Dr. Karthik Rajan
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 was diagnosed with prostate gland infection. I have had the urge to urinate a lot. No burning and no discharge at all. Just the desire to pee. I took two STD panels and three urine tests. They all came back negative. Yet, my doctor said she saw a few white cells when she checked my urine, which meant my body was fighting some bacteria. She also stated that sometimes tests could come back negative when the bacteria is small. I did have unprotected sex with a guy. My doctor also told me I got bacteria from sexual intercourse. She prescribed me an antibiotic, Septra, for 30 days. Yet, I have 18 more days to go, and I still feel symptoms. Some days I feel better, and sometimes I feel the symptoms again. Will the symptoms ever go away? How many days will it take for recovery?
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern.
From your complaints, it appears that you have an infection in your prostate gland. It is normal in such cases to have a negative urine culture with only a few white blood cells. These infections are, unfortunately, persistent and require prolonged antibiotic therapy, sometimes up to three months. The symptoms gradually reduce after two to three weeks of treatment. You can ask your treating urologist to prescribe you some urinary antispasmodic to help with the urgency.
I hope this helps; feel free to revert with any other questions.
Thank you.
Patient's Query
Hello doctor,
Thank you for your response.
Is Septra the best antibiotic for this type of bacterial infection? I was prescribed Ciprofloxacin for seven days when my doctor thought it was a UTI, but it did not work. As I still have symptoms and white cells in my urine, I wonder if Septra removes them and the symptoms. Today is officially two weeks of taking it, and the symptoms are still here. So I am worried. Is this normal for the antibiotic to take this long?
Thank you.
Hello,
Welcome back to icliniq.com.
The antibiotic choice depends on the common pathogens that are prevalent locally. Ciprofloxacin and Septra (Sulfamethoxazole and Trimethoprim) can be used. I prefer Ciprofloxacin, but you can discuss it with your treating doctor as she will better understand the common microorganisms there.
Thank you.
Patient's Query
Hello doctor,
I have been dealing with a bacterial prostate gland infection for almost two months. I was taking Septra in the beginning and then switched to Ciprofloxacin. I have completed my prescription, but I still feel symptoms again. The symptoms are not as bad now, but I still feel the urge to urinate. Never any blood or burning sensation. I feel it below the belly button and above the pelvic area. I took another STD panel to make sure, and everything came back negative. I need further advice. Could this be something else? The urgent care doctor saw white blood cells in my urine, but the test found no chronic bacteria. I have tested for HIV and herpes multiple times, and all tests were negative. My most recent test was done again, and all were negative. No sexual activity for a few months. Could this be something else? As it feels like my bladder, not my prostate? Do I need to take another dose of Septra? Is it normal for this infection to last so long?
Thank you.
Hello,
Welcome back to icliniq.com.
Chronic prostatic infections are complicated to eradicate. Prolonged antibiotic therapy for three months is sometimes required to achieve a cure; even though this long treatment may clear the bacteria, the prostate gland's inflammation may continue even then. Once the cultures become hostile, and the treatment course is finished, the management, if you are still symptomatic, will be targeted to relieve the most troublesome symptoms. At this stage, there will not be any infection, but the previous infection triggered a persistent inflammation within the prostate gland.
Thank you.
Patient's Query
Hello doctor,
Is there any way to stop the persistent inflammation within the prostate gland? It sounds like you are saying the bacteria is gone, but the gland is still inflamed. But why would it still be inflamed? Would it be because of the nerves? What is still causing the inflammation or urge symptoms? Is there something else to treat this? Will it go away on its own?
Thank you.
Hello,
Welcome back to icliniq.com.
The exact reason why the infection persists is not known. What we do know is that there is usually a trigger of prostate infection. The treatment will now be directed at the most troublesome symptoms. Drugs that modulate pain impulses can be prescribed if it is a pain. Antispasmodic drugs will help if an urgent urgency is most troublesome. You will have to discuss your symptoms and expectations with your treating physician, who can tailor a treatment plan accordingly.
Thank you.
Patient's Query
Hello doctor,
I have another doctor's appointment next week. I am just hoping there is a cure for these symptoms. It sounds like you are saying there is no cure. There is no pain. I keep feeling like I need to urinate.
Thank you.
Hello,
Welcome back to icliniq.com.
The inflammation does slowly settle down, but this is not easy to predict. The symptoms may subside with time once the triggering infection has been resolved. If urgency is the chief complaint, urinary antispasmodic drugs with bladder training and fluid intake modifications can effectively control your symptoms.
Thank you.
Patient's Query
Hello doctor,
It is weird because, during the end course of taking Septra, I did not feel any systems for three weeks. Yet, when I stopped taking it after a few weeks, I noticed the symptoms again. So maybe the infection did not entirely leave. What is your opinion?
Thank you.
Hello,
Welcome back to icliniq.com.
Your physician will assess that it is not possible to ascertain this based only on the symptoms. A urine analysis, especially post-prostate massage, may be needed to confirm this.
Thank you.
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Urology
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