Paul a. 2009-04-07 07:27:04
I’m a 68 year old guy, currently being treated by Dr. Irwin Goldstein of the
Center for Sexual Medicine at Boston University Medical School (a marvelous
physician and first-rate scientist whom I recommend strongly). My primary
symptom is a gradual decrease of s**** flow and ejaculatory force, to the
point now where I can barely e******** at all, even with a vibrator, and
get only a little bit of s**** oozing out. I also had low free
testosterone, though that’s been remedied with testosterone replacement
therapy plus DHEA. And I’ve had BPH for about 15 years, needing to urinate
about 4 times a night. But — unlike most of the prostatitis sufferers
here — I have no pain at all. In fact, I have radically decreased
sensitivity in my p**** (Dr. Goldstein measured it).
After determining that fixing my hormone levels wasn’t helping (though I
think it prevented the problem from getting worse even faster), Dr.
Goldstein finally did a TRUS (transrectal ultrasound scan) and was
astonished to discover that my ejaculatory ducts were almost completely
blocked by calcified stones. This was a problem he had not seen before and
had no experience with, so he suggested that I see for myself what I could
find out about it.
That led me to Google and, right off, to Dr. Federico Guercini at the
University of Rome, whom others here have heard of. Dr. Guercini’s
description of prostatitis and its symptoms fitted very well with what I
had experienced, including the “rosary bead” formation of stones and the
compression of the erigens nerve that can cause loss of sensitivity. Dr.
Guercini is convinced that the cause of the calcification is bacterial, and
his recommended treatment is direct injection of a large dose of
antibiotics into the prostate.
I asked Dr. Goldstein to read Dr. Guercini’s famous discussion of
prostatitis (http://www.prostatitis2000.org/eng/intro.htm). Dr. Goldstein
found it interesting but was unable to draw a conclusion as to how sound
Dr. Guercini’s approach is. Nevertheless, at my request he’s planning to
do the antibiotic infusion that Dr. Guercini recommends, though doing the
injection transrectally rather than through the perinium as Dr. Guercini
All this leads to a number of questions I have for this group:
1. Has anyone been treated by Dr. Guercini? How successful was the
2. Does anyone else have the same symptoms that I do (loss of ability to
e******** but no pain)?
3. Assuming that the stones are indeed caused by bacteria (which some
urologists question) and that the antibiotics get rid of the bacteria, what
then has to be done, if anything, to get rid of the stones?
4. Why would Dr. Guercini recommend injection through the perinium (where
it’s much harder to aim the needle accurately) than through the r*****?
5. Has anyone had a transrectal injection of antibiotics? How painful was
All feedback is appreciated.
Makavelimob662 2009-04-07 07:27:10
I wouldnt go injecting things into myself before finding out that
there is an actual bacteria there. My URO told me that stones are
commonly found in prostates, he said they dont cause problems, UNLESS
there is bacteria present as well. You never know what can happen
afterwards, after all, its not their prostate that is getting stuck
with injections of antibiotics, its yours.
Mrpubmed 2009-04-07 07:27:13
The treatment of prostatic stones/calcifications was discussed here
not long ago. Another option discussed was medical therapy to dissolve
the stones. There is a brief description near the bottom of the page
at : http://www.dshoskes.com/cpclinic.html
Jankin 2009-04-07 07:27:16
In article <email@example.com>,
I’d worry about the recommended EDTA rectal suppostories. See
Paul a. 2009-04-07 07:27:22
Here’s what Dr. Shoskes has to say:
“The role of prostatic stones in producing the symptoms of prostatitis is
controversial, especially since many older men without symptoms are found
to have these stones. Nevertheless, younger men with extensive prostatic
calcification are often improved when these stones are eliminated. We have
a limited but very positive experience treating these men with combination
therapy against nanobacteria, a type of stone forming bacteria impossible
to detect using typical culture techniques.Therapy consists of a daily
antibiotic (tetracycline), an oral supplement and an EDTA rectal
suppository and typically lasts 3 months.”
That isn’t very specific, but seems to suggest that antibiotics are useful
even if culturing the urine doesn’t show anything.
Webmaster chro 2009-04-07 07:27:26
Posted via Mailgate.ORG Server – http://www.Mailgate.ORG
Mrpubmed 2009-04-07 07:27:29
No, that’s not what it says. It says that nanobacteria, which can form
stones around them, are treated wtih this regimen even though you
can’t find nanobacteria on bacterial cultures. I saw a paper a while
back showing that tetracycline is the best antibiotic for treating
Antimicrob Agents Chemother. 2002 Jul;46(7):2077-86.
Inhibition of nanobacteria by antimicrobial drugs as measured by a
modified microdilution method.
Ciftcioglu N, Miller-Hjelle MA, Hjelle JT, Kajander EO
Matthew emme 2009-04-08 18:43:05
This is not a common problem. I do not know what Dr. Goldstein wanted to
do, but the standard treatment for bilateral ejaculatory duct obstruction
would be to go in and do a resection of that part of the prostate. This
seems to help many. What did he want to do?
Matthew emme 2009-04-08 18:43:08
On 5/22/04 9:57 PM, in article
I see some stones in probably about 60+% of prostate ultrasounds I do when I
biopsy people for prostate cancer. Some more than others. I have seen
many, many completely asymptomatic people with a prostate that look like a
Some people that put a lot of stock in the prostate stone as the cause of
all peoples problems. I am not one of them, but await some well done
studies that tell me otherwise.
Injections of antibiotics into the prostate is not a high yield thing to do.
Paul a. 2009-04-08 23:36:23
In my case I seem to have ejaculatory duct obstruction due to calcified
stones. According to Dr. Federico Guercini, the stones are probably of
bacterial origin and would disappear after infusion of antibiotics into the
prostate. But how do I know if he’s right? The alternative therapy would
be a resection of the ejaculatory ducts, it seems, analogous to a TURP
I wish there was a “guide to the gurus” available. There seem to be several
gurus in the established urological community — Dr. Shoskes in Florida,
Dr. Polachek in Tucson, and Dr. Guercini in Rome for starters. It’s hard
to tell, though, how much they agree with each other, even. And trying
invasive therapies is not like trying beers, say, to see which one you
like. Given the poor understanding of prostatitis and EDO in the
urological community, how’s a patient supposed to make a wise choice?
Paul a. 2009-04-08 23:36:25
He felt that the problem was outside his range of competence. As he put it,
“it’s not my organ”. That’s why he handed the problem back to me, but he
also wants to be as helpful as possible. He doesn’t feel he can evaluate
Dr. Guercini’s approach, and he’s hesitant to do the prostate infusion
himself because of the possibility of abscesses and infections. There are
questions as to the best route in, transrectal or through the perineum
(Guercini favors the perineum) also.
I’m inclined to think that ejaculatory duct resection is the way to go, but
that still leaves the question of what to do about my severe loss of
sensitivity, probably due to pudendal nerve damage.
On top of that, I’ve got big-time Peyronie’s, Dr. G. tells me. But I won’t
worry about that until the primary problems are solved.