> I've seen four urologists in a capital city and none of them
> did a culture test, save the prostate fluid sample. Perhaps
> they don't offer the culture test because of my insurance? Do
> I have to ask for it?

I wish I had an answer. I've been wandering around the New York City medical scene for 10 months, and it took 4 of those months even to be evaluated for prostatitis (before that there was no operating theory, except that my condition might be bicycling and nerve related).

The fancy phrase is "treating empirically" meaning without waiting for test results, doctors just throw a bottle of Doxycycline, Cipro or (better, because it's coverage is better) Levaquin at you. That would be okay if that worked more often, or if you were taking the antibiotic while waiting for culture results.

In my case, the doc sensibly recommended against a culture initially because I had already started taking antibotics on my own -- which made the culture unlikely to be accurate. And I improved so much for the first 5 weeks, there didn't seem to be a need to culture.

Cultures can be expensive (the semen one around $500) and since they nearly always reveal *something* (necessarily what is causing your pain) doctors are perhaps skeptical of them.

But like you, I just don't get it. Semen and urine cultures are mainstream stuff -- see for example
http://www.prodigy.nhs.uk/guidance.asp?gt=prostatitis
which are the guidelines of the British Department of Health.

And here's the kicker: if Cipro (or whatever they threw at you) doens't work, that's **IT**. No further investigation, no ideas, go home. One urologist recommended I learn how to meditate! (meditiation is swell, but not very antibacterial).

In my case it appears that if I had receive a culture, and the right antibiotic 10 months ago (Ampicillin) then I might have been cured in a few weeks. Instead I have an infection that is disseminated in prostate, testicle & bladder.

G'luck.

- Charles