Posts Tagged ‘prostatitis’

Prostatitis: When It Hurts Down There

August 9, 2015

One of the most common infections affecting men is infections of the prostate gland. This is the gland that is the size of a walnut located at the base of the bladder that surrounds the urerthra or the tube in the penis that transports urine from the bladder to the outside of the body.

There are two kinds of bacterial prostate infections: acute and chronic, but only a few of men with symptoms of prostatitis actually have a documented bacterial infection.

An acute infection of the prostate is characterized by high fever, lower abdominal pain, marked urinary frequency, urgency, muscle aches and pains, pain going down the inner aspect of the thigh, and sometimes urinary retention. The patient looks very ill and the prostate is exquisitely tender on rectal examination. Because it is very difficult for antibiotics to penetrate the prostate and cure the infection, it is important that you take culture specific antibiotics for about six weeks. If the symptoms don’t subside within a few days of starting antibiotics, it is important to be sure that a prostatic abscess is not present as this is a urologic emergency and requires a surgical procedure to drain the abscess. At this stage, it can be difficult to be sure on examination, but an abdominal ultrasound or CAT scan can usually make the proper diagnosis.

In chronic bacterial prostatitis, the symptoms are more subtle. The patient’s main complaint is usually frequency of urination, aching in the prostate or testicles and pain of fullness in the lower abdomen. Patients with chronic bacterial prostatitis usually have a history of a bacterial urinary tract infection. The diagnosis is made by doing a special examination of the urine and prostatic secretions known as bacterial localization cultures. This is done by splitting the urine sample into different segments. You begin to urinate and catch the first few drops in a specimen container. Then you continue to urinate and obtain a sample in the middle of urination (a mid-stream sample). You stop urinating and then your doctor examines the prostate with his finger in the rectum. He presses on the prostate with a technique called prostatic massage. This causes some fluid, called expressed prostatic secretions, to leak from the tip of the penis. These secretions are put into another container and, finally, you finish urinating and the last urine specimen is obtained. All of the samples are sent for analysis and culture. If there are white blood cells or pus cells and bacteria in the prostatic secretions, but not in the urine, a diagnosis of chronic bacterial prostatitis is made. Treatment is prescribing culture specific antibiotics for 6-12 weeks.

Bottom Line: Prostate infections are a common affliction of men. The diagnosis is made with a careful history and physical examination. For bacterial infections the treatment is antibiotics that are specific to the bacteria in the prostate.

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Can’t Get It Up? Your ED (Erectile Dysfunction) May Be Telling You That Your Health Is Headed Down

September 22, 2014

Nearly every man has an occasional problem with his erection. However, if it is a persistent problem, it may be an indication of a more serious health problem. This blog will discuss some of the common conditions that may not have any symptoms that are associated with ED and what you need to do if you do have ED.

High blood pressure

An estimated one in three men with high blood pressure has no idea they have it, and impotence could be a vital warning sign. As we get older, our arteries become narrower and less elastic, which forces our blood pressure to rise gradually as the heart beats ever harder to get blood around the body. This damages the arteries, reducing blood flow to the penis.

What you can do: Ask your GP to check your blood pressure. Lifestyle changes such as increasing exercise and lowering salt intake may improve erectile dysfunction.

If you are already taking blood pressure medication and suffer from impotence, mention it to your doctor as some pills, such as Thiazide diuretics and beta blockers, can trigger or worsen it and your GP may be able to prescribe an alternative.

Heart disease

The many stresses of modern life, compounded with poor diet, lack of exercise, drinking and smoking, can put you at risk of high cholesterol and heart disease, both of which cause narrowing of the arteries, reducing blood flow to the heart — and to the penis. Weak erections can be an early sign of heart trouble.

‘The blood vessels in your penis are 1mm to 2mm wide, much smaller than those in the arteries to your heart (3mm to 4mm wide), so they show up signs of narrowing more quickly.

Impotence occurs, on average, about three years before a heart problem appears, especially in men in their 40s or 50s. Men with erectile dysfunction are 50 times more likely to have heart problems than men with normal heart function.

What you can do: Get your heart and cholesterol levels checked. Improving your diet and boosting exercise levels can reduce your cholesterol levels. Your doctor might also recommend a cholesterol-lowering statin drug. There is some evidence that statins can help with erectile dysfunction.

Diabetes

More than a million people in the U.S. are believed to have undiagnosed diabetes — a condition where your body cannot process the sugar in your blood effectively. Left untreated, this can lead to damage to the blood vessels and the nerves, and can cause poor blood flow to the penis, too.

What you can do: Poorly controlled diabetes can lead to irreversible ED. If you are diagnosed with, or already have, diabetes, keeping your blood sugar levels stable (through diet and possibly medication) may help prevent impotence.

More than 50 per cent of diabetics will have ED at some point, and it becomes more common as they grow older.

Enlarged prostate

The prostate is a small, doughnut-shaped gland that sits under the bladder, around the urethra.

Prostate problems are common with age — typically these are prostatitis, a bacterial infection which causes the gland to become swollen, and an enlarged prostate, which is linked to testosterone.

Both can trigger pain, difficulty passing urine and temporary problems with erectile dysfunction.

Prostatitis can be treated with antibiotics (it usually clears within four weeks) and an enlarged prostate may shrink after treatment with an alpha blocker such as Flomax or Rapaflo or the use of drugs that block the effects of testosterone, reducing the gland’s size.

Treatments for prostate cancer — surgery, radiotherapy, ultrasound, cryotherapy and hormone therapy — can trigger erection problems.

Early prostate cancer can be treated surgically with a nerve- sparing technique, which gives a better chance of erections afterwards.

Erectile dysfunction can be an indicator of other medical problems. If you are experiencing a regular loss of erections or are unable to obtain an erection most of the times you engage in sexual intimacy, you should check with your physician.

Eating and Exercising Your Way To Prostate Health and Preserving Your Potency

December 30, 2012

Location of prostate gland at the base of the bladder and surrounding the urethra

Location of prostate gland at the base of the bladder and surrounding the urethra


I am frequently asked by my patients “What can I eat to reduce my risk of developing prostate cancer?” This is one of the most common questions I am asked by men concerned about prostate health. Undoubtedly, many hope that their doctor will rattle off a list of foods guaranteed to shield them from disease. Although some foods have been linked with reduced risk of prostate cancer, proof that they really work is lacking, at least for now.
Aim for a healthy eating pattern
Instead of focusing on specific foods, dietitians, physicians, and researchers tout an overall pattern of healthy eating — and healthy eating is easier than you might think. In a nutshell, here’s what experts recommend:
1. Eat at least five servings of fruits and vegetables every day. Go for those with deep, bright color.
2. Choose whole-grain bread instead of white bread, and choose whole-grain pasta and cereals.
3. Limit your consumption of red meat, including beef, pork, lamb, and goat, and processed meats, such as bologna and hot dogs. Fish, skinless poultry, beans, and eggs are healthier sources of protein.
4. Choose healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and avocados. Limit saturated fats from dairy and other animal products. Avoid partially hydrogenated fats (trans fats), which are in many fast foods and packaged foods.
5. Avoid sugar-sweetened drinks, such as sodas and many fruit juices. Eat sweets as an occasional treat.
6. Cut down on salt. Choose foods low in sodium by reading and comparing food labels. Limit the use of canned, processed, and frozen foods.
7. Watch portion sizes. Eat slowly, and stop eating when you are full. One of my best suggestions that I have tried to adopt is to eat my entre from a smaller salad plate which makes the portion look bigger. Also, try eating with your non-dominate hand as this will slow down your eating. Finally, after you eat your first portion, wait 10-15 minutes before taking a second portion. This allows your brain to catch up with your stomach and will give you a feeling of satiety without overeating.

Stay active
In addition to eating a healthy diet, you should stay active. Regular exercise pares down your risk of developing some deadly problems, including heart disease, stroke, and certain types of cancer. And although relatively few studies have directly assessed the impact of exercise on prostate health, those that have been done have concluded, for the most part, that exercise is beneficial. For example:
1. Based on questionnaires completed by more than 30,000 men in the Health Professionals Follow-up Study, researchers found an inverse relationship between physical activity and BPH symptoms. Simply put, men who were more physically active were less likely to suffer from BPH. Even low- to moderate-intensity physical activity, such as walking regularly at a moderate pace, yielded benefits.
2. Using data from the Health Professionals Follow-up Study, researchers also examined the relationship between erectile dysfunction (ED) and exercise. They found that men who ran for an hour and a half or did three hours of rigorous outdoor work per week were 20% less likely to develop ED than those who didn’t exercise at all. More physical activity conferred a greater benefit. Interestingly, regardless of the level of exercise, men who were overweight or obese had a greater risk of ED than men with an ideal body mass index, or BMI.
Italian researchers randomly assigned 231 sedentary men with chronic prostatitis to one of two exercise programs for 18 weeks: aerobic exercise, which included brisk walking, or nonaerobic exercise, which included leg lifts, sit-ups, and stretching. Each group exercised three times a week. At the end of the trial, men in both groups felt better, but those in the aerobic exercise group experienced significantly greater improvements in prostatitis pain, anxiety and depression, and quality of life.

Bottom Line: There’s not much you can do about your genetics or what you inherited from your parents. But there’s a lot you can do by eating healthy and exercising regularly. Your prostate gland will thank you.

This article was modified from an article appearing in The Harvard HealthBeat on October 4, 2011 http://www.HarvardProstateKnowledge.org.

When It Hurts Down There In the Prostate Gland-New Treatment for Chronic Pelvic Pain

May 13, 2012

Chronic pelvic pain is a disabling condition with multiple treatment options. However, in men with chronic prostatitis, which is not due to bacterial infection, have difficulty finding relief.
The symptoms of chronic pelvic pain are pain with urination, pain under the scrotum, and urinary frequency and urgency. Now there is a new treatment using trigger point therapy that has been helpful in some men with chronic pelvic pain.
In a study published in The Journal of Urology (Volume 185, page 1294), researchers evaluated the protocol, known as myofascial trigger point therapy and paradoxical relaxation training (PRT), in 116 men who had pelvic pain for several years.
Trigger point therapy, which involves applying pressure on a trigger point in a tight muscle until it “releases,” was performed by a physical therapist for 30 to 60 minutes daily for five consecutive days. A psychologist provided daily instruction in PRT for three to five hours. The goal of PRT is to reduce nervous system arousal in the presence of perceived pain and catastrophic thinking. The men were instructed to use the techniques at home.
At six months, their quality of life had improved significantly, and 82 percent of the men reported improvement in pain and urinary dysfunction. The improvement was described as major or moderate by 59 percent and as slight by 23 percent.
Bottom Line: If you have chronic pelvic pain with pelvic muscle tenderness that has not improved with standard medical therapies, consider asking your doctor for a referral to physical and behavioral therapists with experience treating this condition.

Protect Your Prostate With a Good Diet

October 4, 2011

What can I eat to reduce my risk of developing prostate cancer? This is one of the most common questions urologists hear from men concerned about prostate health. Undoubtedly, many hope that their doctor will rattle off a list of foods guaranteed to shield them from disease. Although some foods have been linked with reduced risk of prostate cancer, proof that they really work is lacking, at least for now.
Aim for a healthy eating pattern
Instead of focusing on specific foods, dietitians, physicians, and researchers tout an overall pattern of healthy eating — and healthy eating is easier than you might think. In a nutshell, here’s what experts recommend:
Eat at least five servings of fruits and vegetables every day. Go for those with deep, bright color.
Choose whole-grain bread instead of white bread, and choose whole-grain pasta and cereals.
Limit your consumption of red meat, including beef, pork, lamb, and goat, and processed meats, such as bologna and hot dogs. Fish, skinless poultry, beans, and eggs are healthier sources of protein.
Choose healthful fats, such as olive oil, nuts (almonds, walnuts, pecans), and avocados. Limit saturated fats from dairy and other animal products. Avoid partially hydrogenated fats (trans fats), which are in many fast foods and packaged foods.
Avoid sugar-sweetened drinks, such as sodas and many fruit juices. Eat sweets as an occasional treat.
Cut down on salt. Choose foods low in sodium by reading and comparing food labels. Limit the use of canned, processed, and frozen foods.
Watch portion sizes. Eat slowly, and stop eating when you are full.
Stay active
In addition to eating a healthy diet, you should stay active. Regular exercise pares down your risk of developing some deadly problems, including heart disease, stroke, and certain types of cancer. And although relatively few studies have directly assessed the impact of exercise on prostate health, those that have been done have concluded, for the most part, that exercise is beneficial. For example:
Based on questionnaires completed by more than 30,000 men in the Health Professionals Follow-up Study, researchers found an inverse relationship between physical activity and BPH symptoms. Simply put, men who were more physically active were less likely to suffer from BPH. Even low- to moderate-intensity physical activity, such as walking regularly at a moderate pace, yielded benefits.
Using data from the Health Professionals Follow-up Study, researchers also examined the relationship between erectile dysfunction (ED) and exercise. They found that men who ran for an hour and a half or did three hours of rigorous outdoor work per week were 20% less likely to develop ED than those who didn’t exercise at all. More physical activity conferred a greater benefit. Interestingly, regardless of the level of exercise, men who were overweight or obese had a greater risk of ED than men with an ideal body mass index, or BMI.
Italian researchers randomly assigned 231 sedentary men with chronic prostatitis to one of two exercise programs for 18 weeks: aerobic exercise, which included brisk walking, or nonaerobic exercise, which included leg lifts, sit-ups, and stretching. Each group exercised three times a week. At the end of the trial, men in both groups felt better, but those in the aerobic exercise group experienced significantly greater improvements in prostatitis pain, anxiety and depression, and quality of life.

This article was excerpted from https://mail.google.com/mail/?shva=1#inbox/132cfb68cd03a854

Your Prostate Infection May Be Caused By Your Peptic Ulcers

June 7, 2011

Treatment for chronic bacterial prostatitis is fairly straightforward: antibiotics for four to 16 weeks.  But what if you have symptoms of both chronic prostatitis and peptic ulcers?  One reader asks:  “I’ve had problems with both chronic prostatitis and peptic ulcers. My doctor said that the two could be related. How can that be?”

The underlying cause of chronic prostatitis remains unknown about 90 percent of the time. Microorganisms suspected of causing chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)  include Escherichia coli, Enterobacter and Pseudomonas aeruginosa.

A relatively new suspect is Helicobacter pylori (H. pylori), which is the most common microorganism in human bacterial infections around the world. This bacterium lives in the lining of the stomach and can cause inflammation and immune responses.

People with certain health problems are more likely to have detectable signs of H. pylori in their blood. These health problems include heart disease, rosacea, chronic bronchitis and asthma.

A recent study in the Scandinavian Journal of Urology and Nephrology linked H. pylori to CP/CPPS. For the study, researchers took blood from 64 men with CP/CPPS and 55 without. They found that 76 percent of men in the CP/CPPS  group tested positive for antibodies against H. pylori, versus 62 percent of the men in the control group.

This was the first study to link CP/CPPS with H. pylori, so the relationship between the two is far from proven. But if further studies show a link, it suggests that treatment for H. pylori-induced peptic ulcers may be beneficial for H. pylori-induced CP/CPPS as well.

Reported in the John Hopkins Medical Newsletter

Flossing Your Teeth and Prostate Disease-There Just Might Be A Connection

August 29, 2010

Who would have thunk that flossing would be prostate gland protecting?  It has been well-documented that inflammation in the mouth, i.e., gum disease is linked to heart disease, diabetes, rheumatoid arthritis, and now even Alzheimer’s disease.  Now good research from Case Western Univeristy in Cleveland, Ohio has made a connection between gum disease and prostate health. The researchers from the dental school and the department of urology and the Institute of Pathology at the hospital found those with the most severe form of the prostatitis also showed signs for periodontitis, or severe gum disease.  It is theorized that reducing inflammation in the mouth-by daily flossing may also reduce prostate gland inflammation.  As my wonderful Jewish mother would say, “It may not help but it vouden’t hoit!”  So if you are looking for one more reason to start flossing, you now have one.

Excerpted from Journal of Periodontology, the official journal of the American Academy of Periodontology

Urinary Tract Infections in Men

May 4, 2010

Urinary tract infections (UTI) indicate inflammation anywhere within the urinary system.  In men it can occur in the kidneys, bladder, prostate or urethra.  UTIs are more common in women, but they also affect men, especially in men more than 50 years of age.  If UTIs are left untreated, they can result in spread of the infection and cause permanent kidney damage.

Prostate infections are the most common infections in men.  Acute prostatitis occurs when bacteria lodge in the prostate and produce symptoms such as fever, chills, difficulty with urination, back pain, or blood in the urine.  The treatment is antibiotics for 7-10 days.

Chronic bacterial prostatitis is similar to the acute infection but without the fever or chills.  These men also may have painful ejaculation and low back pain.  The treatment is also antibiotics but often the medication has to be taken several weeks or even months.  Men with chronic prostatitis also may be advised to avoid caffeine, alcohol, spicy foods and chocolate.

In many men, prostatitis occurs without identifying any bacterial culprit.  This is called abacterial prostatitis or prostadynia.  The symptoms are the same a chronic bacterial prostatitis.  The pain and vague urinary problems are a result of spasm or congestion of the pelvic floor muscles or congestion within the prostate gland itself.  In most instances, antibiotics are not helpful in treating this condition.  The treatment consists of anti-inflammatory medication, muscle relaxants or alpha blockers.

UTIs can also occur after instruments are inserted into the urinary tract such as catheters or tubes as they may transport bacteria from outside of the body to the bladder and prostate gland.

Previous infections such as some of the sexually transmitted diseases may leave scars in the urethra and cause it narrow or stricture.  This disrupts the normal flow of urine and may result in infections of the urinary tract.

The diagnosis of a UTI is made with a history, physical examination and a urinalysis and a urine culture.  The latter is a test that identifies the offending bacterial and the best antibiotic to treat the infection.  Occasionally, additional tests such as a CAT scan and cystoscopy are required.

General measures for treating UTIs in men include increasing the consumption of water. Alkaline substances, such as citrates, taken in water might improve symptoms. By making the urine more alkaline, they make the environment more hostile to bacterial growth and improve the results of antibiotic therapy.

Antibiotics are the mainstay of treatment. Trimethoprim (Trimpex) is currently the first choice for lower UTI , because it is cost-effective, well tolerated and works in 80 per cent of infections. Cephalosporins and quinolones are reserved as second line drugs in patients with lower UTI, but are first choices in patients with signs of kidney infection.

You can prevent UTIs by drinking lots of fluids every day, empty your bladder often and completely, practice safe sex, always use latex or polyurethane condoms, urinate after sex to flush out bacteria, if you are uncircumcised, and wash under the foreskin each time you take a bath or shower.

Although UTIs are aggravating and affect the quality of life of those with the condition, they do not cause prostate cancer, benign enlargement of the prostate, or perhaps more importantly, impotence.

Bottom Line: With an accurate diagnosis and the correct treatment, most cases of UTIs in men can be cured, treated or certainly controlled.

Attention Bicycle Riders-Your Seat May Be Affecting Your Sex Life

April 25, 2010

A middle age bike rider, who was perfectly potent, noted that his penis went numb at the end of a two-day, 200 mile charity ride.  The numbness continued for nearly six months and was accompanied by the inability to achieve an erection adequate for sexual intimacy or impotence.  After a work-up revealed arterial damage at the base of the shaft of the penis, his potency returned after treatments that increased the blood supply to his penis.

To understand the relationship between bicycle seats and impotence, you need to know a few things about male anatomy. The penis is a hydraulic system. During sexual stimulation, its twin chambers fill with blood until it’s firm and erect. After stimulation ends or there’s ejaculation, the blood leaves and the penis softens again. The trigger for this increased blood flow is nerve impulses that originate in the brain and race down the spinal cord to the penis.

When you’re riding a bicycle, your weight is being focused on the perineum, the area between the rectum and the scrotum, and that’s where the arteries and nerves that feed the penis are located. Since the arteries are essentially unprotected, they’re prone to damage from constant  pressure from the bike seat.   When a man sits on a bicycle seat he’s putting his entire body weight on the artery that supplies the penis.

There are a number of things you can do to protect your potency:

• Penile numbness and excessive genital shrinkage are warning signs that there may be too much pressure on your perineum. The nerves in the perineum are being pinched, which means the artery that feeds the penis is also being compressed.

• Make the following changes in your riding style and/or your positioning on the bike: 1) Make sure your saddle is level, or point the nose a few degrees downward. 2) Check to see that your legs are not fully extended at the bottom of the pedal stroke. Your knees should be slightly bent to support more of your weight. 3) Stand up every 10 minutes or so to encourage blood flow.

• There are a multitude of anatomic racing saddles on the market, ranging from ones with a flexible nose to models with a hole in the middle. You may want to experiment with a wider, more heavily padded brand or a “double bun seat” that places the weight on the bones and off of the perineum.

• Heavier riders may be more at risk of arterial compression damage because of the greater weight that’s placed on the perineum. If you’re in this category, you should consider a wider saddle with extra padding.

• When riding a stationary bike, the tendency is to stay seated and grind against big gears for long periods. Get off of the seat as frequently as you would on your regular bike and be certain that it’s set up the same in regards to riding position.

•  Get off of the seat when riding over rough or irregular terrain. Use your legs as shock absorbers.

Most men are not aware of the relationship between their bike and their erections. My final advice for good health is that men shouldn’t necessarily ride farther but ride a lot smarter.