Did the Stamey test show that you have bacterial prostatitis, and did culturing it indicate the bacteria is sensitive to Ciprofloxacin, or was the Ciprofloxacin just given trial-and-error style?

Thanks for getting back to me, Andy and Pratap,

Andy, regarding the Stamey test, apparently no infection was found (I should say that I'm presently in Spain and interacting with the medical staff here can sometimes be a little difficult. Luckily you can download all of your test results from the Health Service app.). The only thing mentioned was that urogenital flora was detected in the seminal liquid but my GP said that was at normal background levels - apparently, no bacterial culturing was carried out. I realise this might cast doubt as to whether I have chronic prostatitis (CP); nevertheless, the only way I've been able to fight the swelling and reduced urine flow is by taking a course of antibiotics (it's worked twice before), thus suggesting a bacterial component to my problem. Anyway, my next urology appt. isn't until late October so I've been wondering if there is another antibiotic that might be effective against CP, or if I should be doing something else.

Pratap, regarding the radical prostatectomy (RP), I think the next time I see the urologist I will reluctantly ask him to go ahead with surgery  (originally I was offered Active Vigilance, Radiotherapy or an RP, and I chose AV). My main concern re. surgery is if there are post-op urinary infections. I know it takes months to regain all function and that a certain percentage of people are unlucky with longer-term ED or incontinence. My dread would be to have repeated urinary infections requiring multiple courses of antibiotics, and the harm that can do to one's body overall. On the plus side, I'd be able to exercise properly again at some point - since the biopsy, any strenuous activity has led to swelling, discomfort, and affected urine flow.

The only other thing to mention is that I'm back to live permanently again in the UK when I'm 60 (in just over a year). I had hoped I could stay relatively stable on AV until then so that I could face any surgery back at home in Oxford, where I'm told the urology dept. staff are really good. However, after this current course of antibiotics, I fear I will be dealing with debilitating CP again relatively soon and be forced to ask them to intervene surgically.

Thanks again for your input, any advice you have is very much appreciated.

All the best to you,

Simon R

I suffered from prostatitis off and on for some years as I side above before I was diagnosed with prostate cancer. I had my prostatic fluid tested a couple of times with negative results. My urologist told me that sometimes the infection is very deep (!) and difficult to cure!  After a few appointments with him I gave up because he simply wasn't interested anymore. As I said earlier I had a hypothesis that if the prostate is removed prostatitis disappears with it and hopefully the cancer too. I am not claiming that my experience verifies my hypothesis, as always in this sort of situation more research is needed for evidence. There is an interesting book by Tim Parks who suffered from pelvic pain for years. It is quite interesting to read although somewhat depressing: 'Teach Us to Sit Still:A Sceptic's Search for Health and Healing'

Since the biopsy (about 5-6 weeks ago) I have had pain in the penis, testicles, bum and general burning sensation inside the middle section, I guess prostate area. Its not excruciating, but there all the time. I cant ejaculate hardly anything, barely a quarter of a teaspoon, although the crimson blood colour has now subsided. A basic urine check at the GP was clear, which seems to be common from what others have said. Only more in-depth testing could identify if this is possibly prostatitis.

Makes me think because around my late 40s, I noticed significant volume decrease in semen, almost dropping off a cliff. I had 2 long spells of quite bad testicle pain. Both were examined for the usual lumps etc, and had ultrasounds. The diagnosis at the time was possible harmless cysts.

I do wonder if that was prostatitis back then or the start of cancer. Have others experienced such a major drop in volume in that way? At the time I just put it down to aging process, but I had much larger volumes prior to those periods.

A significant drop in semen volume or change in consistency can be prostatitis or prostate cancer. It can probably be other things too.

Thanks Andy, that's really interesting. As I said to Pratap, this last year (since the biopsy) has been such a nuisance that I've been thinking of asking my urologist over here for a radical prostatectomy when I see him at the end of October. I used to be really fit for my age, doing strenuous exercise and running. Now if I attempt to do so, my whole pelvic area swells within hours and it's almost impossible to pee, as though the movement causes friction in the area which leads to inflammation.

I'd be very interested to join your zoom call on the next occasion you have a FOPs meeting and would be grateful for a link to it when available.

It sounds like your prostate problems are under control and I'm happy you managed to avoid an RP. Wishing you continued good health and thanks as always for you excellent advice.

All the best,

Simon R