AboutStephen 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 20 years experience. Assistant Clinical Professor of Urology at the Medical College of Ohio. Editor in Chief of eMedicine Urology internet textbook. Author of only 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.
Question I'm a 30 year old male who was diagnosed with CP/CPPS last March. I've been through the normal gamut of drugs: 2 rounds of Cipro (30 days each), one round of Levaquin (20 days), and one of the urologists suggested that I begin taking Quercetin for about six weeks. Unforunately, that did no good. My only symptoms are mild pain during ejaculation, and if I ejaculate three or four days in a row it is not present. VERY occasionally I will have burning during urination, but it goes away after a little while. Also, I have a "bloated" feeling in my lower abdomen and pelvic region from time to time.
I am on a steroid dose pack now, and it's pretty much made all the pain go away, but I've been on steroids for other things and I'm pretty sure it will come back once I'm off the steroids.
I've been through three urologists. One was (in my opinion) extreme. He tested my PSA twice, first time it was 2.4, and then about two weeks later (while on Cipro), it was 1.7. He panicked and suggested a biopsy. I went to a second uro, who said that CP/CPPS can't be cured, that I'm too young for cancer and didn't even examine me. I thought that was worthless. The third uro did a DRE, said it was normal and also said that a PSA of 1.7 even though a little high for my age, was normal. He prescribed the steroids, but agreed with the second uro that a biopsy was ridiculous and could actually make me worse symptomatically.
So, I know this was a long story, but what should I do? Which doctor should I listen to, or should I find another one?
Thanks in advance!
Answer I do not agree with the use of steroids. Too many potential problems and complications to be worth the benefit. Otherwise, I pretty much agree with the third urologist. I see no need for a biopsy at your age without more signs or symptoms of a possible problem.
Other treatments for prostatitis include sitting in a very hot tub of water for 5-10 minutes (often helps, no complications and costs very little). The water needs to be quite hot. For severe cases, I recommend twice or three times a day. Next, use of a flow enhancer like Flomax or Uroxatral. Avoid caffeine and alcohol. Don't smoke (it constricts the blood vessels and causes prostatic congestion).
There is an excellent herbal remedy that has a reasonably good track record that I use in difficult cases. It's called "PEENUTS" and you can order it on the Internet at www.peenuts.com. It's not a nut, it's an herbal supplement designed by a urologist friend of mine who specializes in difficult prostatitis cases. He recommends three caps a day until things are under control, then two. A long term antibiotic is also reasonable, such as Vibramycin. Also you might add one Aleve twice a day as an additional anti-inflammatory. My wife (also an MD) is a true believer in natural remedies and would recommend additional anti-oxidants as well but there is very little evidence that it helps. Still, can't hurt. Good luck.
