Home Forums Hunting & Shooting Hunter's Campfire Chronic Prostatitis

Surgery or radiation can both be curative as a primary treatment.

When my PSA went above 4 my doc sent me to a urologist. He put me on Ciproflaxyn for 30 days to eliminate the chance that the high PSA was due to an infection. PSA remained essentially the same. Then the first 6 core biopsy was negative. Whew!

The next PSA 6 months later was just over 7. Another thirty days of Cipro and again, PSA remained the same. That resulted in a multi-parametric MRI followed by an MRI/fusion biopsy of 16 cores (😚). ASAP (atypical cells) in a couple of cores. Not good but not bad either.

3 months later PSA was over 9, and over 12, five months later. Another 6 months ….17+. So another MRI fusion biopsy found Gleason 7 in 3 or 4 out of 24 cores.

Had robotic surgey a few weeks later and it went well but had a positive margin at bladder neck. PSA a month later 0.027. PSA over the next year slowly rose to 0.110. Not a good trend so saw a radiologist and we decided to do very early salvage radiation.

Anti-testosterone hormone therapy can enhance radiation treatment so I got a 3 month shot of Triptorelin (sp?) and qnother anti-androgen and another injection three months later. Think “hot flashes”and sweats. My wife just laughed and would look at me and ask, “are you having a hot flash?

Radiation started a month after the first hormone shot and was 39 treatments, five days a week for 7+ weeks.

Radiation ended in August ‘18 and PSA been <0.010, or “undetectable” ever since. There’s still that feeling in the gut every year when I have to get it checked.

I had a good record of what my PSA did over 6 years before it was detected and I put the numbers on a graph. I could easily see when the graph took a turn toward the vertical so I knew it was just a matter of time before it was discovered.

I go back to urologist next May. I’m curious what my PSA will be after they took 90% of the tissue out. That tissue had no cancer. Time will tell!!

I had a PAE done last August by Dr. Thomas in San Antonio. My prostate was huge. If it was a bass, it would have been a wall hanger.

A urologist won't recommend it since they can't do it (it gets into their pocket). It has to be done by a radiologist.

As Dr. Thomas described it, there are nodules like grape clusters that cause the enlargement. The beads are 250μm and 400μm (microns) in size (about .009" and about .015", IIRC) that plug the blood flow off and kill the nodules, which then dissolve and are absorbed and flushed out the body. The procedure took a couple of hours. I left the hospital and went to a fund raiser with a friend and had a steak, then drove to Victoria, Texas to see a friend (a doc here on the 'fire), then drove to Utopia. Got in about midnight or so. I had some discomfort, but doing the amount of driving I did right after the procedure (12 hours or so) likely didn't help matters.

It took a week or so for things to start getting back to normal. There was a bit of discomfort for the first week or so, but nothing major.

I started out in Tucson since I was working near Nogales. I went to a urologist there and they wanted to go through the abdomen with three incisions, and down through the bladder to cut on the prostrate. I commented that that sounded pretty invasive and he replied, about a week in the hospital, and a month recovery. I asked about the green laser and was told my prostate was too large to use that one. I didn't like the idea of the TURP so didn't want to go that route, so started looking for alternatives and found the PAE in Connecticut. I found a radiologist in Tucson, but they didn't have a lot of experience.

Further research led me to Dr. Thomas in SA. DR. Thomas has been doing them for years and also teaches the procedure. I went out of my way to go to Dr. Thomas (flew to SA from Tucson to do so).

I found other procedures but all were invasive and some had some pretty bad downsides. As mentioned, the PAE can be done at a later date if necessary, and it really isn't a bad way to go. One downside is that the prostate has to be pretty large for them to do the procedure, the larger the better, and it won't do anything for chronic infection (I recommended a friend with that issue and he wasn't a candidate). Another here on the 'fire was a week from getting the TURP done, and cancelled to go see Dr. Thomas a week after I went. He is doing fine as well now.

I've attached part of an email to Dr. Thomas as he asked how I was doing a few days after the procedure.

Hello Dr. Thomas,

Well, getting better, thank you for asking.

First 12 hours
itching sensation in the prostate & urethra
no pain
urination frequent, mild discomfort, close to full stream
sudden urge to urinate still there
started cipro & steroids

12 - 24 hours
top of right foot itching from toes to ankle, 2-3 minutes, then stopped
itching at prostate subsiding, urethra still itching
no pain
sudden urge to urinate still there
bright yellow/orange urine from Phenazopyridine, possible tint of blood in urine seen on white toilet paper - seemed to separate to outer edges of paper - this was only at the start - did not notice possible blood after the first several times
urination not as frequent, mild discomfort, close to full stream

24 - 36 hours
left leg itching from ankle to knee, all sides, 2-3 three minutes, then stopped
prostate itching nearly gone, urethra itching subsiding
sudden urge still there
penis erectile tissue (shaft, corpus canernosa, I think) tender, sore
urination not as frequent, mild discomfort, close to full stream

36 - 48 hours
prostate no longer itching, urethra itching almost gone
prostate starting to hurt just before and during urination
penis erectile tissue (corpus canernosa) still sore
slight pain briefly in what I believe is the right kidney - possibly 1/2 to 1 hour (this was not related to the procedure as I learned later)
urination becoming less frequent, close to full stream

48 - 60 hours
all itching gone
penis erectile tissue (corpus canernosa) still sore
pain in prostate growing more intense with each urination
urination more frequent, not fully emptying bladder, likely due to pain, so longer at the toilet for second pass to empty

60 - 72 hours
generally run down feeling due to lack of sleep and pain during urination
laid out of work this day
penis erectile tissue (corpus canernosa) soreness subsiding
urination still frequent but becoming less frequent
pain just prior and during urination - started 600mg ibuprofen

72 - 84 hours
better rest after taking ibuprofen
back at work
penis erectile tissue (corpus canernosa) no longer sore
less frequent urination
pain less intense and becoming less painful
at 84 hours (around noon today), not really pain, more like a discomfort when urinating, mostly full stream
This is probably more than you were asking for but I wanted to give you my experience that may correlate with others that you can pass along to the guys coming in. I'm sure each person has different experiences, though some will be similar. Just gives a guy something to expect.

I wasn't ready for the bright colored urine, so figured it may have been from dying tissue until I looked it up and found the dye in the pills are to coat the urethra. Wasn't expecting pain in the kidney so figured it was best to flush so drank more water. Urine is still way more yellow than normal for me, but I suspect that is possibly from the dying tissue being absorbed into the body, though not sure since I don't know when that would start after the procedure.

Never started the hydrocodone and doesn't look like I will have to start. Taking full course of steroids and antibiotics. Stopped the Phenazopyridine after starting the ibuprofen. At this moment, 13:27 Arizona time, 15:27 Texas time, I'm feeling pretty good. Still a bit of discomfort during urination but not bad. I believe the ibuprofen will take care of most of it, especially since the pain is continually subsiding.

Thanks again for the followup. Feel free to pass my experiences along to future subjects that may not be aware of what to expect.

Good info. Thanks. Couple of hours? Do they go through the groin to place the beads?

One of my best friends died two months ago from leukemia, directly tied to the radiation seed treatment. All doctors involved pointed to the radiation treatment, especially at City of Hope Cancer Center in southern CA. It's a rare result, but it happens.

The best outcomes are treatment using da Vinci Robotic surgery. da Vinci results in far fewer patients with urinary incontinence, and more who retain erection ability and orgasms.

That’s the way I’d go if I had prostate cancer. They used robotic surgery to fix my problem. I didn’t take any pain pills, but they didn’t take mine out.

Yup. And you can watch the whole thing. No pain!

As Sakoluvr said, no pain and you can watch.

Mine was from one side only, which may take a bit longer, but there's only one incision to do both sides of the prostrate. Some may elect to go in from both sides, but I think that's the radiologists choice.

In my case, Medicare paid everything.

I read quite a few pages. a few thoughts....
DRUGS..
A. Testosterone Blockers.
1. Proscar and Dutasteride- anti-testosterone, sort of.... it will shrink the prostate. but, will probably experience less libido, retrograde ejaculation, enlarged/tender breast tissue, increased chance for Erectile Dysfunction. They can also cause PROSTATE CANCER.
** I took Proscar for 8 years. Tired all the time. breast tenderness. slight libido loss, but still had sex about 5-7 times a week, but not the same intensity of desire. As soon as I quit it, I was back to my old self in a few days. no longer tired. Strong erections when awakening. intense sexual desire and performance.


B. OTHER PRODUCTS.
1. Flomax- relaxes prostate and also the bladder neck. This aids in the ability to urinate better. It does nothing to stop the growth of the prostate, though. At some point it will likely quit working because the prostate simply grows too large. Side effects: retrograde ejaculation (often). It will rarely cause ED.
** I took this for 20 years +/-. Eventually taking 2 per day. stayed dizzy and usually had retrograde.

2. Rapaflo- very similar to Flomax. Relaxes prostate and bladder neck. likely more effective, but side effects more pronounced. Can cause complete retrograde ejaculation or anejaculation with no feeling of sexual climax. ED is more common than with Flomax.
** I took this for 1 week. Climax was actually painful with anejaculation).

3. Cialis (tadalafil)- Relaxes Prostate and bladder neck similar to Flomax without the side effects. Also helpful if you suffer from ED. So, it has dual purpose. Another benefit is that daily use of 5mg will often reverse 1 negative aging effect. Some men will lose up to an inch of the length and circumference of their penis when they age. Cialis use can reverse that and more.

** I never experienced true ED. I did lose penile sensitivity due to the medications and the enlarged prostate. While I was up to 2 Flomax per day and experiencing lethargy, bad retrograde, and dizziness is when they discovered that Cialis would do the same as Flomax. I told my doc I don't have ED, then he explained it. So, I cut back to 1 Flomax and 1 Cialis per day. Eventually, I quit taking Flomax altogether.



SURGERIES....
** Never, never, ever take the advice of 1 urologist alone. Never agree to a surgery you haven;t personally researched as far as success and side effects. Many urologists will lie to you or not tell you the truth about your chance for side effects.

1. TURP- this is basically a last resort surgery for BPH. Very high chance for incontinence and ED. Most men will never function the same after a TURP. And, a high % will have to do the procedure multiple times because of the damage done to the urethra. it is often just awful.

2. Prostate Removal- Always ask about nerve sparing option. If your MD doesn't have much experience with this procedure, find another MD.... if you still want to have a decent chance of having a sex life at all.

3. PVP Laser - Basically do the same thing as a turp, but using laser to burn prostate material away. Quicker recovery. less chance for impotence. less likely to have incontinence. 78% chance you will have irreversible retrograde ejaculation.

4. Holmium laser- similar to PVP laser if effectiveness and side effects.

5. Urolift- restores urination ability through implanting a device. Improves urine flow by 30% (TURP works up to 90%) it does not work if there is median lobe enlargement at all. Side effects are almost non-existent. BUT, it is not permanent but works for at least 4+ years.

6. Rezum- uses steam to burn away prostate tissue. side effects are less than TURP, but retrograde ejaculation less than TURP or PVP.

7. PAE- Prostate Artery Embolism..... absolutely no side effects that I know of. But, does not work well for median lobe BPH at all. Results are likely only about 5 years.
(I had this 10 years ago. I have(had) median lobe. I'm glad i did it, becuase the only other options were not something I wanted at the time. if worked about the 5 year average)

8. Aquablation- very good procedure. uses water jets to destroy prostate tissue and is monitored by ultrasound to preserve important prostate items necessary for sex and urinary continence. the results last for at least 5 years.

9. FLA- Focal laser ablation- great procedure, but most insurance does not pay for it. You are in an MRI machine, so the md can be meticulously precise in where to burn away prostate material with a laser.
*(I did this 3 years ago by Dr. Karamanian in Houston, TX. It was over $23K, but the best money I ever spent. I was able to get off all my medicines. Chance for incontinence, retro, ED are practically zero. I am 100% satisfied customer.)
* This procedure also works for prostate cancer.

I hope this info helps. Do your research. I had 2 urologists flat out lie to me. I don't trust them at all.

In the meantime, until you figure it out.....HOT Baths for some instant relief....Ask me how I know

Currently lying in hospital bed.

Aquablation procedure completed about 1130lcl.

Notes being taken.

Will catch up later.

PS: Dr said the 'pressure washing' went well.

Thank God for anesthesia....

Wheeled into the OR on a gurney, do not remember the introduction of 'sleep', woke up about 2 hours later with no memory of time passing...

Home now, only discomfort is the foley catheter, absolutely no pain or discomfort directly attributable to the procedure itself.... so far!

Foley catheter sucks

You got that right....

Everyone needs a Foley catheter for a while.

Normally for about a week after a prostatectomy. 😳

mine comes out on Monday, 4 days, not a complete removal of gland, just ablation of interior tissue, 80-90% worth.....

That’s what I had