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Diagnosing Prostatitis: urine vs prostate culture

Posted by normandhebert @normandhebert, Jun 12, 2022

I am beginning this discussion in the hopes of saving other men the nightmare I went through. I am a healthy fit 60-year-old with no health concerns, however, I was diagnosed with prostatitis in January 2022. Began with severe testicular pain and was rushed to emergency room crying uncontrollably due to pain. Pelvic CT, testicular exam Etc ruled out all other conditions and I was diagnosed with prostatitis and sent home with Percocet. To make a 5-month long very painful story short. I went thru Four USELESS urologists, four more testicular exams, 2 digital rectal exams, five urinalyses which all showed no bacteria or stds, 4 wks of levofloxacin, 3 weeks of doxycycline, and 10 weeks of percocet and gabapentin use to manage the pain, along with depression, weight gain etc. FINALLY my own research led me to ask my new urologist about using a semen sample to test for bacteria in the prostate. BINGO, from one sample he identified the bacteria and put me on a specific antibiotic called Suprax (Cefexime) for 2 weeks and the symptoms cleared. Had my first urologist or even the ER doctor suggested testing a semen sample they would have saved me 5 months of the worst nightmare of my life. I hope my post helps other men to avoid what I went through.

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Profile picture for bill899
bill899 | @bill899 | Oct 5 12:00am

well am sure glad ive written down the anti---- heres a little bit about my 6 month bout 25 yearsago---went to a reg doc for lower back pain thought it might be prostate cancer-- thats all i had at the time--- doc says hold on to the table and i said why -- then he grabed my prostate real hard like you were ringing out a dishrag it hert-- then he did a looke at a urine samble and it shoed bacterial infection he said a month of cipro -- well a couple of days and i was hurting worse i couldnt take that then he prescribed flomax and i was in really bad shape-- so i discontinued and got doxyclcline which i could take but it create burnin diring urination-- i put up with it for about 2 weeks still in pain quit as i wanted a beer as i hadnt donr that--- then the burning got worse--- i found out about solaray ginger root tabs it stoped the burning in20 minutes then i got solaray saw palmetto and the prostate pain went away fast! so maybe the doxy killed the infection but the solaray ginger root and saw palmetto saved me!

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bill899 | @bill899 | Oct 17 5:06pm
In reply to @delmar418 "In 2006, I had perineal pain, urinary frequency so bad that I had to carry around..." + (show)
Profile picture for delmar418 @delmar418

In 2006, I had perineal pain, urinary frequency so bad that I had to carry around a 2lb protein powder container in my car so I could pull over to pee in it. Sometimes off to the side of the freeway. The urgency came with extreme pain that had me whimpering until I could relieve myself. This went on for months before I saw a urologist. I had seen a few nurse practitioners in the interim who took urine cultures, all coming back negative.
When I went to friends homes to visit they started asking me if I was doing drugs because of my frequent trips to the bathroom, even after explaining what was happening. I had to pee sitting down. Not only was my prostate enlarged, but it was inflamed, so there had been some obstruction happening for some time.
I was given antibiotics. One offered Cipro, which I didn't have filled. I used bromelain and quercetin capsules along with cranberry concentrate capsules. These alleviated it for a while. The pain went away. Then the pain came back. This time there was visible blood in my urine. I had a friend who knew a doctor whom he asked to refer me to a urologist. The urologist gave me a DRE, only this time he "milked" my prostate until pre-seminal fluid came out which he put onto a slide. He cultured it immediately in his office under microscope. This was something I've never heard of, but it was standard in his practice. There was no bacteria. He diagnosed me with non-bacterial prostatitis. Gave me antibiotics, Macrobid. This seemed to clear it up. Then it came back again so he gave me a cystoscopy. He didn't see anything suspicious. He did see irritation on the bladder wall. He told me I may have passed kidney stones because I also had flank pain on one side. He remarked that he saw indications of bladder cystitis, which again, non-bacterial.
More antibiotics, vicodin and AZO after the cystoscopy. Then it went away. In 2013, it came back, only this time I had no health insurance. So I couldn't afford to see the urologist. I had to go to a free clinic. I had a part-time job. They gave me a DRE, took a urine sample, all came back negative for infection. Diagnosis: non-bacterial prostatitis with possible cystitis. Antibiotics, Cipro. I went back to the bromelain and quercetin, vicodin, drank green tea only. It got to be so unmanageable that I had to leave the desk job. It went away. I went back to the NP, she did a DRE, she did not take a pre-seminal culture. "We don't do that here," she said. Macrobid and AZO.

Jump to Aug. 2022. Extreme fatigue, frequent urination, dizziness, high blood pressure and back pain.
After X-ray of the back came an ultrasound which showed bilateral hydronephrosis and a 99cc sized prostate. The prostate had been causing me to hold more urine that had backed up to my kidneys. I received a catheter.
The reason I point this out is that I was living with a time bomb. Part of it was my fault for not running to the doctor, however it was discouraging me to see any doctor because of the long wait. These tests were months between. Had I had an ultrasound of my abdomen back in 2006, they may have found something.
I believe that much of what provoked the flare-ups of the prostate were due to extreme prolonged stress, poor sleep due to nocturia, pain and diet and economic stressors. Consequently, the most recent enlargement may have been non-bacterial prostatitis which caused urinary retention- coupled with the enlargement- but that's my theory. I live in a foreign country, was filing for a divorce in a toxic marriage, my mother was dying of cancer in the States, the Covid problem- my cortisol levels must have been through the roof and I was in a constant state of anxiety and inflammation.
I have a urologist here, but they don't milk the prostate. It didn't occur to me to ask them! I may ask them if they do another DRE. I recently had an MRI with contrast of the prostate; still waiting for those results to come - the day before my 60th birthday, of course.
I'd like to thank you for your story about prostatic milking for culture analysis, it's something that they SHOULD know about, and be doing TODAY.

Jump to this post

@ delmar418 about 20 years ago i went to the doc(reg) for back pain only he milked the prostate too hard - bacteria showed up but he schould have takin a semen sample instead-- thats when my problem started--prostate pain urinary burning ect ect-- put me on cipro and flomax made it 10 times worse-- went off the doxy for a couple weeks-- still burniing prostate pain like sword up the butt---- then got mad and drank a bee rwhich made the burning worse but tried solaray brand ginger root-- the burning almost went away then took solaray brand saw palmeto for the prostate pain--- kept doing this for a couple of weeks and i was back to normal when the prostate hurt i took saw palmetto and the pain went away in 20 minutes-- i believe the prostate milking started all my symptoms!

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Profile picture for mikenyny
mikenyny | @mikenyny | Nov 11 10:13am

1. I was suffering from Prostatitis in late August this year: pain in urinating and restricted flow. (I am a British male aged 70 years and 3 months).
2. I saw a Urologist at my long-time Private hospital (outside Bangkok, Thailand) and had a Prostate ultrasound, urine test and a PSA test - which I requested.
3. The PSA test had with a result of 1,000 (when I was told it should be 4-8). The Urologist prescribed me 3 medicines: the antibiotic Levofloxacin (500 mg x 1 tablet per day), Finasteride (5 mg 1 x tablet per day) and Tamsulosin (1 x 0.4 mg tablet per day).
4. After 2-3 days, my Prostatitis started to clear up - and was soon gone.
5. I had lower abdomen CAT scan (for my prostate) in late September, which confirmed that I had Prostate cancer.
6. I had a Prostate Biopsy ((after being advised to – big mistake) on the 14th of October.
6a. The Urologist who performed the biopsy told me it was successful and prescribed me the antibiotic Cefdinir (3x100mg per day) Cefdinir which was totally ineffective; after 3 days I could hardly urinate. I checked online and all the websites recommended 3x100mg Cefdinir every 12 hours, so on the 4th day I increased the dosage of this antibiotic, but the increased dosage made me feel ill / caused pains in my chest at night.
7. I had an appointment with this Urologist one week after the biopsy and advised him (6a) the above and I had increased to dosage, but that I was suffering with Prostatitis and constant pain at the rear of my testicles, to which he said: "I'm sorry".
8. Later that evening (after completing one week of Cefdinir), after completing one week of taking Cefdinir, I switched to the antibiotic Levofloxacin (500 mg tablet x 1 per day).
9. This almost immediately improved Prostatitis symptoms and the pain behind my testicles went away, but after one week the symptoms returned (but not the pain behind my testicles). I started suffering constipation, but I continued taking this antibiotic for one more week.
10. I saw another Urologist at the hospital (on November 4th), described my condition to him, and he changed the antibiotic to Ciprofloxacin (500 mg x 2 tablets per day for 5 days). I also advised the doctor that I am continuing to take Finasteride (5 mg 1 x tablet per day) and Tamsulosin (1 x 0.4 mg tablet per day).
11. After taking the Ciprofloxacin for 2 days, I was no longer constipated but then had LBM (loose bowel movement) – basically every time I needed to urinate (2 hours or less), I also had the need for a bowel movement. The main problem I now have is that when I need to urinate every 1 to 2 hours and I have no bladder control before-hand, meaning that I involuntarily start to urinate without control. (However, I have always drank water through the day: 2 to 3 litres per day). I don't drink alcohol or smoke cigarettes).
12. I had a follow-up appointment with the same doctor one week later; I told him that I was feeling much better (which I was) and that I had completed the course of antibiotics. He ordered a urine test to test for infection, and there was no infection. He just mentioned that the test showed that I was dehydrated. I told the doctor that I drank water constantly throughout the day – which I have done for the last 20 years living in Thailand.
Conclusion
1. Prior to the Prostate Biopsy, I didn’t have Prostatitis.
2. After the Prostate Biopsy, I have Prostatitis once again (as per No. 1 above).
3. I checked online last night for a couple of hours, and I have decided to start a course on Norfloxacin 400 mg tablets (1 every 12 hours on an empty stomach) for 28 days.

REPLY
2 replies
Profile picture for bill899
bill899 | @bill899 | Nov 11 2:37pm
In reply to @mikenyny "1. I was suffering from Prostatitis in late August this year: pain in urinating and restricted..." + (show)
Profile picture for mikenyny @mikenyny

1. I was suffering from Prostatitis in late August this year: pain in urinating and restricted flow. (I am a British male aged 70 years and 3 months).
2. I saw a Urologist at my long-time Private hospital (outside Bangkok, Thailand) and had a Prostate ultrasound, urine test and a PSA test - which I requested.
3. The PSA test had with a result of 1,000 (when I was told it should be 4-8). The Urologist prescribed me 3 medicines: the antibiotic Levofloxacin (500 mg x 1 tablet per day), Finasteride (5 mg 1 x tablet per day) and Tamsulosin (1 x 0.4 mg tablet per day).
4. After 2-3 days, my Prostatitis started to clear up - and was soon gone.
5. I had lower abdomen CAT scan (for my prostate) in late September, which confirmed that I had Prostate cancer.
6. I had a Prostate Biopsy ((after being advised to – big mistake) on the 14th of October.
6a. The Urologist who performed the biopsy told me it was successful and prescribed me the antibiotic Cefdinir (3x100mg per day) Cefdinir which was totally ineffective; after 3 days I could hardly urinate. I checked online and all the websites recommended 3x100mg Cefdinir every 12 hours, so on the 4th day I increased the dosage of this antibiotic, but the increased dosage made me feel ill / caused pains in my chest at night.
7. I had an appointment with this Urologist one week after the biopsy and advised him (6a) the above and I had increased to dosage, but that I was suffering with Prostatitis and constant pain at the rear of my testicles, to which he said: "I'm sorry".
8. Later that evening (after completing one week of Cefdinir), after completing one week of taking Cefdinir, I switched to the antibiotic Levofloxacin (500 mg tablet x 1 per day).
9. This almost immediately improved Prostatitis symptoms and the pain behind my testicles went away, but after one week the symptoms returned (but not the pain behind my testicles). I started suffering constipation, but I continued taking this antibiotic for one more week.
10. I saw another Urologist at the hospital (on November 4th), described my condition to him, and he changed the antibiotic to Ciprofloxacin (500 mg x 2 tablets per day for 5 days). I also advised the doctor that I am continuing to take Finasteride (5 mg 1 x tablet per day) and Tamsulosin (1 x 0.4 mg tablet per day).
11. After taking the Ciprofloxacin for 2 days, I was no longer constipated but then had LBM (loose bowel movement) – basically every time I needed to urinate (2 hours or less), I also had the need for a bowel movement. The main problem I now have is that when I need to urinate every 1 to 2 hours and I have no bladder control before-hand, meaning that I involuntarily start to urinate without control. (However, I have always drank water through the day: 2 to 3 litres per day). I don't drink alcohol or smoke cigarettes).
12. I had a follow-up appointment with the same doctor one week later; I told him that I was feeling much better (which I was) and that I had completed the course of antibiotics. He ordered a urine test to test for infection, and there was no infection. He just mentioned that the test showed that I was dehydrated. I told the doctor that I drank water constantly throughout the day – which I have done for the last 20 years living in Thailand.
Conclusion
1. Prior to the Prostate Biopsy, I didn’t have Prostatitis.
2. After the Prostate Biopsy, I have Prostatitis once again (as per No. 1 above).
3. I checked online last night for a couple of hours, and I have decided to start a course on Norfloxacin 400 mg tablets (1 every 12 hours on an empty stomach) for 28 days.

Jump to this post

@mikenyny HOPE MY OTHER POST HELPED-- i had to basicly solve my problem myself over 20 years ago . as stated when the uro milked the prostate i got full blown prostatitus! i never had a biopsy but talked to a person that had 3 done and it really messed him up(prostatitus) no cancer-- the doc kept doing it wow! and the cystoscope that 2 wanted to do and i asked why and his only answer was he could look at the prostate-(rough test)- i said no to that and he ranted that damn internet! as stated the doxyclcline for about 2 weeks helped - then when i went off it was solaray saw palmetto that stopped the sword up you r ass pain and the solaray ginger root(max dose or more) tabs that stopped the burning then slowly it all went away! hope this helps take care its a bitch for sure! bill

REPLY
Profile picture for rw58
rw58 | @roywol | Nov 12 10:26am
In reply to @mikenyny "1. I was suffering from Prostatitis in late August this year: pain in urinating and restricted..." + (show)
Profile picture for mikenyny @mikenyny

1. I was suffering from Prostatitis in late August this year: pain in urinating and restricted flow. (I am a British male aged 70 years and 3 months).
2. I saw a Urologist at my long-time Private hospital (outside Bangkok, Thailand) and had a Prostate ultrasound, urine test and a PSA test - which I requested.
3. The PSA test had with a result of 1,000 (when I was told it should be 4-8). The Urologist prescribed me 3 medicines: the antibiotic Levofloxacin (500 mg x 1 tablet per day), Finasteride (5 mg 1 x tablet per day) and Tamsulosin (1 x 0.4 mg tablet per day).
4. After 2-3 days, my Prostatitis started to clear up - and was soon gone.
5. I had lower abdomen CAT scan (for my prostate) in late September, which confirmed that I had Prostate cancer.
6. I had a Prostate Biopsy ((after being advised to – big mistake) on the 14th of October.
6a. The Urologist who performed the biopsy told me it was successful and prescribed me the antibiotic Cefdinir (3x100mg per day) Cefdinir which was totally ineffective; after 3 days I could hardly urinate. I checked online and all the websites recommended 3x100mg Cefdinir every 12 hours, so on the 4th day I increased the dosage of this antibiotic, but the increased dosage made me feel ill / caused pains in my chest at night.
7. I had an appointment with this Urologist one week after the biopsy and advised him (6a) the above and I had increased to dosage, but that I was suffering with Prostatitis and constant pain at the rear of my testicles, to which he said: "I'm sorry".
8. Later that evening (after completing one week of Cefdinir), after completing one week of taking Cefdinir, I switched to the antibiotic Levofloxacin (500 mg tablet x 1 per day).
9. This almost immediately improved Prostatitis symptoms and the pain behind my testicles went away, but after one week the symptoms returned (but not the pain behind my testicles). I started suffering constipation, but I continued taking this antibiotic for one more week.
10. I saw another Urologist at the hospital (on November 4th), described my condition to him, and he changed the antibiotic to Ciprofloxacin (500 mg x 2 tablets per day for 5 days). I also advised the doctor that I am continuing to take Finasteride (5 mg 1 x tablet per day) and Tamsulosin (1 x 0.4 mg tablet per day).
11. After taking the Ciprofloxacin for 2 days, I was no longer constipated but then had LBM (loose bowel movement) – basically every time I needed to urinate (2 hours or less), I also had the need for a bowel movement. The main problem I now have is that when I need to urinate every 1 to 2 hours and I have no bladder control before-hand, meaning that I involuntarily start to urinate without control. (However, I have always drank water through the day: 2 to 3 litres per day). I don't drink alcohol or smoke cigarettes).
12. I had a follow-up appointment with the same doctor one week later; I told him that I was feeling much better (which I was) and that I had completed the course of antibiotics. He ordered a urine test to test for infection, and there was no infection. He just mentioned that the test showed that I was dehydrated. I told the doctor that I drank water constantly throughout the day – which I have done for the last 20 years living in Thailand.
Conclusion
1. Prior to the Prostate Biopsy, I didn’t have Prostatitis.
2. After the Prostate Biopsy, I have Prostatitis once again (as per No. 1 above).
3. I checked online last night for a couple of hours, and I have decided to start a course on Norfloxacin 400 mg tablets (1 every 12 hours on an empty stomach) for 28 days.

Jump to this post

@mikenyny
I had a similar situation following prostate biopsy. I developed severe debilitating chronic pelvic pain that lasted nearly a year. Guidelines call for mri prior to biopsy but urologists don’t make money from an mri so they like to do biopsy. Never again. Warm sitz baths, daily pelvic exercises, quercetin and Graminex was most helpful.

REPLY
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mikenyny | @mikenyny | Nov 12 1:45pm

I have only been registered to this site for 2-3 days now, but after reading several posts I am getting the impression that a lot of these so-called Urologists (over in your neck of the woods) are in it for the money. This is not the case here in Thailand. I didn't mention in my "list" above that I saw 3 Urologists between the 28th of August and the 30th of September. The first one decided to take his lunch break instead of waiting for the results of my PSA test - so although I was charged for the procedure, he did not provide me the results; instead stating that I could have another PSA test in a few weeks! I went back to the hospital 2 days later to query the bill, and he showed up 20 minutes later with my PSA test results plus the results of my kidney scan. Upon my questing this, he actually replied: "I don't have to provide the test results". I reply to him was: "Unbelievable". Needless to say, I cancelled my next appointment with him.
The next Urologist I saw worked at a government hospital in the centre of Bangkok and worked at my hospital on Sunday morning and Wednesday evening. He told me that the next 2 procedures I needed were (1) a lower abdomen MRI, and a prostate biopsy in that order. He said: "If you have it at this (my) hospital, it will be very expensive and suggested I visit him at his government hospital. I did this and saw him, only to be told that I would have to go to another hospital for these procedures... yes, I was also thinking why didn't he mention this when I saw him at my hospital? So, I basically wasted my time (one day) and money for nothing.
I saw my "Chest doctor" and he told me that he could arrange the MRI (at my hospital). This turned out to be exactly the same price as I was quoted at the "mystery" hospital (that my wife obtained when she phoned them up). My chest doctor strongly recommended that I have the Prostate biopsy and informed me that a "third" Urologist visited my hospital once a week on a Monday evening. The chest doctor organized an appointment with this "third" Urologist, who I saw a few days later - on Monday Oct. 7th. He arranged to do the prostate biopsy one week later - at 6:00 pm in the evening, stating that there was a 5 hour observaton period straigh after the procedure and he recommended that I book a room and stay the night as opposed to waiting at the hospital for 5 hours and then going home. This, I accepted as it made total sense to me - because I could undergo the 5 hour observation period in my hospital room.
As I said in my initial "notation" post above (6a), this Urologist prescribed me a course of totally useless antibiotics - which is why I am suffering with Prostatitis again - just as I was prior to seeing the first Urologist (who actually prescribed me 3 correct medications.)
I spent a couple of hours online on Sunday night - where I found the Mayo clinic site - and upon going through several web sites and checking all the antibiotics available for bacterial prostate infection, decided upon Norofloxacin (which is a fluoroquinolone) 400 mg tablets x 2 a day, which I bought on Tuesday afternoon, and started the course Tuesday evening. The website suggested a 28 day course, so I bought a box of 100 tablets - 10 strips of 10 tablets (which cost all of $12:50 equivalent).

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slarson14 | @slarson14 | Nov 12 2:07pm

Not to make fun of anyone but I am so glad I do not have a prostate gland. My husband had a prostate biopsy done; I insisted on being with him, as I know what it involves and he did not. I also insisted the doctor give him valium before doing the procedure.

This idiot doctor never explained ANYTHING to my husband about what the procedure involved nor did he offer a pain medication before or during the procedure. The urologist also did not offer an MRI FIRST before doing a biopsy. An MRI saves a man the pain, the invasive procedure, and an MRI can also diagnose OTHER conditions a biopsy could miss.

Needless to say, if none of the biopsies hit cancer, it won't show cancer, either.

The biopsy experience was a nightmare: they did 14 biopsies via the rectum, through the rectal wall. My husband is lucky he didn't get prostatitis.

Men need to refuse this procedure unless they are going to give you light sedation, as they do in Europe and many countries. This procedure is PAINFUL even when they use novocaine in the rectal wall. The prostate feels pain, trust me, I have seen it done.

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