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I have been dealing with Chronic Prostatitis for months now-

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Hello,I have been dealing with...
Hello,I have been dealing with Chronic Prostatitis for months now- my doctor has tried every single medication under the sun, to no avail. My prostate is 36 CC's, I am 32 years old. My chief complaint is Urinary Frequency and Pelvic Pain. I pee about 10-12 times per day, sometimes more. My doctor did a Cystoscopy and found that I have a "High Bladder Neck". He says that by doing a TUIP, that will possibly resolve the urinary frequency. However, I have read that TUIP is to relieve a weak stream. I don't really have a weak stream; sometimes I do, but a majority of the time, the stream is OK. It's not as strong as it used to be. Is TUIP the right procedure for me? I have tried every antibiotic, alpha blocker, anti-inflammatory and OAB med at this point and I am at my wits end.
Submitted: 5 months ago.Category: Urology
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Answered in 9 minutes by:
3/16/2018
Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago
Dr. Arun Phophalia
Category: Urology
Satisfied Customers: 39,103
Experience: MBBS MS (Surgery) Vast experience and routinely perform all urology procedures including endoscopy.
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Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago

What did your urodynamics and uroflowmetry show?

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Customer reply replied 5 months ago
On the urodynamics, my max flow rate was 9 mL and my voided volume was 50 mL in my post void residual was 75 mL. However I was having trouble urinating with this catheter in me so I don’t think it was that natural. The general impression was that I had impaired the truth your contractility. Another uroflow tests,my flow rate was a 7, 10, etc. My PVR was 47 ml, and the rest I had 3 ml
Customer reply replied 5 months ago
Impaired detrusor contractility
Customer reply replied 5 months ago
I had an MRI with contrast that showed my bladder is mildly under-distended and I have mild bladder wall thickening
Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago

Did your chronic prostatitis had abnormal culture tests?

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Customer reply replied 5 months ago
Also showed inflamed seminal vesicle and inflammation in the peripheral zone
Customer reply replied 5 months ago
Cultures were negative. I sent my DNA to a DNA sequencing lab and they found DNA trace marks of Lactobacillis Iners and E Coli. However, I have been on antibiotics for months now
Customer reply replied 5 months ago
The DNA lab picks up on all bacteria in the sample, it’s not a culture so I don’t know if those 2 are causing the issue. All I know is that the doctor says that I have a high bladder neck and that he suspects that is causing my Prostatitis
Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago

I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Customer reply replied 5 months ago
Ok
Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago

Few things may be tried as TUIP may not be effective or rarely worsen the situation.

A) Pyogenic and mycobacterial cultures of semen, prostatic fluid (after prostate massage collection) and urine.

B) Prostate massage by a physician or paramedic for 3 times a week for 3-5 week. It relieves the prostate congestion.

C) Trial of a medication called Bethanechol.

Was this information helpful to you? I would be glad to answer any further questions.

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Customer reply replied 5 months ago
What about the high bladder neck?
Customer reply replied 5 months ago
How would TUIP not be helpful if I have a high bladder neck?
Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago

High bladder neck it seems has been proposed in the absence of treatment failure.

If you and doctors are convinced it is high bladder neck, you may go ahead with TUIP.

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Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago

In uroflowmetry if there is resistance shown by bladder neck, incision of prostate would be helpful.

A chronic prostatitis with inflamed seminal vesicle may need further cultures.

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Customer reply replied 5 months ago
Hmmm ok
Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago

Your doctor may also consider following before any surgery;

chronic prostatitis,

pelvic floor hypertonicity,

occult neuropathy, or

increased bladder sensitivity

Should also be considered for your symptoms. All of these can cause poor relaxation of urethral symptoms.

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Urologist: Dr. Arun Phophalia, Urologist replied 5 months ago

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