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Forum Name: Urology Topics

Question: bacterial prostatitis and BPH surgery?


 bigredog8 - Tue Oct 13, 2009 8:38 pm

I have been diagnosed as having bacterial prostatitis by a first urologist, and have been taking levaqiun, 500 mg per day, for more than a month, and continuing. Note that I have never had a UTI diagnosed and urinanalysis has never found problems. Apparently the infection is only in the prostate itself. The first urologist diagnosed bacterial prostatitis with prostatic fluid having a high white blood cell count, from rectal exam, etc., with no bacteria isolated. After the levaquin the symptoms are somewhat better but still very bothersome. This is the second levaquin round. A second opinion by another, well regarded, urologist noticed high post void amount of urine being retained, which was tested for twice, and recommended green light laser surgery with a cytoscopy included as part of the surgery to check for problems I guess. The first urologist said no surgery now because I might still be infected, and surgery when infected could have side effects like sepsis from the infection, even though today the first urologist examined me thought the infection was generally not detectable, except from the symptoms I complain about. The second urologist said I don't need the levaquin, stop taking it. I am confused! Could I have prostatitis and BPH at the same time? Is the green light surgery safe at this point, with another two weeks of levaquin before the surgery? I have asked the two urologists to consult with each other. I am leaning towards the surgery.
 Dr.M.Aroon kamath - Thu Oct 22, 2009 8:47 pm

User avatar Hi,
It is possible for a person to have enlargement of the prostate gland and an associated prostatitis.I assume that a prostatic massage was done and the fluid showed high white blood cell count.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)- i assume what your first urologist was thinking about - a type of non-bacterial prostatitis.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS).This has been sub-classified as inflammatory and non-inflammatory. The inflammatory form is further sub-classified based on the numbers and morphology of the white blood cells and so on.................!
This does not generally need antibiotic therapy.
That is why, the second urologist perhaps has decided(as you probably have BPH and bladder outlet obstruction) to go ahed with the TURP.
Cheers!
 bigredog8 - Fri Oct 23, 2009 4:13 pm

The first urologist thinks I have a bacterial infection in my prostate, because of the white blood cell count you mention after a prostate massage. No problems show on urinalysis. This first urologist saw "nothing much" on PVR according to him. He has been treating me with antibiotics for some time now. When asked he said something about chronic bacterial prostatitis. However, though his treatment has helped, it is not cured in terms of urination frequency or pain. The second urologist never did a prostate massage, just a post void test and a urinalysis, then scheduled surgery with no other tests. He saw a high PVR twice on different occasions. Before the surgery, the second urologist talked to the first one and they decided not to do the surgery. So I am confused, still taking antibiotics, and not sure how to proceed.
 Dr.M.Aroon kamath - Sun Oct 25, 2009 7:59 pm

User avatar Hi,
I really can't comment on why your surgery was cancelled. The only thing i can see that your urologists were very concerned about you (in that, they discussed your case) and probably took the best decision under the circumstances.
I think you should trust them more and heed to their advice.
Good luck!

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