He has recommended surgery as a solution. The only side effect would be that I would not ejaculate anymore. He has never asked for any seminal samples. As I am on an HMO, I have to get recommendations from my primary doctor to see anyone else and even he seems somewhat uncooperative on this. Losing your ability to ejaculate would be a bummer and there is no guarantee it will make you feel better.
Many factors probably determine which is the case.
For example, if blockage doesn't occur and the stones successfully isolate the pathogen then essentially the problem is isolated and no symptoms show. In other cases blockage may occur with successive releases and reblockage due to reinfection. This leads to the up and down prostatitis symptoms. In yet other cases the blockage never unclogs leading to chronic and continuous symptoms. Only by a manual digital drainage of the prostate.