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STDs (Expert Forum)
prostate concerns
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
prostate concerns
by radio_13, Aug 04, 2005 12:00AM
I posted before about having symptoms involving urine retention, dribbling and a general uncomfortable feeling after I urinate, like there was some left in my penis. I was worried that it may have been some std,Chlam or ghon,because I had been with two pro's once unprotected oral , and one unprotected oral and protected(always)vaginal.You informed me of the very low risk of these activities, but went to the doctor anyway and explained my condition. She didn't run any tests , but did do a Digital rectal exam and found my prostate to be inflamed or enlarged. She prescribed 7 days of Cipro xr 1000mg and Avodart.I'm only 40 and thought it strange to have a prostate problem at my age but she said that it does happen, more often than I would think. My question is this, would that medication effectivly treat Chlam and Ghonn if it were indeed that? And I've done some reading on the Cipro treatment, do I need more than 7 days? High anxiety with the prospect of std. Thanks for all your help.
Doctor's Answer
by H. Hunter Handsfield, M.D., Aug 04, 2005 12:00AM
, Aug 04, 2005 12:00AM
As you say, the sexual exposures you describe would not have given you gonorrhea or chlamydial infection; and neither gonorrhea nor chlamydia causes prostate infection or other prostate problems. However, if you had one of those infections, ciprofloxacin would cure it. (Cipro isn't an ideal drug for chlamydia, but in the high dose you are taking, it would be effective.)
Is your doctor a urologist? I am not, but from my somewhat limited knowledge, there are some peculiarities in your care. Are you aware that dutasteride (Avodart) is a testosterone inhibitor? It and related drugs are intended and normally used as lifelong care in older men with prostate enlargement; and to my understanding are not indicated for a short term problem, such as infection causing prostate inflammation or enlargement. It takes many weeks or months for such drugs to significantly shrink the prostate.
Further, I do not believe most urologists would rely on a single digital rectal exam to diagnose significant prostate enlargement; confirmation with an imaging procedure (ultrasound, usually) is the norm. Finally, digital exam is virtually worthless in diagnosing prostate gland infection. The usual approach involve the "3 glass" urine test: urinalysis on the first 15-30 ml (0.5-1 oz) voided urine; a midstream urine; and another urine sample after vigorous massage of the prostate. Comparing the number of white blood cells in each sample and culture for bacteria really are required to localize inflammation to the prostate.
You can put the STD fear behind you, but I fear the main effect of all this may be to transfer your anxieties in another direction. The treatment you are getting is unlikely to cause any harm, at least not with a week of treatment. But I also doubt it will help.
As I say, I am not a urologist, and perhaps your doctor is up to speed on new developments that I am not. But I am skeptical. You might consider a second opinion with a urologist; or post your question (and perhaps my response) on the Med Help Urology Forum.
HHH, MD
Is your doctor a urologist? I am not, but from my somewhat limited knowledge, there are some peculiarities in your care. Are you aware that dutasteride (Avodart) is a testosterone inhibitor? It and related drugs are intended and normally used as lifelong care in older men with prostate enlargement; and to my understanding are not indicated for a short term problem, such as infection causing prostate inflammation or enlargement. It takes many weeks or months for such drugs to significantly shrink the prostate.
Further, I do not believe most urologists would rely on a single digital rectal exam to diagnose significant prostate enlargement; confirmation with an imaging procedure (ultrasound, usually) is the norm. Finally, digital exam is virtually worthless in diagnosing prostate gland infection. The usual approach involve the "3 glass" urine test: urinalysis on the first 15-30 ml (0.5-1 oz) voided urine; a midstream urine; and another urine sample after vigorous massage of the prostate. Comparing the number of white blood cells in each sample and culture for bacteria really are required to localize inflammation to the prostate.
You can put the STD fear behind you, but I fear the main effect of all this may be to transfer your anxieties in another direction. The treatment you are getting is unlikely to cause any harm, at least not with a week of treatment. But I also doubt it will help.
As I say, I am not a urologist, and perhaps your doctor is up to speed on new developments that I am not. But I am skeptical. You might consider a second opinion with a urologist; or post your question (and perhaps my response) on the Med Help Urology Forum.
HHH, MD
HHH, MD
I am in the states, and no she isn't a urologist. I am scheduled to undergo a full physical on WED. After reading up on prostate treatment, I've seen where the avodart would take weeks if not months to be effective on the prostate, also it takes more than a week of cipro to effectively treat a prostate infection.She didn't schedule a follow up but did allow for three refills on the cipro as well as the avodart. the avodart is a thirty day script. I've refilled the cipro and continued another week. While the symptoms seem to be better I wonder if I'm just getting used to the feeling. Is it just bad timing that these symptoms have come up now. Also, what risk am I for HIV? thank you DR.
HHH, MD
thank you