Brief Answer:
Flomax might not help

Detailed Answer:
Hi,
Flomax is an excellent drug to reduce frequency associated with bladder obstruction, I.e. if you have slow flow as well. In your case, at your age it is unlikely to help. If the frequency is really troubling, you can be started on drugs like vesicare which reduces urgency as well
However, many of our patients have this frequency-urgency without any demonstrable pathology such as prostatitis. Even your case, I doubt if there is any infection, but you could be having sequelae of sepsis, such as chronic non-bacterial prostatitis.
In those patients, we do suggest lifestyle changes, bladder retraining which could be categorised as Physio therapy if you like, and relaxation exercises such as yoga or taichi.
Hope I have been of help.

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Brief Answer:
Flares unpredictable, ? stress induced

Detailed Answer:
Hi,
Your condition is one of the commonest which a Urologist faces in clinical practice, and is one of the toughest to treat due to the sheer unpredictable nature of the disease, paucity of findings on investigations and wide variations with results after treatment among patients. Some are very happy while other remain depressed, but a consensus us that stress brings about a flare, and that's where the relaxation cones in. This is not an imagined disease, and physiotherapy helps reduce the firing of pain causing nerves in some lucky patients, while others may have to take muscle relaxing drugs like baclofen, bladder neck relaxing drugs like alpha-blockers, management of chronic constipation if any, nerve-pain killers like pregabalin, long term low dose antibiotic like levofloxacin.
You can stop physiotherapy and you will then realize if it has produced benefit, but you might to take the other drugs in one form or the other for a long duration for relief.
Hope you get relief.

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Brief Answer:
cops is a disease of exclusion

Detailed Answer:
Hi again,
Cp or cpps is a constellation of many symptoms, and is a disease of exclusion, meaning we arrive at that after we have excluded other diseases.
You have had only basic tests done so far, but what could be more relevant would be tests like urodynamics, cystoscopy which are invasive, and I'd rather do them only if you gave persistent severe symptoms or at a time when there is a flare up to achieve some utility.
This also is a disease common among young adults, and I have very rarely seen a man in middle age coming and saying he has had thus trouble since youth. It means that eventually over time, severity decreases and bother is less.
Hope you do not take long to get better.

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Brief Answer:
very difficult

Detailed Answer:
Hi,
There is a lot of overlap of these conditions and it is difficult to tell where the infectious prostatitis ends and where the noninfectious prostatitis begins, but the theory to some simplistic extent is that the body has produced agents to fight infection when there was a minor infection, but now even after the infection has disappeared, the antiinflammatory agents are still fighting, and this produces local symptoms. These get worse when there are triggers such as stress, personal stress being about the worst trigger ever.
There are people, i.e. urologists who claim success in this disorder with use of antiinflammatory drugs, but by themselves, they have significant side effects involving the gut and kidneys and therefore are not really encouraged.
My suggestion has therefore been to let patients gently know about their trouble so they understand the consequences of too much of introspection, and instead realize that positive mindset and destressing themselves has as much to do with cure as any medicine.
I suggest that if you have already had investigations which were normal, do not worry any further. You will be better soon.

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Brief Answer:
possible. but nothing yo worry

Detailed Answer:
Hi again,
The idea of the previous discussion was to emphasise that there is a significant psychosomatic overlay in this disease.
But this also should prove to be reassuring to you. You had investigations done which are normal essentially so there is no major organic disease, so therefore there is nothing to be frightened about.
And as we discussed earlier, the more you worry and get scared, the more frequent would be your flare up. This is the most benign, non progressive disease usually. Be thankful there is nothing serious, and move forward in life with a resolute chin.
All the very best.

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Brief Answer:
problem usually goes way with time

Detailed Answer:
Yes, even with use of antiinflammatory agents, stress can bring about a flare. That , and the fact that they can cause kidney issues is the reason why I do not suggest a long term course of these drugs.
But as I said earlier, we have very few middle aged patients with this problem despite the huge number of young adults who suffer, suggesting that most people adapt very well to this with time or the inflammatory response comes down with time.
Hope you get well soon.

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Brief Answer:
I meant the same

Detailed Answer:
Hi,
I meant the same. The reason why people feel better after some time most likely to be due to a waning of body's inflammatory response.

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Brief Answer:
difficult to predict flare

Detailed Answer:
Hi,
It is difficult to predict when a flare up can occur, and also difficult to say if the disease has gone away completely. If periods of remission ate long lasting with lesser frequency, you may think the disease us on the wane.
If this has been a recent flare after a quiet 3 years, you may need to check if other precipitating factors other than stress are present such as a fresh source of infection, severe constipation, change in diet habits and timings, because several of such patients also harbour disturbances in bowel movements and can be having irritable bowel syndrome as well.

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Brief Answer:
most likrly

Detailed Answer:
Hi again,
The stress that brings a flare up could be an interpersonal one at work or at home, a relocation to a new place or a new job, or death of a loved one. It is usually not physical, from what our patients do explain.
There are no rules, no definite guidelines as to management of this stress, but all Urologists agree that this us frustrating for both the treating doctor and the patient alike.
Think positive, do not let minor issues upset you, and then you will note improvement, I am sure.

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