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Q. Should I get a PCR test for diagnosing the cause of chronic pelvic pain?

Hi doctor,

We spoke yesterday regarding my chronic pelvic pain condition.

I would be doing both urine and semen culture soon. Is there any specific culture or PCR testing to be done? The reason I am asking this is that the traditional dipstick and culture test does not seem to be accurate based on current research.

I have read up on a urologist who has done extensive research on conditions like mine. He mentions that chronic prostatitis and interstitial cystitis are basically chronic UTIs. He has used a method of antimicrobial treatment that has helped many of his patients. His way of testing urine samples are also different.

Please let me know if my condition is possible to be an untreated chronic UTI. Also, what are the specific bacteria and pathogens that I need to be sending my culture for?

I have attached a picture of a more advanced testing method, do let me know if I should get that done. Kindly give your opinion.

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Hi,

Welcome back to icliniq.com.

The method varies, and the PCR (polymerase chain reaction) is accurate when there are atypical bacteria like TB (tuberculosis), for example. Your urine microscopic analysis showed no bacteria. The thing I am trying to get is the sample that contains the organism, like semen. I do advise for PCR if culture is negative and pus cells and leukocytes are there suspecting atypical infection. And that can be the second step. We get urine analysis and culture semen culture, and we go according to the report if there are pus cells and organisms despite negative culture, then we do a urine PCR test. Why do this is because PCR does not provide the sensitivity for that bacteria to the antibiotic. Therefore we will go step-by-step.

Chronic pelvic pain syndrome

I suggest you the following medications:

1) Celecoxib 200 mg once daily.

2) Tablet Tamsulosine 0.4 mg once at night.

3) Toltaridine (Tolterodine Tartrate) 4 mg once daily.

4) Neurobion (Vitamin B1, Vitamin B6, and Vitamin B12) one tablet once daily.

If you have any more queries, please let me know.


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