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prostate massage(draining): Effect on fertlity short § long run
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.

prostate massage(draining): Effect on fertlity short § long run

by hec, May 07, 2002 12:00AM
Hello, I am suffering from chronic prostatitis (I've had it for at least 3 months).  Upon doing extesive research, I have found that antibiotics alone--normally the weapon of choice by the typical urologist here int the U.S.--are not very effective (I amongst many, many am living proof.)  There is a method however known to work in over 90% of chronic bacterial prostatitis which commonly referred to as "prostatic drainage" or "prostatic massage."  This is used in conjuction with specifically chosen antibiotics.  Basically, a rather brief (less than 30 seconds)yet vigorous massage is done via the rectum on the prostate in order to drain it.  It is done 4 days straight then every other day for about 5 to 8 times.  The object is to drain prostatic fluid out along with bacteria which are otherwise trapped in the prostate due to inflamation (inflammation) of the acinus (prostate conducts leading to urethra.) The antibiotics are a complement as another front of attack on the bacteria. [ Before I go on, it is useful to mention that part of the problem is that 5 months ago I had an incidence of testicle infection (I believe both testes) which did lot last too long.]

I am in a sutuation where I must find a cure for this debilitating condition of mine.  However, I plan on fathering a child soon and I am wondering what you have to say about the imlications of the described above prosate massage on my sperm count and overall fertility.  I realize that I am in potential danger now given my described testicular infections which could have blocked some of the conducts carrying sperm as a result of scarring.  However, I know that the prostate plays a role in sperm quality and, in my mind, having a health prostate again in a main way of achieving good fertility.  What do you think?  Do you think I run a big risk of prostate damage rendering me infertile?  Or do you think curing my condition this way (via prostate massage & antibiotics) will increase my chances of improving my ferlity.

Note: I have 1 child already and my wife and I are working this month to conceive after being unsuccessful last month. Any other advice on improving our chances to conceive will be greatly appreciated.

Thanks,

FCH

by Forum-M.D.-DT, May 07, 2002 12:00AM
Thank you for visiting the family practice forum.

Chronic Prostatitis is a difficult infection to treat. Commonly urologists will treat this infection with antibiotics such as "Bactrim", or "Cipro". In my experience, many times antibiotics are not used long enough. The "Sanford Guide to antimicrobial therapy" lists the following as treatment for "chronic bacterial prostatitis"...
Cipro 500mg twice daily for 4 weeks OR
Bactrim DS twice daily for 1-3 MONTHS.
In some cases there can be "calculi" (or stones) in the prostate which may make this infection difficult to treat. Through a prostate ultrasound, you may better determine if there are stones present.
Now, you mention "prostate massage" as a possible treatment. I have indeed heard of this and feel it may indeed be a viable option for you if all other treatment modalities have failed.
The prostate gland secretes fluid which is released with the ejaculate. The prostate gland DOES NOT make sperm. Sperm is produced in the testicles. However, a normally functioning prostate gland is necessary for proper "ejaculation" to occur, therefore the importance of this gland, in regard to fertility, cannot be underestimated. I highly doubt that prostate massage would be detrimental to your sperm count. Which brings up the next point, if your haven't had a sperm analysis, you should have this if you are having trouble conceiving and your wife should be evaluated as well to make sure she is indeed "ovulating".
Prostate infections can indeed spread to the testicles, and infection of the testicles (epididymitis) can most certainly effect normal sperm production. The fact that you have fathered one child already is very encouraging. My gut feeling here is that if you are not getting any results with one or more urologists (if you havent had a second opinion from another urologist ... this may be a good idea as well), it may be time to consider "alternative" treatments. To my knowledge, prostate "massage" as you describe, should not affect your sperm counts.
Best of luck to you and your wife!
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