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Urology  (Expert Forum)
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Re: Your thoughts on prostatic massage....
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Re: Your thoughts on prostatic massage....

by HFHS M.D.-MS, Jan 01, 1995 12:00AM
Posted By HFHS M.D.-MS on January 23, 1998 at 16:56:27:

In Reply to: Your thoughts on prostatic massage.... posted by David on January 22, 1998 at 09:24:34:








Good day,
As I continue my treatment with Cipro, I have spent a great deal of time researching my condition via the Prosate Orginization website.  At this site, prostatic massage is talked about as a very important part of treating a protate infection.
What are the thoughts of the uros here at HF uro forum about this treatment?
Thanks once again for your time.
David



    
Dear David:
Thank you for your question!
What is the address of the prostate Organization website?  Prostate massage is contraindicated in Acute Bacterial Prostatitis!  The massage of the prostate when acutely infected can cause blood poisoning with bacteria, what we call urinary sepsis.  I would not recommend this.   This is very uncomfortable for the patient!  
In chronic prostatitis,  clinicians can isolate where the infection is coming from ( the urethra, bladder or prostate) by looking at the urine before and after a prostatic massage.  The prostate is not acutely inflamed with bacteria and although uncomfortable the massage is usually tolerable by the patient. Most of the time the technique of collecting  expressed prostatic secretions  EPS by massage does not produce a enough sample so most doctors will  just treat according to the urine culture.   The antibiotic  treatment is the same and  the only useful information  the  EPS renders is how long to treat the infection.  The recommended length on treatment for chronic bacterial prostatitis is 3 weeks.  The  uncomplicated bladder infection can be treated for just three days.  If the bacteria was sensitive to the antibiotic prescribed and the infection happened to recur, most urologist would then retreat for the long period.   They may also want to perform other tests like look into your bladder with a light telescope (cystoscopy) and /or order a  kidney Xray called an IVP to make sure the infections is not coming from a kidney or bladder stone.
Back to prostate massage, I have only heard of reports of patients requesting prostatic massage because they previously had relief of their symptoms after a screening digital rectal exam.   This condition is probably not bacterial prostatitis but a form of prostadynia or chronic pelvic pain syndrome.  This condition was addressed earlier in this forum in communication with Davidoff.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Try  not to loose to much sleep over your illness.  Most patients are cured with the appropriate course of antibiotics never to relapse.  
Good Luck
HFHS-M.D. MS
*Keyword: Prostatitis

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