Dr. Choudhary Devendra
Urology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am 35 years old male, with a long history of prostatitis, 3 to 4 years, no symptoms. Now a myriad of symptoms including all the following that come and go. Urgency, sensitive penis, rectal or prostate pressure, no pain but happens after ejaculation sometimes and from a bowel movement. Last urgent care said inflamed prostate on DRE and should take Flomax and antibiotics. Another doctor said maybe IC. The second opinion said he would treat for prostate within one month with Ciprofloxacin. Not sure what to do. Please help.
Hi,
Welcome to icliniq.com.
From history and test report (attachment removed to protect patient identity), it appears as CPPS (chronic pelvic pain syndrome) and not to localize prostate as the source of the problem. You can take capsule Roliflo OD 2 mg (Tamsulosin with Tolterodine 2 mg), Psyllium husk 3 tablespoon at night with one glass water over it, and do perineal exercises. I would like to add anticholinergic to your alpha-blocker (Flomax). You can also do Bahy Pranayam, Moolbandh regularly two times a day which will relax the painful focus in the perineum.
Treatment plan
Preventive measures
Patient's Query
Thank you doctor,
What is the differential diagnosis? Should I get a cystoscopy? How long should symptoms last?
Hi,
Welcome back to icliniq.com.
Differential diagnosis includes CPPS or prostatitis. Cystoscopy will not help. Instead first get a uroflowmetry done, if normal curve, no need of cystoscopy. Urine has no pus cells, post prostatic massage prostatic secretion will rule out inflammatory or infective prostatitis. For CPPS, need to take treatment and perineal relaxation exercises. Duration: Initially take 10 days treatment, then follow-up.
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