Hi,

Thanks for the query.

The symptoms that you have outlined suggest that you could have been suffering from one of the variants of prostatitis. This condition manifests itself in several ways - sometimes it could be acute with fever and severe pain while voiding urine and occasionally it could be chronic with more insidious features such as mild discomfort while passing urine.

Even more common than these two is a condition often referred to “non-bacterial prostatitis”. All the reports show no significant problem, but the patient derives benefit from some of the same medications which would be prescribed for a more acute variant - namely
1) Low dose antibiotics, preferably for a longer duration than usual.
2) “Alpha-blockers” which could relax your bladder neck, and thereby lower the pressure in bladder
3) Anti-inflammatory drugs
As all said and done, the reason you are having any discomfort is because of the mild background inflammation.

We generally reassure the patient that this is not a serious condition, as most of such patients are very anxious with Type A personalities, who keep hopping from one doctor to another with the hope that the condition gets cured dramatically, which unfortunately does not. It takes a fairly long duration of treatment to completely get rid of symptoms, and I counsel my patients that if at the end of 3 months, on a scale of 1 - 10, if their symptoms have come down by over 75% they should count themselves lucky.

Also, as I have mentioned earlier, this is a condition common among very anxious young individuals, and you should learn to relax. This may be accomplished by Yoga or Tai-Chi or a suitable alternative.

A normal CT scan of lower abdomen rules out possibility of cancerous condition of bladder or other renal system.

Hope this answer is helpful to you. Let me know if you have any more concerns.

Regards.

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Hi,

Thanks for writing back.

As I mentioned earlier, this is a fairly common complaint. Although I will not be dogmatic and say that what I have said is correct, (especially in view of the fact that I have not examined you and I do not have the benefit of having all your reports) the symptoms that you have described ( including going nearly crazy) suggests that you have what we term as 'Category IIIB Prostatitis’. This condition was earlier called prostatodynia.

I quote from the authoritative textbook of Urology: ...'The predominant symptom in this condition is pain most commonly localized to perineum, suprapubic area and penis, but can also occur in testes, groin, or low back....Irritative and obstructive voiding symptoms are associated with this condition in many patients... By definition, the syndrome becomes chronic after 3 months duration... The symptoms tend to wax and wane over time... However, the natural history of the symptom complex over the years is unknown.... The impact of this condition on health status is significant. The quality of life of many patients is impaired... the mental health component was affected more than the physical component of quality of life assessment..."

I suggest that investigations like a uroflowmetry or urodynamics study be done to make sure that you have no voiding dysfunction. This would help us detect unrecognized sphincter in-co-ordination, which rarely causes a similar symptom complex. If they turn out to be normal, as they are most likely to be, you can be rest assured that it’s fine!

Also, please learn to relax. Take up a nice hobby, get a pet, go for a long relaxing walk or swim. It is extremely important tht you do this.
l will be quite happy to assist you in the future. Let me know how you are doing.
I hope I have addressed your concerns.
Regards

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