility it might make it worse though he says he has never regretted operating on cases like mine(what the patients thought I don't know) I am extremely tensed up, anxious and worried about this Advice appreciated

2

As far as I know, radical prostatectomy is a treatment for cancer, not for the symptoms you describe. With cancer, your symptoms are not typical. But an expert will know.

I am sorry for your circumstance and advise you to find a teaching hospital near you and google the urologists who work there. Once you’re happy with one, ask your GOP or PCP for a referral.

This is the time for investigation and diagnosis. Not the time for an invasive procedure.

3

In a small minority of cases it is done to relieve the horrid symptoms of prostatitis. I’ve seen 3 urologists up to now - the one I consulted yesterday is a leader in the field - known as one of the best - and has operated many times; but only ten times in a case such as mine. I feel very uneasy and unsure about all this

4

Have you gotten a second opinion? Radical prostatectomy sound extreme. Always good to talk to a 2nd opinion before making any final decisions.

5

From previous post you have already had FLA and PAE without any benefit. Some recent posts have said that symptoms without infections can be stress related have you looked at options to cover that ?

6

Or was it Joe who posted that about FLA and PAE ??

7

Not me - I actually mentioned laser treatment y’day to the Consultant - he said that was the last thing he would do - because that would certainly increase the inflammation.

I am stressed; I’m going out of my mind with it

But I don’t think scrotal inflammation, burning urination etc can be down to stress

I fear that my good bacteria have been wiped by meds of the abx variety -and that’s why my anus for instance feels so acid right now - I doubt I’ve got infections as such; more that the med destruction down below has created such a profound imbalance that I just can’t process food anymore

The radical prostatecomy is surely a dubious option

8

This is the 4th Consultant Urologist I’ve seen

  1. he said that I should learn to live with it(it’s worse now) and that any meds they might prescribe would only “weaken me” - I wasn’t impressed at the time - now I suspect he may have been right.. he said that he didn’t know what my problem is - he ventured there might be “sludge in the pipes” - at least he didn’t make things worse or try to fool me

  2. went to London; saw expensive urologist said I had variocele and tried to sell me a 6.5k microsurgical denervation operation - wasn’t happy about set up

  3. Consulted another urologist - firstly he thought it was CPPS territory - pelvic floor - I went to a chiropracter who prodded and poked trigger points; said it wasn’t. On second visit I insisted on the semen sample - which resulted in the unfortunate AM prescription

  4. Went to see head honcho of 3) - he recommended prostatectomy

9

Get as many opinions as you can but remember no matter what procedure you choose you will have to sign a waiver of liability which protects the doctor, staff and hospital.

10

The Consultant said that there was a greater than 50% chance that my pains would be rectified; he said that of the 10 he’d done with prostatitis like mine he didn’t regret doing any of them - which implied that at least they weren’t made worse. There’s one example on their website of a guy who was totally restored by the op - that leaves the other 9 of course

11

Maybe it’s a combination of these two:

Google on “What Do I Do If You Have Both IBS and CP/CPPS?”

What Do I Do If You Have Both IBS and CP/CPPS?

Due to the high overlap rate between IBS and CP/CPPS, be sure to be open with your doctor about all of your symptoms, whether they be bowel, bladder or sexual in nature.

Both disorders appear to benefit from an excellent working relationship with a physician. Your doctor is in the best position to identify treatment options that take into account all of your symptoms.

Although as of now there is no known system-wide dysfunction that may be contributing to symptoms of both disorders, it never hurts to incorporate strategies that benefit your overall health into your life. Pain sensations can be enhanced by stress and anxiety, so it may be helpful to look into mind/body activities that ease stress and tension, such as meditation, relaxation exercises, and yoga.

12

Thanks, I’ve been wondering about IBS recently - to have both would be a real bonus - I’m very open at the GP surgery - not sure it’s a 2 way process

I haven’t done anything much about stress, medication, yoga etc - I’ve never been convinced by the mind body connection; obviously I don’t know of course - I’m listening to the Cricket - Test Match Special - that relaxes me

13

Someone recently posted a discussion about how his uro convinced him hoLEP is the best procedure for prostatitis. If you can’t find the discussion, let me know.

14

Same here regarding mind-body connection. I’m skeptical, but am willing to consider it.

FWIW, this book at least made some sense when I read it: Relaxation Revolution: The Science and Genetics of Mind Body Healing by Herbert Benson.

In the book, Benson recommended spending 15 minutes doing any kind of meditation to get into a relaxed state. After that, he said to spend 15 minutes doing mental imagery where you imagine yourself in a “remembered well state” – i.e. a scene where one has no symptoms of the sort one currently has and can move about without any pain.

15

Consultant told me that lazer treatment could make my symptoms even worse - add to inflammation.. He said the whole thing had to go removing any trace of infection that might be lurking there - I’d like to see the discussion - thanks hank

16

Thanks - when my symptoms are really atrocious I can’t read books; I used to be an avid reader.. I kind of do the well remembered state - drinking beer - going to football matches - country pubs - long walks over the hills - family stuff - all the stuff I can’t do now - I’ll give 15 minute sessions a go, try to

17

Here is the link, hope it helps.* Chronic Prostatis and BPH, PAE, HOLEP - Men's health - Patient Communities

18

ian ,
ive suffered from multiple bouts of prostatitis. The multitude of symptoms can be horrendous. The problem is that it is a condition not very well understood by the medical profession. ive looked into the condition very deeply indeed. Stress is a definate trigger for it. There is one pill which has helped me clear it up and that is Diazapan ( valium) .There are plenty of studies you can read about why it helps. .I can only assume it works by either relaxing the pelvic muscles which are causing the referred pain or it relaxes the individual that in turns relaxes the pelvic muscles. i took one week course and it went completely. A prostatectomy seems extremely radical and i fear it may not work . Please consider this decision carefully.

19

If your situation is uncommon, the best advice I can offer is to treated by whoever has treated most with your symptoms, even if that is not many, it’s many more than the competition and that’s what matters. A physician’s experience is all that matters.

20

“Learn to live with it” is what I heard from my former oncologist. That is not a treatment plan. That said, sometimes there are no treatments that have wide approval, so what is left is either to do nothing or to be experimental.