Prostatitis - pain when urinating & ejaculating

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mansman
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Joined: Sat Jan 14, 2012 6:53 pm
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by mansman on Wed Oct 17, 2012 10:30 am

Prostatitis - pain when urinating & ejaculating

I'm living with prostatitis and still getting pain when urinating and sometimes when ejaculating. I've been diagnosed by GP with Prostatitis.

Still wondering whether or not to try Fluoxetine - any help or advice would be welcome.

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Dr Hilary Jones
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Joined: Wed Nov 14, 2012 11:14 am
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by Dr Hilary Jones on Thu Nov 15, 2012 12:05 pm

Re: Prostatitis - pain when urinating & ejaculating

Prostatitis can cause a range of symptoms . The ones you are experiencing but also pain in the perineum and scrotum and pelvic pain and discomfort.If tests reveal active infection treatment with a 6 week course of ofloxacin can be effective and there are other antibiotics also. If no infection is identified and the symptoms are due to sterile chronic inflammation an anti-inflammatory medication such as diclofenac can be a good solution.Your local Urology clinic or even STD clinic (despite chronic prostatitis not necessarily being a sexually transmitted disease) are good sources of additional help.
Dr Hilary Jones

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Philippa Aslet
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by Philippa Aslet on Thu Nov 15, 2012 12:30 pm

Re: Prostatitis - pain when urinating & ejaculating

Prostatitis can be a very uncomfortable and distressing condition.
I agree that a six week course of antibiotics and anti-inflamatory pain killers are the best first line treatment. Alpha blockers are a group of medicines that can also be helpful but would need to be prescribed by a doctor or prescribing specialist nurse.
Prostatitis can become a chronic condition in some men, so if your symptoms are persisting then I would encourage you to ask your GP to refer you for a specialist review.
Philippa Aslet
Senior Urology Specialist Nurse

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Mr Omer Karim
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Joined: Wed Nov 23, 2011 2:46 pm
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by Mr Omer Karim on Thu Nov 15, 2012 5:29 pm

Re: Prostatitis - pain when urinating & ejaculating

Thank you for your interesting post. It would be worth having some more background information about your diagnosis and how long you have been suffering with these symptoms? A useful starting point would be to complete a prostatitis questionnaire (http://www.windsorurology.co.uk/Downloads/NIH_Form.pdf).

You ought to have some baseline investigations by a urologist otherwise if the underlying cause is not treated, you risk getting recurrent bouts of infection. The management of this condition is not always satisfactory therefore a multidisciplinary approach is necessary.

Various options have been put forward for prostatitis / chronic pelvic pain syndrome which include:

1. Antibiotic prophylaxis (antibiotics which cross the blood-prostate barrier) e.g quinolone derivatives particularly ofloxacin, norfloxacin

2. Alpha blockers

3. Anti inflammatory / analgesic

4. Anticholinergic

5. Prostatic massage (self / partner)

6. Transrectal electromagnetic stimulation

7. ESWL (extracorporeal shockwave lithotripsy) - a German trial has shown good early results and it is approved by the German Urological Society

8. Minimal experimental therapy of intraprostatic Botox injections

9. Behavioural therapy

10. Finally, living with and understanding the problem will lessen the burden. It has been noted that lifestyle changes play a key role in resolving the issue as it seems to affect those people with a target driven culture (stressed managers, doctors, CEO, lawyers etc). I would also recommend you read a book entitled "Headache in the Pelvis" by David Thomas Wise and can be obtained on Amazon.
Mr Omer Karim
Consultant Urologist

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Dr Jon Rees
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by Dr Jon Rees on Thu Nov 15, 2012 5:43 pm

Re: Prostatitis - pain when urinating & ejaculating

Hi,

I sympathise - living with prostatitis is not much fun, and it is a stubborn condition to treat. We don't really understand fully what causes it, but we have a range of things we can try.

I see a lot of people with prostatitis as a GP and can often treat people without specialist referral. however, not all gp's are confident in diagnosing and managing prostatitis, so you may need help from a urologist if you are not making progress.

I agree with the replies above. A course of an antibiotic such as ciprofloxacin for 4-6 weeks can help some people. If you also have urinary symptoms such as a slow flow then using a drug called tamsulosin can help.

You ask about fluoxetine. This type of drug (SSRI) is not usually used for prostatitis. However, an older type of anti-depressant called amitriptylline can sometimes be used at low doses and can help some people.

There is some limited evidence for using complimentary therapies, particularly a rye grass pollen extract called ProstaBrit - some of my patients have found this helpful.

Finally, we often recognise that prostatitis can be worsened at times of stress and it is important to think if this may be contributing to your symptoms.....

Hope that helps
Dr Jon Rees
GP, Backwell & Nailsea Medical Group with specialist interest in Men’s Health and Urology

http://www.talkhealthpartnership.com/on ... n_rees.php

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