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32 year old living with Chronic Bacterial Prostatitis

Posted 12 Nov 2020 at 21:13

Hi guys!


For years i have been going often to the bathroom. 2 years ago it got worse. 10 times per day, 3 times per night. Sometimes a pain in the lower abdomen. No swelling, no smelly discharge from penis, nothing like that. Fast forward until this year in March. I finally found a good urologist. He tested me using PCR method from the EPS(Expressed Prostatatic Secretion). He found 3 things. 


-Trichomonas vaginalis

-Candida(did not specify which type).

He put me a on a treatment with a medicine for each of the above. Doxicicline for Chlamydia, Metronidazol for Trichomonas and Fluconazole for candida. At the end of the 2 week treatment i felt better, i went to the toilet 1 time per night and 5 times per day max. Gradually tho, it got worse. I went back to see the doctor, redid the tests(30 days have passed since the end of the antibiotic treatment). 

The test came back clean. I am...clean.  I asked him how can this be. He told me that because i had this condition for a very long time beside an infection i also had an inflammation. The infection is solved but the inflammation is not. Hence the name "chronic prostiatitis". He basically told me that there is nothing i can do except take NSAID(non steroidal anti inflamattory drugs) when i feel the situation is hard to bear. 

Of course i do not feel like giving up, i am only 32 years old but i do not know what to do. What do you guys recomend me to do? 

Thanks in advance!






Posted 13 Nov 2020 at 04:57


Excellent that your urologist used EPS - most don't know to do this, and the bacteria often don't show in urine or semen samples. When your urologist redid the tests, were they also based on EPS?

Many antibiotics also have anti-inflammatory properties. People can take these, feel better, and then have the symptoms come back. What often happened in this case is that symptoms resolved as a result of the anti-inflammatory properties, which wear off when you stop taking the antibiotics, but the antibiotics never killed the infection. That can be because of wrong antibiotic, resistant bacteria, or (common in the prostate) the antibiotic never got to the infection.

A PCR test won't (as far as I know) identify if the bacteria are sensitive or resistant to the antibiotics. I think what's more usual is to culture the EPS (grow bacteria from it), and then test those against a standard set of antibiotics to find the antibiotics the bacteria is sensitive to.

Another problem is getting the antibiotics to the infection in the prostate. Prostatitis usually resides significantly in the ducts, and antibiotics often don't make it there. Only some antibiotics can get in to the prostate to work (and I don't know if the ones you list can). This may mean having prostate massage (similar as for EPS) while you're on the antibiotics.

I think you may have already seen that we have a urologist specialising in prostatitis at The FOPS. The next support meeting is probably going to be on 2nd Dec, which I would encourage you to join.

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