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Chronic bacterial prostatits, burning urination, taken antibiotics, itchy thigh, acidic urine. Suspecting kidney stones

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Practicing since : 1995
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I am diagnosed for chronic bacterial prostatitis with staphylococcus_haemolyticus during results shown for micro-biology culture taken with sperms sample sometime in november last year back in jakarta. then i was given anti-biotics amox-clavulanic for a 6 weeks, --had a burning feeling during urinating --followed by a orgasm sensation after the last drop of urine. after 6 weeks still not feeling better, back then i was told by the doctor in jakarta to continue taking the medicine again for another 6 weeks and together with consultations from other doctor(one of them is the doctor from healthcare magic was told to take harnal ocas for 4 weeks for the anti-biotics to penetrate well into the prostate. I was told to take flucanazole for my yeast infection treatment for 5 days, i took it and i still felt itchy in my inner thigh with reddish extra skin. but much better with less frequency on the itchy part compared to before taking the 5 days flucanazole treatment. I am currently on that 6 weeks treatment, another 2 weeks before finishing the treatment. Right now my symptoms are: 1.Milder burning sensation feeling when urinating compared to before (always happening in the morning when i urine) but i can feel that the urine is acidic 2.when i masturbate the night before, i will feel this burning pain even worst when i urine in the morning. (this never happens before i contract this disease even last time when i masturbate 2-3 times at night this never happen in the morning-the burning pain when urinating) 3.Again either both ways i always felt the sort of like "orgasm" sensation after my last drop of urine for about 5-10 secs XXXXXXX i have read thru some articles in the internet, could that be "piss shiver" or something like that? with heat discharge from the body and that the body is feeling cold? please clarify me. 4.After i had sex, when i ejaculate right now i still felt pain on my last shot of ejaculation. Compared to last time when i first had the disease, will feel pain during first shot of ejaculation which i guessed my condition is better now but still there is still pain during ejaculation. 5.I am currently thinking of alternative solutions to my problems, i will continue taking the anti-biotics for the next 2 weeks, i will again order flucanazole for my yeast-infection 5 days treatment which i have read from the internet its called skin fungal infection-candida, jock itch. please also clarify me. Also i would be taking the urine-alkalinizer treatment for 2 weeks (URAL) which i have placed an order for this.(to neutralise the acidic urine i felt when i urine in the morning) lesser on the burning part now but still occur a little bit. I do not really know what i am doing, what other ways i should be doing for me to be Normal again as last time. I had taken some other tests:usg bladder,usg prostate,flowmax,micro-biology sperm culture,urine analysis which i can send the whole reports including last year reports when i first had this problem as i went to see doctor in KL, Malaysia before in JKT. I am suspecting other,perhaps kidney stones or other prostate causes. I will go for another urine analysis again, and full blood count test tommorrow as i lived in a smaller town of indonesia and the laboratory is not as advance compare to jakarta thats what i could do at the moment.
Posted Tue, 22 May 2012 in Urinary and Bladder Problems
Answered by Dr. V. Sasanka 18 hours later
Your symptoms are suggestive of prostatitis, and actually whoever has advised you so far as far seem to have done a reasonably good job.
You definitely need to take antibiotics for a fairly long time, at leats 2-3 months. Alkalinizing urine usually helps as you have found out yourself.
I doubt if Fluconazole will be of help, though.
I would certainly suggest that you use Flomax or a suitable alternative - this will help you void well.
You also might have to take some drugs called anti-cholinergics to relieve bladder spasms in conjunction with alpha-blocker agents like Flomax if you have severe lower abdominal pain. But not everyone benefits, and thus a review of your scan reports is required before you start these medications.
Anti-inflammatory drugs often help by relieving the swelling of an infected prostate, and you might have lesser pain while voiding urine, especially after you have recntly ejaculated.
You can also try some relaxation exercises like Tai-chi or Yoga. They will be very useful to relieve the stress.
If symptoms persist, a urologist might request you to get a trans-rectal ultrasound examination, and depending on findings, advise you further. This might have to be done in a city with good facilities like Jakarta.
I hope I have been able to help you.
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Follow-up: Chronic bacterial prostatits, burning urination, taken antibiotics, itchy thigh, acidic urine. Suspecting kidney stones 26 hours later
Hi.. I am ordering another month of antibiotics(3x30) supply as told. Together with Harnal (Tamsuloin Hydrochloride) for 4 weeks(1x30). I want to ask you regarding reliving the bladder spasm. Does it have any bad side effects for me in the long-term after taking these medicine? anti-cholinergics - can this cure my spasm after voiding? I am also ordering for my anti-inflammatory drugs for 1x30 another month. Can you tell me what kind of scan reports do i need to undergo before i can take which medicines? Please let me know of all the tests i should go for so as to get a better understanding of my illness so as to get cured as soon as possible. Such as: Express Prostatic Secretion, Full Urine Analysis, trans-rectal ultrasound examination, Microscopic Urinalysis, Urine Culture, sonogram or IVP (intravenous pyelogram) ->For Upper Urinary Tract(There is a little crystal in my urine test), VCUG (voiding cysto-urethrogram)->lower. etc. I am still searching for the trade names used for anti-cholinergics used in Indonesia. Do you know one of? BUSCOPAN PLUS (Hyoscine-N-butylbromide XXXXXXX Parasetamol)-->this is what i found. Is that the one? Please also let me know the proper dosaged used for anti-inflammatory(normally as told by my local doctor 1x30),anti-cholinergics=buscopan plus. Thanks
Answered by Dr. V. Sasanka 13 hours later
Wow! You certainly have done your research here.
Buscopan plus is very mild anti-cholinergic, and if your spasms are significant enough to trouble you, you might have to use something like Detrusitol (which is an American brand, quite expensive) so you can probably use the local Indonesian version which should hopefully be just as useful. It does not have many side-effects but some people experience dry mouth. Definitely Tamsulosin should be useful, so please continue Harnal.
I do not think that you should take any anti-inflammatory drugs for one month continuously. You could have stomach or kidney ailments.
I do not think at this stage you need an IVU or MCUG. A trans-rectal ultrasound will be of use however. Obviously Expressed prostate secretions would be useful, but more in the context of an acutely infected prostate. Anyway, it will have to be done with the help of your local urologist.
Hope I have been of help. Let me know how you are progressing. Also very important - please learn some relaxation exercises - they are as important as any medicines. You should not be stressed.
Above answer was peer-reviewed by
Follow-up: Chronic bacterial prostatits, burning urination, taken antibiotics, itchy thigh, acidic urine. Suspecting kidney stones 25 days later
Hi. How are you? Sorry for the late Reply. I just came back from Singapore. I went to see one of the doctor there in XXXXXXX Eagles Hospital. He did an urine analysis for me and it shows that my white blood cells are 0 -> when i took that urine analysis i stopped taking the usual antibiotics which i have been taking. So he said that definetely i am not having chronic bacterial prostatitis but instead of that he said i am having Chronic Pelvic Pain Syndrome. He did a prostate message for me for 2 times and give me lyrica(medicine to relax my pelvic muscles). He also gave me a list of exercises for me to do to relax my pelvic muscles and i am asked to come back again to have my botox injections. Can you explain to me more about my situation? What is Chronic Pelvic Pain Syndrome??? How can it be cured??? what causes this? I read some of the articles over the net and it might be caused by the sequella of STDS. I asked him and he said that some patient can be cured right away after 1 botox injection some may need to do 3-4 times of botox injection. What is your recommendations?
Answered by Dr. V. Sasanka 3 hours later
Glad to know that you went finally to see a Urologist!
Under the circumstances, the diagnosis of Chronic pelvic Pain Syndrome is almost always right. The cause is unknown, but several theories have been postulated some of which have implicated a previous infection, an autoimmune mechanism, etc. STDs? - Yes, but in a minority.
What usually helps is a combination of drugs, not necessarily in the same way in everyone, and thus treatment is highly individualized. A part of these drugs is alpha-blockers ( That's why I suggested you continue Tamsulosin -Harnal). An Antispasmodic might help if used judiciously ( You can try low dose Tolterodine - detrusitol) if the spasms are severe.
Lyrica helps any neuralgia, and probably does help in ove 60-70% of my patients with other drugs like Baclofen or Botox which might be useful in selected patients. However, Botox is quite expensive, and needs several sittings, and if and when I do suggest this line of treatment, I inform my patients that the cure might not be total just to ensure that they do not get disappointed if treatment is not upto their expectations.
I did recommend that you learn Yoga or Tai-Chi or any other suitable relaxation exercise. This was anticipating this CPP (Chronic Pelvic Pain) problem, which happens typically in type A personalities - anxious, 'achievers'. So really you should learn to de-stress yourself. Swimming or any aerobic exercise also might help. Hope you are eating well with a good appetite. Try to avoid constipation. These are triggers locally which can bring about some more discomfort. Do those exercises to relax the pelvic floor muscles as has been advised.
As a matter of fact, your condition is fairly common, and is seen in quite a few patients by any urologist with a reasonably good practice, and each individual urologist has his own pet line of treatment. As long as you realize that there is nothing life-threatening going on, and you will eventually improve, half the battle is won.
Let me know how you are progressing.
Regards and best wishes.
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