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Diagnosed with BPH and prostatitis. DRE done and depressed with anxiety. On Cipro. Suggest?

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Hi my name is XXXXX. I was just diagnosed with bph. My prostate volume is 35cc. I am an avid cyclist,runner and lift and swim. I juice and eat really healthy. I had a dre done on 7/24/13 and that is when my naturopath diagnosed my bph. Later that same day I went to the ER with what they diagnosed as prostatitis. I have been depressed and anxiety ridden ever since. I have been on Cipro for almost 28 days and I am worried about the side effects. Is it also possible I have cp/cpps? I have bee trying to research what would have made me have an acute case of prostatitis a few hours after the dre? Thanks,XXXXX
Posted Thu, 10 Oct 2013 in Men's Health
Answered by Dr. M Y Shareef 1 hour later
Brief Answer:
Details of the problem will help in opining.

Detailed Answer:
Hi XXXXXXX ! Good morning. I am Dr Shareef answering your query.

At the outset I would advise you not to be depressed or anxious for the diagnosis of BPH and/or Prostatitis. If it is BPH, this pathology is a normal phenomena in the process of aging.But many persons having BPH do not have any symptoms also.
Prostatitis can occur when there is an untreated sexually transmitted disease, which can give rise to prostatitis by an ascending infection.You have not mentioned about the problems you had for which you got a DRE done.

If you can please send me the details of all your symptoms and reports of all the investigations till date, I can better suggest you on the course of action one should take in your condition.

Awaiting your reply. Thank you for using XXXXXXX forum for your health query.
Above answer was peer-reviewed by
Follow-up: Diagnosed with BPH and prostatitis. DRE done and depressed with anxiety. On Cipro. Suggest? 4 hours later
Thank you Dr. Shareef. The DRE was done on a general physical. My naturopath wanted me to have a metabolic ratio and a cbc and an AC1 test and a fasting blood glucose done. I am 60 now so he wanted to add a complete abdominal and a thyroid ultrasound, also a TRUS and a colonoscopy.

He was just trying to do an all around complete physical and blood tests and US tests to rule out any thyroid C/A and prostate C/A and/or enlargement and any risk of colon C/A.

UHC was covering all my tests for my yearly wellness exam. I really haven't been having major symptoms of BPH, maybe a little urinary dribbling after, but flow and hesitancy were not any kind of bothersome problem. A few wake up calls to the bathroom some nights but I had been hydrating heavely with water almost up until bedtime. I am a habitual water drinker. So I just figured I was waking up to urinate because of drinking before bedtime.

The issue that scared me was the effect a few hours later from the DRE. The trip to the E.R.! The ARNP attending told me that a DRE sometimes can induce a case of worse symptoms of an already existing case of prostatitis that was contained in the prostate gland prior to the DRE. She said that's probably why you didn't even feel or suspect any conditions or symptoms were apparent before the DRE.

She also said it could also be a major pelvic floor muscle spasm from being a high endurance athlete and having tight pelvic floor muscles. But she suspected it was prostatitis because my WBC count was up a bit. No fever or chills. So she sent me on my way with 7 days worth of Cipro and a refrral to a urologist.

That was on 7/24/13 and I am just now starting to feel like it is making some kind of improvement. I haven't been running or cycling, just yoga. Cipro has some major tedonitis and tendon rupture risks and now the FDA is warning about possible permanent nuropathy issues with the antibiotic. It has a black box warning as you know.

Yes i got scared about the BPH also because it can cause AUR and renal failure and the surgeries and drugs to treat it are not really how most men at 60 want to treat it. I have also read and heard horror stories of men having terrible cp/cpps and BPH together. They are on disability and depressed and anxiety ridden and have isolated themselves from social life. Researching on google can be a godsend and also a paralizing curse!

Yours in Health, XXXXX P.S. Great news about your liver! I have many friends with Hep-C. The USPTF has moved HEP-C testing to a grade B. So more and more cases of Hep-C are going to arise. Hep-C infection is huge! It is not just 4 million, it is much larger than that!
Answered by Dr. M Y Shareef 2 hours later
Brief Answer:
Ill effects of gathering excess web information

Detailed Answer:
Hi XXXXXXX ! Nice to have the details about your interaction with your doctor along with the reports of investigations.

It is good that you do not have any major symptoms of BHP. If too much of drinking of water before bed time is the suspect, then you can discontinue taking a lot of water before bed time and see if your symptoms of waking up for passing urine gets reduced or relieved. If it gets relieved then you need not worry. As I have already mentioned even those with big prostate may not have any symptoms at all unless the median lobe is also enlarged and pressing on the urethra and to land up in acute urinary retention, and a renal failure, you have to have initial symptoms of BPH obstructing your urinary flow. So I think that your apprehension and anxiety on BPH and its effect are unwarranted for.

Similarly if you do not have any findings in your urine microscopic exam and semen analysis after DRE, and are asymptomatic after taking the course of antibiotic, you do not have to get apprehensive about it. Usually prostatitis will also cause some urinary symptoms and pain in the genital area which as I suppose you do not have. I am not aware as to why you are getting yourself associated with CPPS. A single routine digital examination will not result in a CPPS. Possibly you are right that surfing the net at times may cause you more trouble than what you actually are in. Say by any chance if you had a latent prostatitis as per the doctor of the ER, that would have been cured by this long duration of the antibiotic. You can opt for a routine and culture of both urine and semen samples of yours.

Yes - because of the family history of Diabetes and hypertension, you should have a routine blood sugar test and a routine blood pressure check up with serum lipid profile, and blood urea with serum creatinine done at regular intervals. There is no specific treatment for Hep C infection. As such you do not need to worry as your liver function test is normal along with the normal ultrasound. There are some liver tonics available in the market, but their efficacy is controversial.

I am sure you are maintaining a good health due to your active sports life, and I pray God will keep you like this in future also. Uncalled for anxiety is the worst enemy of the health,and so please avoid it. It is good to have information from the net, but one should not get trapped by it. I hope you understand.

I presume that I have explained your query by now. If you have any other question please feel free to ask. Thanks and good luck. Dr Shareef.

Above answer was peer-reviewed by
Follow-up: Diagnosed with BPH and prostatitis. DRE done and depressed with anxiety. On Cipro. Suggest? 9 hours later
Hi again Dr. Shareef. I did have major overall genital pain that is just now clearing up. I was on Cipro for 28 days. It hurt to sit for very long and it really burned to urinate and my prostate felt swollen and my rectum burned also.

It was very frightening to me. I thought what if I have to put up with this the rest of my life after getting a common DRE done. I wished I hadn't even had the physical after this happened because my overall health and mindfullness was in great shape.

I had wished I had just gone with the PSA and the U/A and would have been done with it. No expensive ER trip and no heavy anxiety and wishing I could go back and not be in the state I was in.

I have been out of my excercise routine for 2 months now and that is not good for me. Most men nowadays just go with a PSA and a U/A at their physicals and that's how mine was in the past. I hadn't had a DRE in probably 10 years or more. Sometimes I wonder when it comes to knowledge and medicine the less is more approach is better for the mind and the pocket book! It is also not fun running from urologist to your doctor to a TRUS etc.

What are we to do as human's. Be proactive with our health or just try to be intuitive and eat as well as you can and excercise and try to live as happy as you can. Maybe ignorance is bliss! Medicine can be so exasperating and trying and expensive. What is right and wrong. Should one have a colonoscopy a prostate TRUS a FNA biopsy and more US of everything.

I've always believed in knowledge is power. But sometimes if given the wrong information and knowing about something can make a person obscess and focus on a diagnosis of what was there but no knowledge of it and now you know.

We live in a very mixed up world of what is the right medicine and what is money driven. I have had a hard time with this because it has made me afraid to get on my bike and ride again and cycling is my feedom and passion. So is running and weight lifting and just being happy.

I have many male friends that will not get tested for Hep-C because they feel fine and are fit and don't drink and feel if they had the diagnosis of being positive it would ruin their mental wellness and they would worry and stress about it. In the buddhist sense of it you should just be happy in every minute of the day and not worry about the future as it doesn't exist in the "Be here now" sense.

Yes I have anxiety over this and I probably should not. But I thought I would breeze through the physical as I said and go on and have my colonoscopy and be done with all the tests until next time. I should just try to realise that when we have tests or physicals something may come up. It's all in how you handle it.

This has interfered with my soul and confidence as a male. AUR and ARF are extremely frightening to me. I must get back to running and cycling and pushing forward, I must because that is all there is. Trying to use herbal remedies for quite a bit of my health situations. Live raw foods also. I am looking at using an auyrvedic formula for prostate health Gorshuradi Guggulu, you might look into it for your own prostate health.

Let me know about your HEP-C and how things are going for you.

Yours in Health and well being, XXXXX
Answered by Dr. M Y Shareef 12 hours later
Brief Answer:
Nice to see your positive attitude

Detailed Answer:
Hi XXXXX! Good afternoon. I saw your return mail after finishing my hospital engagement, and was quite moved with it. You are the first person amongst the people with whom I have interacted till now who went so deep philosophically.

Perhaps you are right in saying that more knowledge at times lands you in trouble, but at the same time we never leave our quest for learning. In our side of the continent, routine voluntary health check ups are not the rule, but are exceptions.

I think gaining confidence in yourself depends largely on you. You do not have to worry for ARF and AUR when you do not have any preliminary symptoms of the problem which can lead to this. And I am sure that you being a sports person and a positive thinking man can do it without much effort. So, you can gradually start with your daily routine once your symptoms are relieved, which already has started the signs of improvement as said by you. Once you start it , I am sure you won't look back again.

Regarding my Hep-C status, I do not hesitate to confess that I have not yet got it done, and I do not feel that I need it at present. As such this test is not done routinely in this part of sub continent. I am 58 now, and I go for my morning walk and a bit of jogging within my limits for 45 minutes daily. I am happy to XXXXXXX a person like you who also is more active at this age and this is what positive thinking is.

WIshing you good luck, and full of confidence. Dr Shareef.
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