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Urology/Puzzling Prostatitis? Follow up


Hello again Stephen. My last question to you was on 12/14/2012 "Puzzling Prostatitis"
Since that date I completed the Aplrim without much effect. I changed GPs to get another opinion. The second GP questioned the effectiveness of Alprim here. He prescribed 2 courses of a fluroquinolone - Norfloxib twice a day. He also ordered another more detailed urine test and another PSA test. The urine test was negative - there is no bacterial infection and the PSA, 0.9 -up 0.2 from early November. His conclusion was that there was some kind of irritation of the urethra and that was about all he could do. He said I could see a urologist if I wished if the symptoms continued after finishing the second course of Norfloxib.
when I raised the matter of  eliminating caffeine, alcohol etc, he was of the opinion that was irrelevant. My thinking is that those recommendations are relevant here.
So I have cut out alcohol, caffeine, spicy food and started the sitz baths. And I will commence the second course of Norfloxib today.

In reading your answers, I have seen you write about potassium sensitivity in urine. Just out of curiosity, I worked out my daily intake of potassium and it adds up to between 6500 and 7000 mg per day, every day - and  may a little more on some days. I wonder if this intake level may have some bearing on the symptoms I am experiencing. My diet has been pretty much the same for years so I'm thinking this parallels the bouts of prostatitis that I have had over time. I understand that a potassium sensitivity test can be done but, short of that, would you think 7000mg daily over a long period of time may be a contributing factor.
As a final note, I find the baths helpful while the impact of the elimination of alcohol, caffeine, spicy foods etc I think is longer term? What would you suggest as a next step.
Thanking you in advance


I can't determine if your potassium intake is excessive or not from your description, but if you are doing all the right things and you've eliminated much of the potassium and it is not having any effect then you have an answer.  

My next suggestion is to consult a urologist because your current treatment after 2 GPs is not sufficient.


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Stephen W. Leslie, MD


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


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.

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

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.

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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