Doctors I've seen:

first my primary who said it's impossible to have a prostate problem at my age, and refused to send me to a specialist. He took a urine sample examined it under a scope and found nothing. Basically implied it's in my head.

Next day I went to an after hours clinic because I was in too much pain and got a hold of antibiotics finally. They did a urinalysis but never told me what they found.

Couple days later the pain was so intense I wanted to go to the emergency room but parents insisted I see my primary and have him send me to someone. So when I showed up he took another urine sample and again found nothing (obviously b/c I started abx) and sent me to a uro immediately that day.

The uro sent my sample in for culture and found nothing (again I was on abx). Did a prostate exam, and a bladder retention ultrasound test and said I was empty.

I decided to step up to the best ranked hospital system in my area. Made an appointment with a primary (urinalysis while on abx) in that network and got a referral. The uro I saw was a joke. All my info was given to a half wit physician's assistant and the guy rushed me out with a recommendation for pelvic floor physical therapy. He talked over me and didn't let me tell him everything. They did a urinalysis after I'd been off the abx for 10 days. I don't think they found anything. I'll never go back to him.

Now I'm planning on scheduling an appointment with a well rated urologist in the area based off reviews from healthgrades, and vitals. I know the doctors themselves can just go on there and rate themselves up but I'm willing to give this guy a shot. When I go in I'm going to insist on tests. I'm going to schedule an appointment for tests before I leave his office that day regardless of whether he feels it's necessary. But first I want to do these cultures and see what's going on for myself.

The first two months of this was hell from mid sept til about mid Nov. I'm just happy I'm not having days like those anymore. Multiple two-week rounds of cipro may have been responsible for the improvement. But during those two months it was so bad I wouldn't drink any fluids for 48 hours a lot of times so I wouldn't have to urinate. I hardly ate anything because everything would cause it to flare up. I'd go days without eating and drinking. Anyways I can say the worst is behind me, but I still just want to get back to normal.

jimijams,

you can buy sterile qtips for transferring as well as sterile urine collection cups for either. for culturing semen I used the following procedure:

buy and store TSA w/ 5% sheep blood and/or mueller hinton agar plates (or potato dextose agar/ta if fungi) in refrig until needed.

ejac straight into plates that are warmed to RT or sterile cup, spread evenly with sterile inoculation loop, qtip seal with tape, turn upside down and incubate at RT for 48 hrs or at 35C for 24 hrs in dark space (no drafts). if anything grows use sterile loop to transfer some of bacteria to a broth dilution (mcfarland .5 std) and incubate again. swirl dilution and pour evenly over mueller hinton plate removing excess. place abx discs on plate and incubate again. rings will form around abx discs - some greater than others. its crude but your sample is fresh (if off abx) and it won't be tampered or misused. I sent my semen off 3x through my docs - 2x were negative and 1x they lost it. I've been able to grow something every single time on my own- negative controls came up negative too so my positives are not from contamination.

hope this helps.

oh wow thanks, That really helps. I'll be doing that for sure. I love science too so this is right up my alley. You meant spread evenly with sterile inoculation loop OR a q tip right? Inoculation loop sounds more professional, think I'll use that.

few things:
-should I only incubate them for 24-48 hours or would longer be ok? I've heard some strains take several days to culture

-How long should I incubate them in the mcfarland sltn?

-And where do I get abx disks?

Thanks again, this helps a lot

Probably the smartest physician you've seen yet. I strongly advise that you follow his recommendation, and as soon as possible, too. The longer you let this go, the more aggressive the treatment will need to be. Care to disagree with me, go back and read my posts throughout this thread. I too thought for sure I had an infection 11 months ago. Not one of the so-called "smart" physicians you're looking for, that gave me round after round of antibiotics, was of any help to me at all whatsoever. Instead, 3.5 months of physical therapy has given me my life back, as well as a fluctuating 75-85% reduction in my symptoms, depending on the day. You have no idea how extremely lucky you are that you found a physician so soon that suggested pelvic floor PT. I'd be very interested to know where you saw this physician, and what his name is, because he should be awarded for his honestly and knowledge. You most likely have pelvic floor dysfunction also known as pelvic floor hypertonicity. I highly doubt you have an infection, since you have taken "weeks" of Ciprofloxacin and are still not "cured".

Welcome to the boards. I've been to hell as well, and I'm on my way out. Start researching. Also, stop trying to culture your own bodily fluids for infection. If something comes up positive, you most likely have contaminated it during the screening process. You aren't a lab technician, nor do you have the ability to prescribe yourself medications to combat whatever results come back, so why waste time and aggravation. There are doctors out there that will culture your semen. Stop going to urologists and visit an infectious disease specialist if you really want to rule out an infection. I did this to get my semen cultured and guess what? Negative.

EDIT: For your own good, I'll provide yet ANOTHER link to an article for you to read. PLEASE do so.

https://physical-therapy.advanceweb.c...le-Malady.aspx

This is what I also thought when I read this. I wish my uros had told me from the start that muscles can play a major part in all this mess. Instead I had to find this myself through the internet and through my own experience of treating this through stretching and relaxation. You guys who live in the USA do not even realize how lucky you are to have specialized pelvic clinics that can effectively tackle the problem. Not many but at least it is available to you. Us who live in other countries have to treat this mostly by our own means through books, internet, stretching, meditation etc

Not only that but even if they do culture something it will not mean that this is what is causing them problems. Normal asymptomatic men do not have sterile prostates. I need to find those studies again that demonstrated that normal men have usually more bacteria in their prostates than men with CPPS. People who still look into the infection theory and keep taking antibiotics despite negative cultures and months of antibiotic treatment are just beating a dead horse.

I appreciate your feedback sparky but you too shouldn't jump the gun and assume that pelvic floor dysfunction is most likely what I have especially when you don't know what symptoms I have. It very well might be but we can't say for certain. Plus when I took Cipro for the lenghiest period is when I experienced the substantial improvement that brought me to where I am now as opposed to the horrendous first couple months. Mt biking is a known aggravator of the prostate so that too kinda hints at prostate problems, but could also hint at pelvic floor issues as well.

I may not be a lab technician but I'm in school for engineering and am very scientific oriented. I assure you I could handle the culture procedure and I tend to trust myself more than doctors. Hate to say it but I've seen too many who go by the books, have no scientific mind or approach to problems, and no ability to think outside the box. There's a lot of incompetence out there in other words.

And even though that guy may be right about pelvic floor physical therapy. He rushed me out, didn't listen to me at all, didn't do or suggest any testing, and relied completely on what his assistant told him, and I gave her a LOT of info. She gave him very little info. I'll never go back to him. And the guy should be awarded? Come on...like I said we don't know what's going on with me, and he has a lot to learn to be a good doctor. Believe me I've been to many. The good ones ask many questions and have a genuine desire to get to the root of the problem.

And I research the hell out of everything. I have other illnesses as well that I've devoted god knows how many hours of research to trying to figure out how to treat them. That's why I'm here, like you, I'm learning more about this. The trouble is is that based off my symptoms it's very difficult to say it's definitely this or that. It kinda falls under the definitions of a few things.

Regardless I'd be interested in hearing what I need to do for pelvic floor PT if you don't mind recommending some exercises and best of luck to you.

[[I hardly ate anything because everything would cause it to flare up. I'd go days without eating and drinking. Anyways I can say the worst is behind me, but I still just want to get back to normal. ]]

Yep sounds like prostatitis , a lot of us get flare ups from hell eating certain foods. Tomatoes and caffeine are mine.

[[ first my primary who said it's impossible to have a prostate problem at my age, and refused to send me to a specialist. ]]

How old are you ? My father has had acute episodes of prostatitis since he was 18 or 19 according to my mother, he is 51 or 52 now.

Tests to consider - prostate massage examining and culturing the prostatic fluid. you should be off all antibiotics for at least 14 days before this test is conducted. And a very simple test which I wish I would have done and saved myself the time and money instead of getting that stupid ct pelvic scan that cost $1500 total, Is a transrectal ultra sound

A transrectal ultrasound of the prostate gland is performed to:

• detect disorders within the prostate.
• determine whether the prostate is enlarged, with measurements acquired as needed for any treatment planning.
• detect an abnormal growth within the prostate.
• help diagnose the cause of a man's infertility.

A transrectal ultrasound of the prostate gland is typically used to help diagnose symptoms such as:

• a nodule felt by a physician during a routine physical exam or prostate cancer screening exam.
• an elevated blood test result.
• difficulty urinating.

The transrectal ultrasound is painless and usually costs $450 -$600
which is cheap considering most scans cost in the 1,000 range. If you are having erection difficulty like most of us are, it will show lack of blood flow to the prostate. But those 2 tests are a must for diagnosing chronic prostatitis in my personal opinion

__________________
My names not harry crumb. I just like the movie !!

Hey Harry, I'm 29, this all started when I was 28. My primary isn't good at all so I rarely trust what he says.

Instead of the prostatic massage and getting a culture that way couldn't I just sample some of my semen in an agar petri dish like others have said? I'd rather do that to be honest unless the prostatic massage method would yield a better result or something.

I'll see about the transrectal ultrasound, I just saw that mentioned somewhere else recently. Just really not looking forward to a cystoscopy but at this point I could probably suck it up if they felt it was necessary.

I can get erections and maintain them if aroused and they still come about on their own here and there but I'm starting to notice I don't get morning erections anymore. I don't know how long that's been going on for.

jimijams,

you can buy most everything at hardy diagnostics (plates, abx discs). Sterile innoculation loops are at carolina biologicals. Amazon also sells some of these items.

if you don't have an incubator that can reach 35C then I would essentially double the times at RT so 48 hrs for plate and broth.

hope this helps.

Although I firmly believe that most cases start with an infection and that doing pelvic floor therapy will help in cases where there is still an infection, it will never completely heal unless the infection has definitely been resolved. Which is why I did everything all at once. I planned out my treatment for many months and researched so much to combine everything to beat it. I'm gonna reply to everything people have asked me shortly, I've just been busy.

Morning erections; The biggest factor here was consistently doing the relaxation and reverse kegels during the day. Getting erection quality back seemed to be more responsive to working on the PC and BC muscles in the pelvis area than antibiotics. Even though antibiotics may have given me a HUGE relief from pain, sexual dysfunction seemed to be more related to pelvic floor dysfunction. Read Amy Stein's book "heal pelvic pain"

Improvements during pelvic floor therapy
-Better orgasms
-Stronger erections and better able to maintain them
-Increased libido
-Increased morning erections.

For those that think Doxycycline is just having an anti-inflammatory effect, consider taking 50mg a day (submicrobial dose). It is used for other conditions at this dose to ease inflammation. Also low dose doxycycline might have a positive effect by inhibiting quorum sensing and cell-cell communication in bacteria.

Also remember the studies I provided showing that sometimes bacterial infections can cause inflammation that will persist for months to years after being eradicated.

Trigger: bacterial infection > autoimmunity (in some cases) > pelvic floor dysfunction

Got to make sure you deal with all problems. And lets face it, chornic prostatitis isn't a simple problem.

Actually, mountain biking compresses the pudendal nerve and creats tension in the pelvic floor musculature through pressure and repetitive hip flexing movements. This causes shortening/tightening of the pelvic muscles, which leads to spasms and trigger points in the muscle fibers. Mountain biking does not aggravate your prostate, but rather all the muscles surrounding it, as well as the nerves that innervate them.

But hey, best of luck with your cultures and by the way Ciprofloxacin, or any of the quinolone antibiotics are known for having an anti-inflammatory effect. They also cause tedon rupture and a slew of other side effects.

[[ Instead of the prostatic massage and getting a culture that way couldn't I just sample some of my semen in an agar petri dish like others have said? ]]

Yes ...actually a semen culture would be preferred, with prostate massage you are only getting prostate fluid. But with the semen culture you are getting the semen and the prostate fluid. And as strange as it may sound some times the semen will show infection when the fluid shows no infection. Reason I stated prostate massage is the average urologist won't do any kind of semen testing with prostatitis, in fact just getting a prostate massage from one can some times be difficult.But if you have found one who will test the semen or you are going to test it at them. Then it would be more preferred method than just prostate fluid testing. Their is different sources you can use to grow the fluid on most use agar, one guy on here I think uses sheeps blood.


[[ Just really not looking forward to a cystoscopy ]] never had one but remember reading an article some time back. I can't remember it exactly but I can add lib. I think the person in the article stated he was scared to death before hand and even shaking.They actually used something to numb him down there so he wouldn't feel any pain from the cystoscopy. I think he said it did sting pretty bad to urinate for 48 hours after the test, then the stinging and burning finally stopped. And that he still had some penis soreness for about 7 days then that finally quit as well.


[[ I can get erections and maintain them if aroused and they still come about on their own here and there but I'm starting to notice I don't get morning erections anymore. I don't know how long that's been going on for.]]

Yeah that's how it starts. those symptoms are starting to spread. That infection or whatever you have in your prostate that is doing this to you, is slowly starting to spread to different nerves and areas of your prostate.
Eventually you could end up with erection troubles to the point you won't be able to get an erection even during sex and also ejaculatory problems such as no sensation during ejaculation, burning ejaculation or stabbing ejaculatory pains, some times the ejaculatory ducts can even become clogged or blocked where barley any ejaculation comes out of the penis.

I will offer you one bit of advice.
Whatever you do, DO NOT TAKE STEROIDS !!!!!!!!!!!!!!.
I was put on prednisone and my prostatitis was mild before that drug.
It made mine a hundred times worse. prednisone weakens the immune system dropping it down to nothing. with the immune system completely weakened and crippled by the steroid if their is a fungi, bacteria ,virus anything like that in your prostate that stuff will take full advantage of the weakened immune system and it will hit your prostate harder then you ever imagined making your symptoms 100 times worse then you could ever imagine.The reason mine is so bad as it is was because I took prednisone, and mine gets so bad sometimes that it is very hard not to commit suicide from the pain level. And one day I'm sure a urologist will want you to either take some oral prednisone or get you a shot of one. Avoid steroids like the plague !!!

Sparky, go to bikeforums.net and read for yourself the countless prostatitis stories and how most were bacterial and treated with antibiotics. I don't think I read of any one of them using pelvic floor PT to treat it. I've read so many places the link between bacterial prostatitis and mt biking, horseback riding, motorcycling etc. that it can't be denied. Besides I have no pain or tension in my pelvic muscles whatsoever.

I'd rather test things out then just jump and say it's something. If I find that there's no fungal or bacterial cause then I'll consider pelvic floor muscles to be a possible cause.

@ sparky

Here are some symptoms of Pudendal Nerve entrapment
Pain or numbness involving the area between the legs, including the genitals and occasionally some of the inside of the thigh. Often only one side is affected. The pain may be aggravated by sitting.



Another site shows the following symptoms

Pain immediately upon sitting, combined with episodes of penile numbness, and/or urinary or fecal incontinence,


I have to admit some of these symptoms do sound familiar on the board.
I know I have heard people talk about having penis numbness, and numbness between the legs. But again people need to do tests than to subscribe to one theory. I recently found out even the PSA tests for cancer can have error in them. One guy that I read about had 2 PSA tests that showed he did not have prostate cancer.



And turns out he actually had prostate cancer even though his PSA levels were actually under the levels which indicated prostate cancer. That is the problem with tests is they are not 100% accurate. By the way the guy later found out it was prostate cancer, thanks to a prostate biopsy



Top 5 reasons urologists refuse to treat chronic prostatitis

https://prostatitis.ning.com/forum/to...why-urologists

Sorry I do not understand how one can get bacterial prostatitis from riding a bike. I got bacterial prostatitis from oral sex which seems to be along with the other types of sex (anal, straight) a good way to get bacterial prostatitis. This most often evolves to something completely different (CPPS) which has its own life and keeps going for much longer after the initial infection has been cleared. I had a quick look at that site and while it may be good for biking info I really doubt that you will read there the latest research news about what is causing prostatitis. Pelvic floor dysfunction theory is very new. It came up and slowly becoming mainstream in the last 10-15 years. I am not surprised that bikers ignore it when most uros ignore it. Read instead the chronicprostatitis.com forum which is much more focused on that disorder. You will read plenty of biking stories there too but without the bacteria component.

Reading a little on the bikersforum you see the same story repeating itself like almost every other prostatitis forum. A bout of prostatitis hits, doctors prescribe antibiotics "curing" the problem temporary until it hits again. That's because antibiotics act as anti-inflamatories in CPPS and simply improve the inflammation without addressing the real culprit and that is why the problem hits again at a later date.

The study below is one of the several studies demonstrating that CPPS does not seem to be related to a bacterial etiology

https://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract