I quote from Krongrad's site:
Concerns and ObjectionsTwo years ago a man came to us with an eight-year history of chronic prostatitis. This man was completely relieved of his symptoms with a laparoscopic prostatectomy. The relief has endured for two years and there is no reason to believe it will return. Since then, other men have gotten relief for a broad range of severe and chronic symptoms. Among them are two men with 20-year histories of failed treatments. One of these two is an anesthesiologist and pain specialist who was “at the end of the road” until his laparoscopic prostatectomy.
Let me list my concerns and objections to this development and the idea that prostate removal is a cure for CPPS:
1) Through Drs Dimitrakov and Shoskes and others, we know of men who have had prostate removal but no change in symptoms:
2) The prostatitissurgery website has all the hallmarks of a seat-of-the-pants operation:Newsgroups: sci.med.prostate.prostatitis
From: Jordan Dimitrakov
Subject: The pain is still there
I had just had a sobbing experience with a patient. Here it is.
He is a 46 year old man who has had severe pelvic pain for 8 years. He had urethral burning, dribbling and different degre of ejaculatory dysfunction. So, he came to see me 6 months ago and he was very distressed.
"Well, doc," he said, "I know I have chlamydia prostatitis and I know this is incurable."
At this time he had been prescribed a month's treatment of Roxythromycin by a dermatologist.
"I know you are the chlamydia man and you can tell me if I have it. But then," he went on, "I'm afraid I might have pased it on to my children. I want you to test them."
I agreed and he told me the whole story. He had been going to several urologists for the last 8 years and he had had multiple courses of antibiotics which did have some effect at the beginning. Then he began feeling this awful pain in the prostate area and the groin.
"And then I kept going to several urologists but they all told me "It's in your head. Go see a psychiatrist" So I did go and told the psychiatrist "Doc, I have a ball in the bladder" and he replied "Boy, you have a ball in your brain - you are not going anywhere." So, he put me in psychiatry - but I am no full and in a week I told him "Doc, the ball is gone" and so he said "Off you go!" But I know it's there".
That was six months ago. I did perform a PCR and it was positive. I performed a cystoscopy and an urethral stricture was discovered which was incised. A biopsy for IC histology was taken and it was positive for IC.
I suggested a treatment for IC but the patient was not convinced this was the problem. So, he went to see the Top Urologist in the country.
Now he came back again.
"Well, doc," he said, "the Top Urologist said I must have my prostate taken out - so I did it. But the PAIN IS STILL THERE. How is that possible? He told me that the prostate had several areas of granulamatous inflammation from the intraprostatic injections of Gentamycine and Ciprofloxacin I had 5 years ago. But I still had the feeling of a small ball - as large as part of rice inside my bladder. And I still pee too frequently."
I still insisted on treating IC. Who knows - maybe he'll think it over this time?
Jordan Dimitrakov, MD
From: Daniel Shoskes <[email protected]>
Subject: Re: The pain is still there
Presuming that his prostate was removed by a radical prostatectomy, this is the third case I am aware of where a man's symptoms were unchanged following the operation. Dr. Alexander presented the history of one patient whose pain did resolve after radical prostatectomy (there was cancer found as well).
Daniel Shoskes MD
* Notice the slapdash aspects (missing data, misspellings underlined in red, hyperbolic statements underlined in blue) of a site thrown together in the last few weeks.
* Notice that this is a "clinical trial", which allows the doctor to operate (for financial gain) under the guise of "research", and where the patient must sign disclaimers waiving the right to seek legal restitution in the event of an unsuccessful outcome or even greater pain. Patients are effectively guinea pigs. Radical prostatectomy may turn out to be an option for a tiny minority of men with extremely intractable, prostate-centred cases, or it may not ... you won't know until a proper study is done and published in a peer reviewed journal. We are far from that situation at this stage. STAY AWAY UNTIL WE HAVE MUCH BETTER DATA. And remember that reputable studies have found that the prostates of men with chronic prostatitis / chronic pelvic pain syndrome are essentially normal.
* Notice the association with entities like the Prostatitis Foundation and the Manila Clinic (Dick Feliciano), both of which I regard with the deepest suspicion inasmuch as that they represent the very worst aspects of the prostatitis scene.
* Notice the naming of the NIDDK on the page as if to associate the site somehow with the US government. However, the NIDDK has nothing to do with this site or doctor, as far as I am aware.
3) The men who are undergoing this surgery are not men who have tried the protocols we recommend at this site. They are the sort of men who have only tried the typical treatments meted out by the typical uro: antibiotics and alpha-blockers. To go straight to radical, life-changing surgery before trying our recommendations of a range of conservative and highly successful treatment regimes is nothing short of insanity.
4) Even though Dr Krongrad styles himself as a doyen of laparoscopic prostate surgery, he had never done it just 10 years ago: "Dr. Krongrad observed his first laparoscopic prostatectomy in Paris in 1999" (from aventurahospital.com). And Dr Eden apparently performed his first laparoscopic radical prostatectomy in the UK in 2000. The whole concept is new to medicine, like a new (and lucrative!) toy with which they all want to play. Beware of surgeons when they find a new technique or instrument! They will explore any avenue they can in the hunt for profit. If they can get chronic prostatitis / chronic pelvic pain syndrome patients to submit to surgery usually reserved for prostate cancer patients, the rewards are huge, absolutely enormous. This will be especially helpful for them now that more conservative approaches to prostate cancer (hormones, watchful waiting, radiation etc) are becoming more popular, thereby drying up their lucrative prostatectomy income streams. So don't become some surgeon's patsy!
5) Krongrad and to a lesser extent Eden are actively promoting this surgery on the internet. Krongrad is involved in several websites (e.g. prostatitis.ning.com aka "The Prostatitis Social Network"), where he and the infamous Dr Feliciano answer patients questions in ways that lead patients to seek treatment with them.
6) Lastly, but most importantly, prostate removal can have very serious side-effects:
Really guys, you'd have to be half-way crazy to consider this surgery until absolutely every other thing has been tried, including a full visit to Dr Wise at Stanford.Risks of radical prostatectomy
The risks after surgery are similar to those of any major surgery. They include:
• Heart attack
• Blood clots in the legs
• Infection at the incision site
• Post-operative bleeding
• Death (rare)
Recovery time for laparoscopic prostatectomy
The procedure usually takes 3-4 hours but can last up to 8 hours. Average hospital stay is two days. Unlike open surgery where the catheter stays in for 2-3 weeks, laparoscopic prostatectomy patients often have their Foley catheters removed on the seventh day after surgery. Recovery time to normal activity averages 2-4 weeks.
Side effects of radical prostatectomy
Common side effects of a radical prostatectomy include:
• Impotence (51 - 96% impotence rates have been shown)
Bottom line is that this is simply another thing to avoid at all costs, in my fairly well educated opinion.