Laparoscopic Prostate Removal
for Severe, Treatment-Resistant
Chronic Prostatitis

                                                                            

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Rich: Chronic prostatitis, irritable bowel syndrome, anxiety.

A Texas rancher doing great after surgical treatment for chronic prostatitis.Rich Ellenberger
Texas


I am a 43-year-old male. My 11-year journey started in December 1997 with a severe acute bacterial prostatitis.  After going to a urologist close to my home in Houston, I was put on the antibiotics to treat infection and on alpha-blockers.  But the side effects hurt my stomach and caused me to be very anxious

Thinking I needed to see another urologist, I went to Baylor College of Medicine urology department in downtown Houston.  The urologist there put me on Augmentin for 1 month after having cultured S aureus.  After that he said no bacteria could have possibly survived 30 days of Augmentin and he declared me cured despite the continuation of and my complaint of symptoms:  Pain in the left epididymis/left testicle, pain when sitting, pelvic pain, perineal pain, difficulty starting urinating, interrupted urine flow, and pain after masturbation or sex.

Desperate, I got on the web and searched for help.  That both helped and hurt.  It helped because I got more information about prostatitis, but hurt because I saw other men were in such dire straits as I was and it was increasingly becoming obvious I had something that traditional urology did not know how to deal with.  I remember a particular urologist in Houston who told me I needed to go on an anti-depressant, thinking my anxiety was causing the prostatitis.  No, I have prostatitis, therefore I am anxious.
 
I next got wind of the Prostatitis Center in Tucson Arizona.  He used the Manila Protocol of every other day prostate drainage and massage and heavy antibiotics. I went to Tucson and was under their care for 3 months. They helped me get my prostatitis in check, but the antibiotics screwed up my vestibular system in 1999 by trying IV antibiotics, with the idea that IV antibiotics penetrate the prostate better. Problem is they also cross the blood/brain barrier and damaged the vestibular hairs in my inner ears. To this day I can’t balance well when walking in the dark.

This prostatitis disease is an awful disease, and the men who have severe cases will do almost anything to get rid of it.

In 2000 I saw a urologist in Houston. Finally, someone who understood the severity of my problem.  He also understood the need to aggressively treat prostatitis with antibiotics to beat back the chronic infection to manageable levels.  My partner was taught how to do prostate drainage, so for years this worked to keep it manageable.  That’s another thing.  Having a loving, understanding spouse really helps. I could not think what a mess I would have been had I been alone, and my heart goes out to guys who have to deal with this alone. 

Anyhow, the new urologist did surgery to remove my left and right epididymides, which ended up curing my left testicular pain. That bought me some years of relief by getting rid of the worst of the pain symptoms. But I still would get this nagging, congested feeling and pinching pain on the right side of my prostate.  Since my semen would almost always culture up some bacteria, but my prostate fluid would not always grow something, I remain convinced that my right seminal vesicle was screwed up and the source of the problem.

In summer 2008 I was having a particularly bad flare-up. I urged the urologist to remove my seminal vesicles, but he said they are nearly impossible to get to, and he cautioned me about removing my prostate, saying I could trade one disease for another.  Incontinence.  But that would be temporary, right? Well, yes. Erectile problems. Also temporary?  Maybe, maybe not.  Since I never had an erection problem even with my prostatitis, I felt I would be in the majority of men who don’t have long term erectile dysfunction.  But you will not ejaculate so orgasms will be different.  But likely I will still have orgasms, they’ll just be dry, right?  Most likely. Well I said, what are we waiting for?  The benefits outweighed the risks in my mind. Alas, he was moving to Austin and didn’t feel comfortable taking out my prostate.

Anyhow, I got on the web again and typed in “Cure Prostatitis” and it immediately found a man who was cured of his prostatitis with minimally invasive surgery with Dr. Krongrad. It turns out that so were other men. It was worth a try.

Krongrad agreed to the surgery and I went to Aventura, Florida and had the surgery on December 28, 2008. The day after surgery I had gas pain, probably from the anesthesia. I also have irritable bowel syndrome, so that probably made that worse. After another day I was okay.

Oh, guess what?  The pathology report found early stage prostate cancer, apparently something Dr. Krongrad is seeing with more than half of his prostatitis patients. Good to get that out of my body and not have to worry about prostate cancer later!

I knew the catheter would not be fun.  I was right. But it doesn’t hurt, and the days go by quickly. I flew back to Houston 8 days after surgery.

I had the catheter out 11 days after surgery. Then the incontinence started.  Having your urethra cut, prostate removed, and urethra re-attached is a traumatic event, and having it kept open albeit necessary, makes it difficult to shut off urine once the catheter is out. The good thing is you can really feel when the urine gets past where the prostate used to be, so that feels abnormal and triggers you to get up and run to the bathroom.  But with each passing day I got a little more control, could hold it a little longer. I wore a relatively thick large pad for a month, then was able to go to a small thin pad for another month.  Some time before the 3-month point I no longer needed any pads.

Here I am at 6 months after surgery and I declare it a success.  Here are the long-lasting improvements it caused:

  • I can pee at a urinal next to another guy.  I used to have to lock myself in a stall and even then it took a long time to start.
  • I can pee freely with no hesitancy, and my stream is wide and strong.  I don’t know what to do with all the extra time since it takes 1/5th of the time it used to pee.
  • No more pain in the perineum.  I still had some a couple months after surgery, but no more.  It settled down.
  • No congested feeling in the area the prostate was.
  • No more antibiotics killing my stomach and intestinal flora.
  • No need for prostate massage.
  • No more urologist visits!

Here are the negatives, which at 6 months are still improving:

  • Erectile function is pretty slow to come back. I think the trauma to the urethra sends a signal to the brain that all is not well. It just takes time. With Viagra, Cialis, or Levitra, erections were near normal after 3 months. They cause sinus congestion and headaches though.  Erections are near normal now after 6 months without any drugs, and I think they will eventually get back to normal.
  • I do miss ejaculating semen. But my orgasms are pretty good and getting better as my erections improve. The nice thing is I still have the pre-ejaculatory fluid that comes from the Cowper’s gland. So sometimes I have a little drop of that. I used to hate pre-cum, as it is called. Now I am thankful I have it.

In terms of remaining symptoms, I still have some minor pelvic pain occasionally after orgasm, but nothing like before.

You must weigh the pros and cons before you act.  How bad a case of prostatitis do you have? I was ready for it to be over. My horrible saga of prostatitis is over, and I have the rest of my life to look forward to without the fear it caused. I can enjoy the tiny herd of 5 buffalos I am raising with my partner as a side hobby.  And I can dream of the day I will own a big ranch with a couple hundred buffalo, without the fear of “Oh my God, what will I do on a ranch in the middle of no-where and my prostatitis flares-up?”

I am grateful to Dr. Krongrad for developing minimally invasive prostatitis surgery and helping men with severe, long term cases of prostatitis. He is a pioneer and he gave me back my life.


------------- Addendum at 2 Years After Surgery -------------


It has been 2 years since I had Dr. Krongrad remove my prostate through minimally invasive laparoscopic surgery. It was the second best decision I've made in my life, second only to working for NASA. I am doing great! 

CPSI scores after Prostatitis SurgeryThe graph shows my CPSI scores before and after surgery. My score was 30 before surgery and down to 12 by 6 months, which is when I wrote the report above. Now, at 2 years post surgery, my CPSI score is down to 4 !

Here is how I feel:

- Urination:  No problems whatsoever! No issues with incontinence, but since the prostate is not there, I can feel if a drop or two of urine is wanting to flow past where the prostate was - that can be caused by a big sneeze, or walking downhill on rocky terrain (such as at my ranch) - but it never gets past the penis ... just a new sensation that wasn't there before.

- Erections:  I still benefit from Cialis, but ever so slowly over time I feel the strength of erections coming back.

- Orgasm:  Orgasms are at least 90% as good as before. The only minus is I don't have that little sensation of semen passing.  I still miss ejaculating, but with my orgasms as good as they are, I still get lots of pleasure from sex.  The benefit of a pain free prostate area was well worth this minor cost.

- Testicular pain:  I still have very minor right testicular pain, which was probably totally unrelated to my prostate.

I am very happy with the results and would do it all over again. It's a big step, and a little scary, because it is like using a nuclear weapon on prostatitis. But it totally annihilated my prostate pain, so it was very effective. 

For men who have had years of prostatitis and have tried everything, laparoscopic prostatectomy is a viable option with the potential for enormous benefit:. It worked for me!

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