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Chronic nonbacterial prostatitis. Kidney stone removed. Test showed normal. Alternate treatment?

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52 year old male - chronic non-bacterial prostatitis for 2 1/2 years - on and off many different antibiotics - psa fluctuates from 2 to 7 down to 3.6 then up to 7.1 - 12 core biopsie 10 months ago negative - Cystocopy 6 months ago normal - abdominal and uro CT Scan normal except for 4mm kidney stone. Removed successfully through lithotripsy.
- Could stable stone cause prostatitis symptoms prior to removal and elevate PSA?
- Could Gardnerella bacteria lay in prostate undetected and cause symptoms and elevate PSA?
-Tried Cipro, Doxy, Erytabs, Sulfa, Macrobid -
1. any other antibiotic you would recommend?
2Would metronidazole be something I ask my doctor to prescribe?
3.What other courses of treatment would you recommend?
Posted Mon, 13 Aug 2012 in Urinary and Bladder Problems
 
 
Answered by Dr. Chandra Shekhar Sharma 5 hours later
Hi,

Welcome to XXXXXXX

Answers to your questions are as following:-

(i) Kidney stone doesn't cause Prostatitis and increase in PSA.

(ii) Peoples with Prostatitis due to Gardnerella, may not have any symptoms, but it can be detected by microscopic examination of expressed secretion of prostate.
PSA is raised due to Prostatitis.

1. Drug resistance is very common. Culture & sensitivity test of expressed secretion from prostate is required, to identify causative organism and effective drugs.

2. Metronidazole is effective against Gardnerella. If gardnereralla infection is confirmed by microscopic examination of expressed secretion from prostate, you can ask your doctor to prescribe medicines for its cure.

3. In addition to antibiotics on the basis of C & S, prostatic massage and hot sit bath will help.

Thank you for posting your query. Hope you found my response to your query informative and helpful.

If you have further concerns in this regard, I would be happy to discuss those with you as well.

With good wishes,
Above answer was peer-reviewed by
 
Follow-up: Chronic nonbacterial prostatitis. Kidney stone removed. Test showed normal. Alternate treatment? 1 hour later
Thank you for your reply.

3. In addition to antibiotics on the basis of C & S, prostatic massage and hot sit bath will help. -- What does the abbreviation C & S mean?

my urologist does not believe in prostate massage or expressing secretions to try to identify organisim. I might try to find a different urologist.

After lithotripsy I was urinating sand particles. Uro doc said that would aggravate the urinary tract and prostate as i was passing these sand particles
 
 
Answered by Dr. Chandra Shekhar Sharma 38 minutes later
Hi,

Welcome again,

C & S stands for Culture and Sensitivity.

Suppose you are taking an antibiotic, against which infecting organism is resistance, it's of no use.

As drug resistance is common and bacteria can develop resistance during treatment also, it is better to know effective medicines against infecting organism and take two antibiotics simultaneously.

C & S is preferably done with expressed secretion of prostate and if expressed secretion are not obtained, C & S is done with urine obtained after prostatic massage.

Hope you found my response to your query informative and helpful.

If you have further concerns in this regard, I would be happy to discuss those with you as well.

With good wishes,

Above answer was peer-reviewed by
 
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