Prostate Health (cont.)
I do think it's very important that he be evaluated with
repeat PSAs and most likely with biopsies if the PSA is still above one and a
Ever since I had
the cancer treatments, my prostate has dried up and I have no semen.
That is correct.
Obviously if a man has the prostate removed, there will be nothing to come out
because the majority of the fluid that does come out during ejaculation is from
the prostate and adjacent glands called the seminal vesicles and during the
surgery those are removed; so there should be nothing coming out after
The tissues are killed by the radiation. The goal is to
kill the cancer cells and in so doing many of the adjacent normal prostate cells
and seminal vesicles do whither up and atrophy. So after radiation, cryotherapy
or many of the other conservative treatments, having no or minimal ejaculate is
considered the norm.
|"One thing to remember is that anything that happens
from the base of the bladder all the way out to the tip of the penis is
felt as urethral, penile pain." |
that following a radical prostatectomy some men find masturbation more
pleasurable than intercourse. Is this true and why?
My answer to this
would be that it's very individual. I had not heard this before, but it may have
to do with the fact that after surgery, there may be a compromise to some of the
nerves and there may be a need for more physical stimulation to achieve the same
level of satisfaction. So that is something that is totally individual and will
depend on the person and their relationships and specifically the treatment and
how effective it was and what injury may have occurred at the time.
seeing my urologist for a couple of months now and he says I have prostatitis. He put me
on Cipro XR 1,000 milligrams and I think it's finally working. But when I pinch
my penis, the tube and back up to the head, I still feel some discomfort. Is
there anything you can tell me? This is very depressing. Also, my semen is still
a little clumpy, but not like it was.
Prostatitis is a
name applied to a significant number of different problems. Prostatitis can be a
bacterial infection of the prostate from any one of dozens of different
bacteria, it can be viral and sometimes it's just an inflammatory irritation.
The nice thing about Cipro and other antibiotics in that
category is not only do they kill most of the germs that live within the
prostatic tissue and fluid, but there's also an anti-inflammatory component.
What we often do with men that have prostatitis is not
only do we use a long course of antibiotics, such as Cipro, but we also usually
add additional anti-inflammatory medications for the very reason he describes in
that sometimes there's continued irritation of the urethra and prostate from the
swelling that goes along with the infection. Whether the doctor uses
over-the-counter anti- inflammatory medications such as ibuprofen or whether it
is prescription medication such as Celebrex, the doctor will have to
individualize the treatment for that particular person. Oftentimes these
anti-inflammatory medications help significantly.
One thing to remember is that anything that happens from
the base of the bladder all the way out to the tip of the penis is felt as
urethral, penile pain. So pain in the prostatic urethra is felt out towards the
tip. A bladder stone can be felt as pain in the tip, a kidney stone passing can
even be felt as pain in the tip of the penis. The fact that he is feeling pain
along the urethra suggests that there's probably still some inflammation going
on and if he continues to have this he should talk to his doctor to follow up.
In addition, there are medications that are topical
anesthetics that will numb the urethral lining and possibly improve his symptoms
years old and about four to six months ago I started getting up once in the
middle of the night to urinate. At first it was every so often but now it's
happening every night, once a night. I stay away from drinking large amounts of
fluid two hours before I go to bed. During the day I go every two or three hours
depending on the amount of fluid I intake. Is it normal for me to be going like
this? I don't want to continue losing out on sleep.
He is right to be
concerned because most 24-year-olds do not wake up once at night to urinate.
Even men in their 40s, 50s, and 60s aren't happy if they have to start waking up
once at night every night. The fact that he is getting up makes me wonder.
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