Laparoscopic Prostate Removal
for Severe, Treatment-Resistant
Chronic Prostatitis

                                                                            

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Don Fairbanks: A complicated medical situation.

Dilative cardiomyopathy and chronic prostatitisDon Fairbanks
North Carolina

I had chronic prostatitis for approximately 14 years. I got it when I was forty years old. It started off mild and I was given a round of antibiotics. They worked well initially and the symptoms disappeared after 4 weeks.

Within days of going off the antibiotics, my symptoms returned and grew steadily worse. I returned to my doctor and he started me on the same round of antibiotics. This time, however, the antibiotics seemed to do very little in regard to helping the symptoms and as the weeks passed the prostatitis symptoms got worse.

By the time I went back to my doctor after the second round of antibiotics I was in pretty rough shape. Cold sweats at night, perineum pain during the day. I felt like I had fever in my body from the waist down to just above my knees: Chronic prostatitis with symptoms of fatigue, perineum pain, feverish sleep, and constant malaise for approximately the next 4 years.

During those 4 years, I sought medical help and advice. I stopped all alcohol consumption; I went on strict diets and exercise programs. I took supplements designed for prostate health.  I learned everything I could about my disease. I spent a lot of time online researching my disease and joined a few support groups. 

I got prostate massages, where the doctor presses firmly on the prostate to stimulate the prostate and express possible bacteria from the prostate. I went to a couple urologists who seemed to be almost unaware of my condition. Each of the urologists offered treatments and procedures that are used for prostate enlargement. These included TURP and TUNA, however both of these procedures are designed to deal with benign prostate hyperplasia and after doing more research on these procedures I found that there was no real positive result in regard to prostatitis. In fact, most of the stories I read on support groups indicated to me that symptoms worsened after such procedures. I contacted at least 4 urologists that would consider the TURP or TUNA procedures. None would consider a prostatectomy.

I had suffered with the symptoms I mention prior, as I said for around 4 years. Then the symptoms started to lighten up and to my great relief on a scale of 1-10 where I had been easily at an 8-9 most of the time my symptoms dropped to around 2-3. After 4 years of the symptoms I had been dealing with a 2-3 was a welcome relief.  However the symptoms stayed with me for the next ten years. I never really felt well, my urine stream was very weak, and I got up to go to the bathroom several times a night. I was always aware of pain in my prostate, sometimes better, sometimes worse. I would get flare-ups perhaps every other or third month and never really could find out what would cause them.  I had come to the conclusion that it was my lot to just deal with this disease called chronic prostatitis for the rest of my life.

In the early spring of last year I started noticing symptoms like a urinary tract infection again and immediately went to my doctor and he started me on a round of antibiotics. The antibiotics did not work, the symptoms got worse, and I knew I was having a full-blown recurrence of my prostatitis. Within a week or so I was have the old symptoms of night sweats, feverish feelings in my body and terrible perineum pain.

I got acupuncture treatments for my problem with mixed results. I would seem to get a little better and then would get hit with very bad flare up that would just fracture me. My prostatitis was back just as bad as it was 14 years earlier. I was devastated.

As I started to research online once again, I hoped that for this severe recurrence there had been a breakthrough. That is when I discovered minimally invasive laparoscopic prostatectomy for my problem. The first time I called Dr. Krongrad’s office, I spoke to Hope and she had me fill out a Chronic Prostatitis Symptom Index (CPSI), and it turned out my score was 36, which is very high.

I got a phone call from Dr. Krongrad later that afternoon and he discussed my particular case and said that he believed he could help me. I simply could not believe my luck had changed. I started making arrangements to get the surgery.

Part of getting ready for the laparoscopic prostatectomy is a required pre-operative consultation, which includes a physical examination with my primary doctor. When I got the results back it appeared that I had a slightly enlarged heart, so my doctor sent me to I see a cardiologist as soon as possible. I had an echocardiogram which showed a depressed ejection fraction, which meant that my heart was pumping only a fraction of what it should have been pumping; my diagnosis is what they called a dilative cardiomyopathy, which negated a release to have my prostatectomy.  I was devastated and was about as depressed as a person could get at that point.

I called Dr. Krongrad to let him know about the new cardiac diagnosis. I was praying that the possibility existed that somehow this operation could still be performed. As I told Dr. Krongrad about my diagnosis, I'm sure he could sense my despair and trepidation. I had dealt with my prostatitis for 14 years and now that I had a glimmer of hope to be rid of this dreadful condition it seemed as if it were to be snatched away from me at the very last moment.

After I told Dr. Krongrad, he simply said "the short answer is yes, we can still do the operation." He went on to explain I needed to do whatever the cardiologist recommended and he would speak to the cardiologist and they would work it out. Once again I could only marvel at finding surgeon who was not only willing to make an effort to relieve my prostatitis but willing to coordinate with my cardiologist to define a reasonable path through my newly diagnosed (but asymptomatic) heart ailment. I was also glad the operation could be done laparoscopically, which means that contrasted with open prostatectomy, there would be much less blood loss and pain: That it would be a safer way to go. I was also glad my surgeon had lots of experience. 

I took my medications and followed the cardiologist’s recommendations. Dr. Krongrad got in touch with my cardiologist and discussed the procedure. Within a couple months, my cardiologist signed off on the prostatectomy. I scheduled the procedure with Hope for October of 2010.  My sister and I drove down to Miami on a Sunday, I saw Dr. Krongrad on Monday morning for a pre-surgery meeting and to get my instructions for pre-operative bowel prep. 

I checked into Jackson North Medical Center very early the next morning; this is a branch of Jackson Health System, which was recently ranked by US News & World Report as the best in South Florida. The wheeled me into a preparation room where I met the team of techs, doctors and nurses that would be performing the operation. I was pleased to discover that my anesthesiologist had been a cardiologist in his former professional life and that he had been fully informed of my complex cardiology situation before I ever arrived at the hospital.

The next thing I knew I was waking up from the prostatectomy. Now at this point I would like to say that it was a breeze, but that in fact was not the case.  It was a wholly unpleasant experience for that afternoon and into the evening. The nurses, however, were very pleasant and understanding. I felt like my bladder would burst, but the nurse would come in and reassure me that my urine was flowing properly into the catheter bag.  Dr. Krongrad came in very early the next morning, did a quick once-over, got me on my feet and into a chair and, before I knew it, my sister and I were on our way out of the hospital and back to the hotel. The next 3 days were a bit unpleasant but not unbearable.

The pathologist found that my prostate had lots of inflammation in it along with micro-abscesses.

I went to Dr. Krongrad's office that Friday morning for my post-op check. He released me to go home. We hit the road and got to north Georgia by 10:00 PM. I drove myself back to North Carolina the next morning. Chronic Prostatitis Symptom Index after laparoscopic prostatectomyI was back to work a week later.

I used adult diapers for 2 weeks, switched to pads for another 8-10 weeks, and have not had to use either since then. I had perineum sitting pain for about the same period of time but that also subsided.  By the end of the third month after the operation I was feeling pretty spry. Each day I felt a little bit better and was grateful for every bit of it. 

I am now 6 months out of surgery and my problem is cured: I haven’t felt this great in years. I can sit at the computer full days with no problem. I can travel with no problem. I am fully continent and can empty my bladder in seconds instead of minutes. My general malaise is gone. The graph shows my CPSI scores: They dropped from 36 before surgery to 0 now.

The last question on the CPSI is "If you were to spend the rest of your life with your symptoms just the way they have been during the last week, how would you feel about that?" At 6 months, my answer was "delighted."

Thank you Dr. Krongrad, Hope and Ruth for giving me my life back.

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