Path: ratbert.tds.net!HSNX.atgi.net!news-was.dfn.de!news-spur1.maxwell.syr.edu!news.maxwell.syr.edu!newsfeed.wirehub.nl!feeder.via.net!24.0.94.134.MISMATCH!newshub1.home.com!news.home.com!news1.alsv1.occa.home.com.POSTED!not-for-mail
From: Daniel Shoskes MD <dshoskes@ucla.edu>
Newsgroups: sci.med.prostate.prostatitis
Subject: Patient History Post
Message-ID: <130320000911029365%dshoskes@ucla.edu>
MIME-Version: 1.0
Content-Type: text/plain; charset=ISO-8859-1
Content-transfer-encoding: 8bit
User-Agent: YA-NewsWatcher/4.2.6
Lines: 42
Date: Mon, 13 Mar 2000 17:11:07 GMT
NNTP-Posting-Host: 24.11.202.68
X-Complaints-To: abuse@home.net
X-Trace: news1.alsv1.occa.home.com 952967467 24.11.202.68 (Mon, 13 Mar 2000 09:11:07 PST)
NNTP-Posting-Date: Mon, 13 Mar 2000 09:11:07 PST
Organization: @Home Network
Xref: ratbert.tds.net sci.med.prostate.prostatitis:40513

Here is a recent message from the Institute for Male Urology mailing
list (accessible from http://www.urol.com)


Tale of 3 patients:

Here is a synopsis of 3 patients seen this past week in our clinics.

1) 48 year old man with a 20 year history of prostatitis. Antibiotics 
never fully effective before. Never had a culture of prostatic fluid 
(EPS) despite seeing 6 Urologists before. EPS showed 50 WBC per high 
power field. Culture for 7 days showed enterococcus in the EPS but not 
urine or urethra. Treated with Avelox (gatifloxacin) 400 mg daily plus 
prostatic massage weekly for 3 weeks. First 2 weeks had >50 WBC/hpf 
which dropped to no WBC by third week. All symptoms resolved.

2) 63 year old man with 8 year history of prostatitis. EPS showed 10 
WBC/hpf and culture showed low counts of Staph epidermidis. Patient 
had pain and voided 3-5 times per night. Antibiotics and prostatic 
massaged cleared bacteria but did not improve symptoms. Started on 
Prosta-Q twice a day. One month later had moderate improvement. 
Increased Prosta-Q to three times per day. One month later all 
symptoms resolved except now gets up twice at night to urinate.

3) 36 year old man with 16 year history of prostatitis. Has seen over 
20 Urologists around the world. Previously failed antibiotics 
including direct injections and prostate microwave therapy. Cultures 
negative, no help with massage. Tried Prosta-Q for 2 months with no 
improvement. Treated with stress relaxation techniques under 
supervision of psychiatrist, Elavil and Neurontin. Pain significantly 
improved.

These 3 patients demonstrate our long held view that chronic 
prostatitis is a multifaceted disorder which may be caused by 
infection, inflammation or neuromuscular tension/spasm. It is NOT a 
purely infectious, autoimmune or pelvic muscle condition and we 
believe that dogmatic approaches to therapy that focus on only one 
etiology will fail most patients.

Daniel Shoskes MD
Institute for Male Urology
http://www.urol.com