Urology/Prostate

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Question
QUESTION: Hi Doctor
is the following medicine help in reduction of symptoms of chronic pelvic pain syndrome.
alpha-blocker
sawpal or brostar (sawpalmetto)
in addition to antibiotics

ANSWER: Mahmoud:

Alpha blockers may help.  No good scientific evidence that saw palmetto actually helps.  Amitriptyline may also help.

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QUESTION: thanks doctor. can you summarized what usualy the symptoms of CPPS.
i feel usualy with pelvic pain espically when the urine volume increase in the bladder. and some pain after sex. recantly i made medical tests for the UTI and all of them is okey

ANSWER: Mahmoud:

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterised by pelvic or perineal pain without evidence of urinary tract infection that typically lasts longer than 3 months. Symptoms may wax and wane. Pain can range from mild discomfort to debilitating and  may be intermittent. Pain may radiate to the back and rectum, making sitting difficult or it may go to the testicles or penis.  Dysuria, arthralgia, myalgia, unexplained fatigue, abdominal pain, constant or intermittent burning pain in the penis, and urinary frequency may be present. Frequent urination and increased urgency may suggest interstitial cystitis (a chronic inflammatory condition of the bladder) or prostatitis. Post-ejaculatory pain, mediated by nerves and muscles, is another symptom of CPPS in some men.  Some patients report low libido, sexual dysfunction and erectile difficulties.



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QUESTION: thank alot dr
what is the suitable medicine and practice for this symptoms

Answer
Mahmoud:

Typical treatments include antibiotics, ibuprofen, alpha blockers like tamsulosin, hot sitz baths 2-3 times daily, use of a donut for sitting, various pain medications, elmiron which helps to protect the lower urinary tract lining, amitriptyline which often helps in pelvic discomforts and various dietary measures such as caffeine avoidance.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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