Can they tell the difference between bp... - Men's Health Forum

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Can they tell the difference between bph/ chronic prostatitis / CPPS with a cystoscopy?

Uneasy10 profile image
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Background - for the past couple of years I was having problems with passing water, ed/ejaculation problems, pelvic and urethral pain, nerve pain reflected down into the legs and feet when sitting (seems to be brought on by sitting), loss of genital sensation.

After a longwinded and tortuously slow process with the GP and urology departments, they decided to do a cystoscopy (painful) to see what was going on. No evidence of stricture, but they said I have bph and have probably had prostatitis. Was put on alpha blockers and told to return for follow ups.

Fair enough, the camera must show the prostate blocking the urethra. My only question is how they can differentiate this between BPH (which is what they have said), and chronic prostatitis? Is that possible? My father was diagnosed with bph but this was in his early 80's (he most likely developed symptoms in his 70s). By comparison, I was 38 when this started (now 40).

The alpha blocker seemed to reduce the pain initially (I thought it was working), but now it's flared up again. The pain plus my age makes me think that this is due to inflammation (ie prostatitis) rather than bph, plus there may be some danger of compressed nerves from cycling. The question really is, can a camera test differentiate these things? Surely all it will show is a blockage at the prostate, but not much else.

Background is I am T1 diabetic (good control) , and worked as a cycle courier for about 18 months (2-3 years ago). Urine tests have always been negative for infection and PSA has always been "low". These tests have been repeated at least 3 times with the same results.

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Sometimes possible diagnoses are made by what can be seen and sometimes what is not seen or the symptoms displayed. You may want to ask your urologist, perhaps via his secretary, whether he/she can ask your GP to try you on a different alpha blocker or on a 5 alpha reductase inhibitor.

Here is the NHS information on prostatitis: nhs.uk/conditions/prostatitis/

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