So, just came back from this urologist visit. Nice guy, seemed knowledgeable as he explained everything. He gave me a DRE, said I didn’t have a “tight ass”, or the chronic pelvic issues (I hadn’t even asked about this yet, although I’d mentioned the prostatitis angle). Didn’t think I had prostatitis, I didn’t have pain when he checked me out, didn’t feel inflammation. Didn’t think there was reason to do the ultrasound, he didn’t just want to take my money, but he was willing to do it, so I’m booked for mid-July. (Said he’d be looking for blockage bottle-necking ejaculate, nodules, inflammation, etc).
Regarding Dr. Georgiades’ screening labs, he said that we could test for chlamydia & gardnera vaginalis (but that it’s cheaper to take cyclosporine); that anyone’s test would show gram + and gram - bacteria; and that mycoplasma and ureoplasma tests were more for fertility purposes and highly expensive out-of-pocket tests (unnecessary in his view). He agreed with my desire to quit screwing around w/ TRT and meds (like using flomax, for my slight perceived urinary issues which he said were average/normal), since my apparent recent baseline Testosterone of 540 that was on file wasn’t all that bad (not sure where I’m at presently; I’d dabbled with clomid/testim a few months ago, my baseline appears to be in the 500s post-finasteride when I’m off Clomid, but I haven’t gone a long enough time w/o it to truly see where I bottom out). Was blunt about not knowing what the root cause was, and acknowledging that between my penile revascularization, injection therapy, TRT, cialis, etc, I’ve tried most options. Cautioned against using my 60+ mg mega-doses of cialis, saying that above 20mg, you’re getting more side effects than actual benefit. But he was happy to help me out with scripts and samples (damnit–forgot the samples!!!).
Mentioned that I could pursue the physical therapy / pelvic floor route, but that it typically isn’t linked to E.D. and that he just doesn’t think I suffer from it. Also could refer me to a sex psychologist which kind of stirs me up. I mean, on the one hand, of course I have secondary psychological issues from this whole predicament, so it might not a bad idea, but clearly, I woke up one day w/o a morning erection and it just got worse from there; it’s not psychological, we all know that. And he wasn’t implying that it was, still, that was kind of annoying, because he didn’t put much stock in PFS, saying that those of his patients who take the drug and experience side effects get relief upon quitting the drug. I didn’t have the energy to debate the matter. Also told me to check out the Actis Constriction Ring to help w/ sex.
So where does this leave me??? I have no f’n clue. I have another urologist appointment booked for next week, I’m going to try to be more forceful in asking for the lab tests. On the one hand, I don’t think I have some obvious, acute prostatitis situation, I think this urologist knew his stuff in that area; on the other hand, you have this confident Dr. Georgiades guy who doesn’t put stock in the traditional diagnostics on this matter. I’ve also been experiencing morning erections with the use of Nystatin (at higher doses) for the last few weeks. Is it treating a systemic infection? Or having a general anti-inflammatory effect? I visit a new hormonal/holistic M.D. tomorrow to explore all sides of this, including attempting to discuss Chiln’s Cortisol 101 stuff (I e-mailed him all the primers in advance and he said he was familiar with this stuff, whether or not it was my issue remained to be seen).
I want to do my due diligence with local testing, local urologists, and exploring what this new doc might have to say first…but I don’t rule out that trip to Greece if all else fails. Or linking up with some PFSers who want to organize a trip / house to stay in. I’m not ready to do this just yet, and it would be a huge financial challenge, but it is an option.
