Frustrations with Urologists: The Need for Thorough Prostate Care

This type of doctor is too careless and lacks responsibility?

I have been suffering from chronic prostatitis for over two years and have visited several hospitals, including Chimei Hospital, Kaohsiung Chang Gung Memorial Hospital, and various urologists.
They only asked a few questions and diagnosed me with chronic prostatitis without conducting any thorough examinations, such as prostate-specific antigen (PSA) tests, prostate biopsies, or analyzing prostatic secretions obtained through digital rectal massage.
Despite my repeated requests for further investigation, they insisted that it was unnecessary, particularly avoiding rectal examinations due to concerns about cleanliness.
I feel very frustrated because, after two years of consultations, my condition has not improved, and I have only been prescribed antibiotics and anti-inflammatory medications.
My health has been deteriorating, and I am losing weight.
It seems that the doctors I have seen are not taking their responsibilities seriously; it feels like they only know how to prescribe medications without offering any other solutions.
I had hoped that a large hospital like Chang Gung would provide better care, so I traveled from Tainan to Kaohsiung, but the outcome was the same—just more prescriptions.
Each time, I tell the doctors that I have taken many medications without any effect, and they always say to "give it a try." I truly don't know what to do anymore.
Please, I need help from the doctors.

Lin, 20~29 year old female. Ask Date: 2005/08/27

Dr. Pan Zhenqin reply Urology

A 28-year-old young patient does not need to undergo prostate-specific antigen (PSA) testing or prostate biopsy, nor should they.
However, if diagnosed with chronic prostatitis, a digital rectal examination (DRE) to assess prostatic secretions is necessary.
I believe that in a urologist's daily practice, the number of DREs performed on patients is not insignificant, so no urologist would refuse to perform a DRE due to concerns about cleanliness.
I am unsure how many consultations you have had at each hospital; if you only have 2-3 visits at each place and do not return for follow-up, it is possible that the physicians at each location may not have enough time to make a definitive diagnosis before you leave.
Generally, a DRE for a 28-year-old male is typically performed only after first-line medical treatments have proven ineffective.
The issue is not about cleanliness, but rather about the necessity of the examination.
After all, a DRE is not a comfortable procedure for patients.
I recommend that you seek a hospital for more long-term treatment.

Reply Date: 2005/08/27

More Info

It sounds like you are experiencing significant frustration with your chronic prostatitis treatment and the care you have received from various urologists. Chronic prostatitis, particularly the non-bacterial type, can be a challenging condition to manage, and it’s understandable that you would feel disheartened if you have not received the thorough evaluation and treatment you believe you need.

First, it’s important to recognize that chronic prostatitis can manifest in various ways, and its causes are not always clear. The symptoms can include pelvic pain, urinary issues, and sexual dysfunction, which can severely impact quality of life. Unfortunately, many urologists may rely on standard treatment protocols, such as prescribing antibiotics or anti-inflammatory medications, without conducting more invasive tests like prostate biopsies or advanced imaging studies, especially if they suspect a non-bacterial cause.

Here are some points to consider regarding your situation:
1. Need for Comprehensive Evaluation: It is crucial to have a comprehensive evaluation that includes not just a physical examination but also laboratory tests such as prostate-specific antigen (PSA) levels, urine cultures, and possibly imaging studies. If you feel that your current urologists are not taking your concerns seriously or are not performing adequate evaluations, it may be time to seek a second opinion from a specialist who focuses on chronic pelvic pain or prostatitis.

2. Consider Specialized Clinics: Some medical centers or clinics specialize in chronic prostatitis and pelvic pain syndromes. These facilities often have a multidisciplinary approach, incorporating urologists, pain specialists, physical therapists, and psychologists to address the various aspects of the condition. They may offer treatments that are not typically provided in standard urology practices, such as pelvic floor physical therapy, biofeedback, or nerve blocks.

3. Communication with Your Doctor: When you see a new doctor, it’s essential to communicate your history clearly and express your frustrations. Be specific about what treatments you have tried, what has or hasn’t worked, and how your symptoms affect your daily life. This information can help the physician understand your situation better and tailor their approach to your needs.

4. Exploring Alternative Treatments: In addition to traditional medications, some patients find relief through alternative therapies such as acupuncture, dietary changes, or supplements like saw palmetto. While these treatments may not be universally accepted, some patients report positive outcomes. Discuss these options with your healthcare provider to see if they might be appropriate for you.

5. Mental Health Support: Chronic pain and health issues can take a toll on mental health. Consider seeking support from a mental health professional who can help you cope with the emotional aspects of living with chronic prostatitis. Support groups, whether in-person or online, can also provide a sense of community and shared experience.

6. Documentation and Advocacy: Keep a detailed record of your symptoms, treatments, and interactions with healthcare providers. This documentation can be invaluable when discussing your case with new doctors or if you decide to pursue any formal complaints about your care.

In conclusion, your frustration is valid, and it highlights a significant issue in the management of chronic prostatitis. Seeking a second opinion, considering specialized clinics, and advocating for yourself are essential steps in finding the relief you deserve. Remember, you are not alone in this journey, and there are healthcare professionals who can help you navigate these challenges.

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