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Cycling and prostate issues

User
Posted 03 Jan 2021 at 13:09

First post...66, fit and healthy, very keen and able cyclist, and have been for 15 years. I had a UTI about 13 years ago...horrid, but resolved with antibiotics..Trimethroprim for 14 days. I took up jogging about 6 years ago, but was worried by ' joggers' haematuria ', which followed a run over 5km. Had full scans, cystoscopy, etc, no cause for concern, but scans revealed ' calcifications , mild nodularity, moderate enlargement ' of the prostate. I actually had had a paragliding accident and fracture a vertebrae, so my osteopath told me I shouldn't be running anyway, so taking the two things together I stopped the jogging. So, haematuria is a thing of the past. But still cycling, competitors, 120 mile sportives etc, with no problems. Then September 2019, UTI reared its head. I took Nitrofurantoin for a week, it cleared up, and I went off for a solo cycling tour of Bosnia and Croatia a week later. Its a bike I dont use much, and the saddle isn't the best. So in the first real days cycling, the UTI came back with a vengeance, I was in the A & E in a small town being given Urifos. It cleared up, and I carried on, perhaps a bit too soon. I got very dehydrated, and had to cut my trip short. Since then, I've been plagued with recurrent UTIs, treated them with Nitrofurantoin, they clear up, and they recur. I've been on antibiotics for 3 months out of the last 15. I also have intermitted but chronic pain about 70mm above my umbilicus, tenderness and ' heaviness ' in the scrotum and testes. The urologist determined that ' it must be bacterial prostatitis ' as the urine sample showed up E. Coli infection.  The treatment did nothing to alleviate the pain. PSA is 1.2, I dont have classic prostate urination issues, but I do have a small bladder - 300 ml max - it seems. I was clear of UTI between July and November of 2020, and then got on the bad saddle again, and hey presto, a vicious UTI attack again! I'm still working with the legacy of this, having taken 28 days of Nitrofurantoin, and then a Urifos sachet. Still plagued by the gut ache, and ' ball-ache ' . I have consulted privately, top sports urologist in London, who said I need to be 'aggressive  'with treatment, take Ciprofloxacin, Tamsulosin and Atrhotec.  Having a very active lifestyle, ( well previously anyway  !) , as a farmer , being a keen cyclist, and being 66 years old, and having seen mixed reviews of the Cipro treatment, I decided I would not take that course. Of course with the pandemic, its very difficult to get more imaging and diagnosis. So, I'm inclined to go private. It seems very difficult to get a proper diagnosis, and develop a treatment plan for this. But I am interested in what seems a causal link between bad cycle saddles, poorly designed clothing, and whether the perineal area, bulbar uretha and its tissue, can become inflamed, lead to infection, and this infection can migrate to the prostate. More later!

User
Posted 03 Jan 2021 at 18:29

Very happy with my Specialized Sitero saddle on the road bike. Although it's designed as a TT saddle, I use it all the time.

Understandable that you declined cipro. The potential (but rare, they say) side effects are pretty horrible. Permanent tendon damage etc. Most people who have a TRUS biopsy are given cipro. I just rolled the dice and took it. OK, thank God.

The thing is that cipro is one of the very few antibiotics which can actually reach infections inside the prostate, which is why it's prescribed - even though there are potentially horrible side-effects. The side-effects of prostate cancer, ultimately, are worse. And septicaemia is pretty bad too. It's all a balance.

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

User
Posted 05 Jan 2021 at 10:01
Ciprofloxacin is the standard antibiotic prescribed for UTIs. I've been prescribed it many times and it really does work. I wouldn't personally let a tiny number of adverse reactions put you off taking a highly-effective medication.

Best wishes,

Chris

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User
Posted 03 Jan 2021 at 15:12
Are you using a prostate friendly saddle now?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 03 Jan 2021 at 15:19

Hi, yes I am. Not that I am cycling very much just now! I fitted a special seat on my indoor training bike, which is essentially two buttock 'pads '.....but it wouldn't be safe for a road bike. It certainly saves the perineal area...! I've got another seat for the road bike, with a much shorter, ' stepped ' nose, and a continuous depression running along the centre. I haven't really tried this one out....winter in Wales! I think old padded shorts lose a lot of their 'stuffing'  too...and this all compounds the issue. Bur first I need to resolve the underlying prostatitis issues before I seriously get pedalling again.

 

User
Posted 03 Jan 2021 at 18:29

Very happy with my Specialized Sitero saddle on the road bike. Although it's designed as a TT saddle, I use it all the time.

Understandable that you declined cipro. The potential (but rare, they say) side effects are pretty horrible. Permanent tendon damage etc. Most people who have a TRUS biopsy are given cipro. I just rolled the dice and took it. OK, thank God.

The thing is that cipro is one of the very few antibiotics which can actually reach infections inside the prostate, which is why it's prescribed - even though there are potentially horrible side-effects. The side-effects of prostate cancer, ultimately, are worse. And septicaemia is pretty bad too. It's all a balance.

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

User
Posted 03 Jan 2021 at 18:55

Good to see another keen cyclist on here! So glad to read your story, and to know your ( seriously ) back on the bike. As it looks, I dont have cancer, but do have this recurrent situation. Getting a diagnosis is key, and its difficult at any time...and particularly now. I'll have a look at the recommended saddle you have....it does look useful. Still has a nose though...does that cause pressure on the perineum at all?  The road saddle I bought is a ISM PN4.0 saddle. Keep riding that bike!

 

User
Posted 03 Jan 2021 at 20:37

Originally Posted by: Online Community Member

it does look useful. Still has a nose though...does that cause pressure on the perineum at all?  The road saddle I bought is a ISM PN4.0 saddle. Keep riding that bike!

No pressure on the perineum as far as I can tell. I try to sit 'back' on it rather than riding 'on the rivet' (even though my avatar shows me on the rivet), but also have it angled slightly downward at the front.

Your PN4.0 looks ideal too. Is it comfortable?

I think the question I'd be asking the doctors in your case is "is there any antibiotic other than cipro which could shift this?" I don't really see why cycling alone can "cause" an infection, unless there's something there to begin with that's never really cleared up properly and gets aggravated by the repeated action of the cycling. (e.g. like reopening an old wound).

 

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

User
Posted 05 Jan 2021 at 10:01
Ciprofloxacin is the standard antibiotic prescribed for UTIs. I've been prescribed it many times and it really does work. I wouldn't personally let a tiny number of adverse reactions put you off taking a highly-effective medication.

Best wishes,

Chris

User
Posted 05 Jan 2021 at 10:19
Chris thanks. I suppose I’m being cautious because of my age and profession. On the farm, I get in and out of tractors, a lot of handling of sheep, silage etc, twisting and turning, and also my cycling, and I’m well over 66, I’m anxious that the tendinitis might prevent all of that. I suppose the other query is about its effectiveness. I don’t know your full story obviously, but you say you’ve taken it many times, which makes me wonder about how effective it is. I’ve been told that it’s the only cure for prostatitis by a urologist, but it seems to be more than about 20-30% curative in the complete sense. I’m glad to hear that it has provided some respite for you in any event. Thanks for your input.
User
Posted 05 Jan 2021 at 11:07

Sorry, I should have said "many times for different UTIs". Probably half a dozen different occasions in all over my lifetime. Sometimes it's needed two courses, but it's always worked. I've never had prostatitis, but I have had various other issues over the years. The last time (a few years ago) it was an infection of the epidysimis - the "pipe" running from the prostate to the testicles which carries seminal fluid - which resulted in intense pain in one of my testicles. Ciprofloxacin cleared it up in a few days.


Best wishes,
Chris

Edited by member 05 Jan 2021 at 11:08  | Reason: Not specified

User
Posted 27 Apr 2021 at 12:36
An update on this 4 months later which may be useful for followers of threads on prostatitis. I could not get what I felt was the proper forensic investigation and diagnosis of my suspected prostatitis from the NHS. At the recommendation of a urologist on a very supportive and excellent on-line forum, I consulted privately and had the following; CT abdominal scan with contrast, urodynamics, rigid cystoscopy with biopsy, and prostate massage to express secretions for culture. There is no bacterial prostate infection, so the entire assumption that I had to take antibiotics to cure a deep seated infection was erroneous...and I'm glad I didn't take Ciprofloxacin unneccesarily. I actually have numerous minute calcifications in the trigone area of the bladder, and these have been setting up a cycle of inflammation and infection. We now have a number of options to consider for treatment of this. I add this post to the thread principally to reinforce the take-away from my experience. Yes, my prostate was tender, but to then jump to the conclusion it is a bacterial infection is just lazy medical practice. A proper forensic investigation should be started at the outset; it would have saved me a lot of pain, anxiety and cost, and it would have cost the NHS less in the long run, as I wouldn't have had to spend 18 months presenting at the GP and at the Urology service in the hospital.

User
Posted 27 Apr 2021 at 17:00

Good to know you've got a proper diagnosis now.

Have you still been able to get out on your bike during this process?

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

User
Posted 27 Apr 2021 at 17:17
Hi. I’ve not been cycling very much principally due to recurrent UTIs while this has all been going on. Oddly, the bladder biopsy has settled things down and I haven’t had a UTI since the 19th March and symptoms have hugely improved! So I did a really tough, Welsh, hilly 60 mile ride the other day, and have felt no after effects!
User
Posted 27 Apr 2021 at 17:36
So the seat that I’m using might be changed back to a conventional one once I’ve seen if this ‘ settling down ‘ endures! Theoretically the prostate is not implicated so the saddle design should have nothing to do with it!
User
Posted 27 Apr 2021 at 21:52

Originally Posted by: Online Community Member
So the seat that I’m using might be changed back to a conventional one once I’ve seen if this ‘ settling down ‘ endures! Theoretically the prostate is not implicated so the saddle design should have nothing to do with it!

I don't know if perineal pressure from the saddle affects the bladder or not. Probably less likely than the prostate as it's a bit further away. Good luck with your experimenting.

I did an 84 last weekend and climbed Dragon Hill at Uffington with three mates (after cycling 40 miles to get there). Longest ride I've done since surgery last June. 😀

_____

Two cannibals named Ectomy and Prost, all alone on a Desert island.

Prost was the strongest, so Prost ate Ectomy.

User
Posted 28 Apr 2021 at 04:32
Very good to hear about your cycling recovery...sounds like a great ride!
 
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