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Chronic prostatitis and chronic pelvic pain syndrome - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Good Posted in: Urinary and Bladder Problems
Answered by

General & Family Physician
Practicing since : 2009
Answered : 623 Questions
User :   I am have prostate problems and always burning during urination and rectum irritations. what can I do to minimize irritations

Doctor :   Hi
Doctor :  
Please proceed
Doctor :  
What is your age?
User :   43
Doctor :  
Were you diagnosed with Prostrate problem by the Doctor, or you assume to have?
User :   diagnosed with chronic prostates
User :   taking meds for about eight years
Doctor :   Ok

Doctor :  
What are the recent tests done?
Doctor :  
Do you have some reports
Doctor :  
Any recent urine infection
User :   various scan, urine tests, blood tests etc
User :   yeah have some reports
Doctor :  
Ok when were they done?
User :   december
Doctor :  
Any infection said by the Doctor?
User :   no, none
Doctor :  
How frequent is such pain for you?
Doctor :   What medicines are you taking for the chr prostatitis?
User :   its always there when passing urine and passing stool
User :   now taking Evion 400 daily and Pregab 75 twice daily
Doctor :  
Ok with your history I understood that you have chronic prostatitis along with chronic pelvic pain syndrome
Doctor :  
The medicines that you take are good
Doctor :  
But the medicines should be rotated with other
User :   there is not relief
Doctor :  
antidepressants which your Doctor should take a call about
User :   whats that
Doctor :  
After the examination if there is muscle spasticity, the Doctor should put you on anti muscle spasmatics
Doctor :  
Some times mild opioids also help
User :   what should i do now
Doctor :  
You can go back to the Doctor, ask about rotation of medicines
Doctor :  
with Opioids, Muscle relaxants, Antidepressants
User :   ok
Doctor :  
If there is swelling of prostate, sometimes the Alpha blockers are also helpful
Doctor :  
If not given to you yet
Doctor :  
So note these things and please take them to your Doctor
User :   whats antidepressants for
Doctor :   For pain relief
Doctor :  
They will not depress you
Doctor :  
though
Doctor :  
At low doses they are equally pain releivers
Doctor :  
I hope you are seeing a Urologist for the treatment of this
User :   why is the burning sensations is there
User :   yeah
User :   do you recommend a specific test
Doctor :   Look in chronic pains, there is some mechanisim called sensitisation
Doctor :   Sensitization is the process by which stimuli are perceived to be greater than before .

User :   prostate is so large that i could touch it
Doctor :  
Then the best way would be to get a surgery done, have you spoken about this
User :   not yet
User :   any side effects
Doctor :  
What is its size on Ultrasound?
Doctor :   Are you with me?
User :   4.8cm
Doctor :  
Weight?
Doctor :  
IT cannot be one dimension, it has a 3 dimension
Doctor :  
so please tell the other two measurements
Doctor :  
May I know your name?
User :   yeah it give d1 d2 and d3
I think you are short of information about your problem
Doctor :  
How to tackle it, what are the treatment options available to lead a good life
Doctor :  
As I have told you the medication options for pain
Doctor :  
There is a surgical modality and physiotherapy which can help you
User :   can you explain
Doctor :  
If you say that you have big prostate I opine you have to take a second opinion from a Urologist
Doctor :  
Incision of the bladder neck by surgery has been reported to be effective in men with prostatitis with irritating pain during urination
User :   yeah, but the doctors always say its normal for the age
Doctor :  
However some urodynamics are done before the surgery is helpful or not
User :   and i have been taking the medicine for so long without any relief
Doctor :  
Some local injections are also helpful
Doctor :   Perception of pain, can lead to both reflex and local voluntary muscle contraction, which may result in more pain and dysfunction

Doctor :  
nearly all clinicians agree that almost all chr prostatitis people have some chronic tension and tenderness of the pelvic floor musculature.
Doctor :   Specific exercises to improve strength, relax muscles, and restore balance are helpful sometimes.
Doctor :  
Those will be told by physiotherapists
Doctor :  
You should also mind that the pain cannot be cured for ever with medicines, the threshold for pain perception should be improved
User :   you mean its in my mind
Doctor :   Cognitive-behavioral interventions are successful in chronic pain, a psychologist can help

Doctor :  
I do not say it is in your mind
Doctor :  
but a psychological factor has contribution too
User :   one doctor stated that to me
Doctor :  
Look, the cause of the pain, is many factors here
Doctor :  
1) Muscular contraction
Doctor :  
2) Local factors like other infections, sexual life
Doctor :  
3) Psychological factor
User :   tell me more what you mean about sexual life
Doctor :  
The ultimate thing is that you should have considerably less pain and the perception of pain should not hinder your active life style
Doctor :  
Is it not?
User :   sex is a pain for me now
Doctor :  
Yes I know and can understand
User :   its more pain than pleasure
Doctor :  
Since it is bothering you more, I think this is the right time for you to take a better decision on how to get relief from the pain
Doctor :  
As I have told you, there are three ways
Doctor :  
1) Rotating the medicines so that you do not get habituated to them
Doctor :  
2) Surgical option
Doctor :  
3) Other alternative methods like Physiotherapy, CBT by psychologist
User :   will surgical option be long lasting
Doctor :  
That you have to ask an Urologist
Doctor :  
I am a General Physician and I cannot answer that question
Doctor :  
I recommend you take an opinion from a Urologist
User :   ok
Doctor :  
If you can send us the report scanned copies I can help you get a better opinion from him
Doctor :  
I can arrange a phone call / Email answer with the details you provide
User :   do you think I should under go some fresh tests, cause there might be changes since December.
Doctor :  
You can send the same if the Urologist recommends fresh ones, you can get them done
User :   if so what tests do you recommend
Doctor :  
I do not recommend any now.
User :   ok
Doctor :  
Since this is a chronic problem you can always take an opinion
Doctor :  
with the current state
Doctor :  
If the Uro recommends some based on your history then you can get them done
User :   so i will consult with the urologist
Doctor :  
Ali, your problem is not temporary
User :   even with surgery I guess
Doctor :  
so the solution should be as better as it can
Doctor :  
so that it does not hinder your daily activiy especially sex, urination and defecation
User :   ok, thank you
Doctor :   Is there anything else I can help you with?

Doctor :  
Please feel free to chat with me whenever you like
Doctor :  
A small home remedy for burning urination
Doctor :  
The first thing to do is to drink a lot of water. 1) Drink at least 15 to 20 glasses of water throughout the day. This flushes out the bacteria causing the infection from your system over time.
Doctor :   Abstain from sex if you have too much problem
Doctor :   3) Drinking a mixture of half a teaspoon of baking soda in a glass of water everyday will greatly help heal the burning sensation.

Doctor :  
4) Cranberry juice a glass a day helps
Doctor :  
5) Increase the intake of vitamin C through milk and fresh fruits and vegetables.
Doctor :  
I hope I am understandable
Doctor :  
Did you follow all my advices?
User :   yeah, that would be really helpful
User :   wont citric fruits increase burning sensation
Doctor :   No
Doctor :  
They are fine, and if you feel they increase
Doctor :  
then restrict them
Doctor :  
Ok
Doctor :  
Please fill the feedback form say done when done
User :   yeah
Doctor :  
Thanks for consulting me
Doctor :  
Bye for now
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