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Tomsullivan
06-27-2012, 08:31 AM
Hello everyone,

I'm extremely confused and frustrated by what I've been told about what may be going on with me, and I'm hoping that perhaps someone can clear things up for me.

Background: I'm a 28 y/o male and have had the following symptoms for at least 5 years: frequency/urgency/hesitation, random shooting pains on both sides of pelvic region, testicles, or rectum,occasional mild burning sensation when urinating. I have noticed that the pains will sometimes occur more when I feel an urge to urinate, but not exclusively.

After seeing a urologist, I've learned that my bladder capacity is normal, as demonstrated by morning voids. Urinalyses show no evidence of infection, and digital exam found no enlargement of prostate. A cystoscopy found a polyp at the bladder neck near the prostate. I was told that this may or may not be causing symptoms, and that it could be removed by cystoscopy w/ fulgration. I had that procedure done, and the biopsy came back showing cystitis cystica. At the follow-up the doctor diagnosed me with chronic prostatitis, prescribed me Cipro, and instructed me to monitor my diet. After doing some research, I'm left with several questions:

1) I've learned that cystitis cystica is caused by inflammation of the bladder, as a result of infection or medical procedures, and that it can produce the symptoms that I experience. I can't find any relationship between it and non-bacterial prostatitis. Since the biopsy was taken from the bladder only, why would the doctor presume a prostate condition?

2) When the doctor said that "cystitis" was found, I asked if it was interstitial cystitis. She said that it was not
because IC is a diagnosis of exlusion and, in my case, an actual inflammation was found. I'm confused because from what I've read about IC, it can exist with or without inflammation of the bladder?

3) On the same point, I've learned that non-bacterial prostatitis (CPPS) falls into two categories, one with inflammation and one without, and that some doctors believe that the latter form may be the same condition as IC. Since there was no testing of my prostate, other than the digital exam, I would assume it's not known whether or not my prostate is inflamed. In that case, how could my doctor rule out IC?

4) The recent studies that I've read have indicated that treating non-bacterial prostatitis with antibiotics may not be worth the risk of side-effects and resistance. I was given 7 days of Cipro and told to call back if my symptoms
persisted. I'm assuming that they will and, if so, do you all think I should continue antibiotic treatment just in case?

Thank you so much in advance for your responses. I really just want to get to the bottom of what's going on with me and what I should do about it.

icnmgrjill
06-28-2012, 05:33 PM
Well, you fell into the prostate donut hole, for the lack of a better term. Men who experience lower urinary tract symptoms are almost always first given a diagnosis of prostatitis and you're actually quite lucky that they did look into the bladder. Some men are sent away with chronic prostatitis and antibiotic treatments that they use for years before discovering that it was actually IC instead. It's a dilemma that men with IC often struggle with. You are definitely not alone!

It's ironic though that they did not do a prostate biopsy yet classified you with prostatitis. Similarly, it doesn't sound like they found infection either in your urine? Normally, doctors will express some fluid from the prostate during the exam that they then culture looking for bacteria. Was that ever done? That said, a weeks experiment with cipro is fairly common though, as you pointed out, comes with risk... including tendon rupture. For myself, I always wait for a positive urine culture before I take any strong antibiotics because so often IC flares feel the same.

So, I agree with each one of the points you've made. Their explanation seems inconsistent.. and I think it's worth another discussion with your doc.

As to what you can do?? I would at least try modifying your diet immediately to see if the reduction of acidic foods and caffeine makes a difference. Betcha it might. You can find our diet list at: http://www.ic-network.com/diet/

Welcome to the ICN! - Jill

p.s. Did you find our men's board yet?