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Do I have prostatitis or prostate enlargement?

Q: Last year, I had disc prolapse in L4-L5 and L5-S1, with nerve compression. Immediately after that, I started getting a burning sensation/discomfort in the left side of my urination line. I went for a surgery for L4-L5 and during that time they diagnosed that I was also having a prostrate problem (size 29 gms). When I had an ultrasound, five months prior to this, there was no sign of this problem. After the surgery, the burning sensation had subsided. It was in October that I was asked to undergo a DRE test. The reports diagnosed it as prostatitis along with a urine infection. I was given some medicines and some food supplements to maintain prostate health. Till the time, I had the medicine, I felt better. In the ultrasound, the prostate size was reduced to 25gm. I did a PSA test as well. The result was negative. After stopping the medicine for a month, the problem emerged again. The prostate size is 32 gms and I also have a urine infection. I have started taking Levofloxacin again. Please clear the following doubts. 1. Do I have prostatitis or prostate enlargement? I am 36 years of age, and as per doctor, in my age enlargement is uncommon. Does prostatitis cause prostate enlargement? 2. Is there any permanent cure for this? 3. Is there any relation between disc prolapse and prostate problem? I,d like to mention that my surgery was done on L4-L5 only.

A:Prostate is not a problem. Everybody born as male has to have a prostate gland, so it is not possible that it was negative on any scans. The size of the gland is immaterial and two scans done on same day by the same sonologist may give vastly different readings. Laymen like you give importance to it as that is the only thing you can understand in the report (prostate volume in gm or ml). It is enough to know that the prostate is close to a normal sized prostate. The problem is not the prostate, but that you have urinary symptoms, which are interactions between the bladder muscular contractions and opening of the bladder outlet (that is where prostate is sitting and thus comes into picture, and is only one of many factors causing such symptoms). Bladder contractions, as well as outlet opening, are controlled by nerves and reflexes via the spinal cord, and may indeed be affected by any spinal pathology or intervention. Such affections may be diagnosed with appropriate tests. You may be permanently cured only after one has reached the cause of the problem, and it turns out to be a correctable one.

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