Prostatitis exam

Does anyone have any experience with physical exams due to prostatitis?

When I check the internet some sites suggest antibiotics are prescribed after a urine exam… other sites suggest a urine sample is taken and after a prostate massage an other sample is taken.

Does anyone have any real life experience on this subject?

Not prostatitis per se, but back when I was 26 years old, I had a case of epididymitis. That's an inflammation of the epididymis, which is the little sac that surrounds part of each testicle, connecting it to the spermatic cord. I had an examination by a urologist who first had to rule out prostatitis. So he milked my prostate through digital rectal exam and examined the fluid under a microscope. I wrote an account of the exam in my blog, if you'd like to read more details.

https://en.zity.biz/index.php?mx=blog;ox=showpage;pg=6821

Done that rodeo multiple times.

You'll probably get a urine test to differentiate between UTI and prostatitis. Provider may or may not do a DRE to feel the prostate texture. If the prostate is intected it feels different ("boggy" is the word they use) to a non-infected one, but I only got this on my first one. After that they just relied on symptoms and the urine test.

You may also get a STI screen, as these can sometimes be an issue in prostatitis.

I keep expecting my doctor to say "you've been in here enough that we need to get you to a urologist" and have a more detailed look at it, but that hasn't happened yet.

Oh, one other thing. You might get a referral to a PT to have a pelvic floor evaluation. This can help if muscular dysfunction is a component.

I had it last year. The PA did an instant test for microscopic blood in my urine and prescribed a sulfa drug. Next day I was contacted via MyHealth that I didn’t need the antibiotic. OA was female. My symptoms persisted so I made an appointment with my doctor group and saw a male doc. He again ordered urine, bloodwork for STI and PSA. HE told me to keep taking the drug previously prescribed. Two days later I was asked to come back in as my PSA was high at 17! At that appointment he told me the PSA score told it all: prostatitis! I ended up taking a different drug for 6 weeks. It took 3 months for my PSA score to return to normal but in between that I had at least two other PSA tests that showed declining scores.

No DRE. STI came back negative too.

@Srgfgahs If you don't mind me asking, what were your symptoms that got your ordeal started?

@BenDover my primary symptoms were a slight burning sensation in my urethra and milky discharge.

@BenDover my primary symptoms were a slight burning sensation in my urethra and milky discharge.

Start, then it moves up (in me anyway) to the center of the pelvis and gets worse to where you dread peeing or ejaculation, then eventually just about everything you do hurts in the center of the pelvis. That is odd now that I think about it, first time they did the PSA but not subsequently, and prostatitis is known to cause a spike in PSA levels.

I had recurring urinary tract infections, would clear up for a few weeks and come back. Went to my urologist and she examined my prostate and said it was soft and boggy which was a sign of chronic bacterial prostatitis. She massaged my prostate for a few minutes and collected the secretions at the tip of my penis to look under a microscope and then had me pee a small amount into a specimen jar to send away. The prostate massage was actually pleasurable and took my mind away from the other symptoms. Had to take antibiotics for 3 months to clear it up

I had an inflamed prostate, so my doctor took two urine tests and tried pressing my prostate with his finger, which was tender. I was given antibiotic tablets that lasted for 2 weeks and had to be taken 3 times a day

This all started 2 years ago.

These dam doctors don’t listen I had to go to a urologist my primary doctor said my PSA was 9 and then the Urologist said it was 12 I ask could I have an prostate infection and after 2 years 2 biopsy’s and a 2 MRI the urologist put me on a 2 week dose of antibiotics and 3 weeks later my psa dropped to 2.3 now I go back to enjoying my Foley’s

I had it in september of 2023 but i report it to the hospital with a fever weak unable to pee. And the er did what i always do take all sorts of samples give it to the doctor the results and later on he came and told me i had that. I had a week stay. They actually were going to do surgery but the backup for surgery was almost 3 months and i told them that will not do and i cancel the surgery by some act of god i'm not even taking medication and not having problems thank you dear lord

Urine dipstick is common. Rules out other UTIs. Beyond that it varies. Sometimes I have had a DRE to check for "boggy" prostate, sometimes they just say "ah" and write out a prescription for antibiotics. Once the doctor ran a gonorrhea test because evidently that is sometimes a cause. Never had the prostatic fluid check, but every so often I get hints from the doctor that if it keeps occurring they will look into it more, which might involve that.

I have ongoing or how my urology PA comments, lifelong, that being bladder incontinence & urinary retention, (isotopic or atonic ) spermatocele, (already one surgery) and high riding prostate, so yes, a lot going on all the time. Several times treated for Prostatitis with antibiotics. Yes 100s of DRE's. I do think prostate milking that is done for me does help much better then antibiotics.

I had prostatitis following a catheter session about 7 Years ago.

Symptoms were:

- Fever, chills, and feeling very sick for about 5 days

- Pain when urinating

- Pain in the area between the scrotum and rectum

- Discomfort of the penis and testicles

- Painful ejaculation

I was astonished how such a small organ could make you so sick.

Because of the heavy symptoms I went to my general practitioner right away.

She listend to my complaints, gave me a DRE, diganosed Prostatits, prescribed Antibiotics and reffered me to an urologist.

I saw the urologist about 3 weeks later. At this point all symptoms were gone.

The urologist did another DRE, took a blood and urine sample and wanted me to bring in a sperm sample.

After the result of all test were available she told me, that everything seemed to be ok again.

She warned me to refrain from all manipulation of the prostate and to avoid catheters whenever i can, as this could easily lead to a relapse of the prostatitis.

Until today I followed her advice even if it is hard for me, considering that I like catheters very much.

I had prostatitis following a catheter session about 7 Years ago.

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i too got a prostate infection from inserting a catheter for a vid i made for Dom Guy. No prostate massage when i went to the doctor, just a urine sample. my primary symptom was a full feeling and difficulty urinating, urethral obstruction due to the swollen prostate. Doctor prescribed antibiotics and Flowmax and the symptoms went away in a few days. i didn't tell the doctor how i got it the infection, too embarrassed. i also found the doctor attractive, so not sure how i would felt if He'd done a prostate massage?

I got prostatis about 14 years ago. I had a pain in my balls and behind them. I also had abdominal pain and frequent urination.

I ended up going to the urgent care, and they referred me to a urologist. They fondled me in the front and then gave me a DRE. “Bogey” was the exact word the nurse practitioner used to describe my prostate. They gave me antibiotics and it went away in less than a week. It has reoccurred from time to time, and usually occurs for 2-3 days and then begins to recede without antibiotics. I think i’ve seen my primary care Doctor, once since the diagnosis specifically for prostatis.

i too got a prostate infection from inserting a catheter for a vid i made for Dom Guy. No prostate massage when i went to the doctor, just a urine sample. my primary symptom was a full feeling and difficulty urinating, urethral obstruction due to the swollen prostate. Doctor prescribed antibiotics and Flowmax and the symptoms went away in a few days. i didn't tell the doctor how i got it the infection, too embarrassed. i also found the doctor attractive, so not sure how i would felt if He'd done a prostate massage?

@tallslenderguy Dint know Catheters could cause prostate infections. The urethra passes through the prostate but the cath doesn’t touch it. Not sure of the connection between the prostate, or how prostate fluid gets into the urethra when you ejaculate, but there has to be some connective path for that so I suspect a urinary infection could sneak in to the prostate (not a doc or medically literate here!). Any info how the two are connected would be interesting.

I suspect you would have enjoyed a DRE from an attractive male doc given your disposition! for men. 😉

BTW it’s “Flomax” not “Flowmax” - looks like spellcheck got you, but as a medical pro, surprised you didn’t catch it. 😀😀😀

@tallslenderguy Dint know Catheters could cause prostate infections. The urethra passes through the prostate but the cath doesn’t touch it. Not sure of the connection between the prostate, or how prostate fluid gets into the urethra when you ejaculate, but there has to be some connective path for that so I suspect a urinary infection could sneak in to the prostate (not a doc or medically literate here!). Any info how the two are connected would be interesting.

I suspect you would have enjoyed a DRE from an attractive male doc given your disposition! for men. 😉

BTW it’s “Flomax” not “Flowmax” - looks like spellcheck got you, but as a medical pro, surprised you didn’t catch it. 😀😀😀

Haha, yeah, got me. i usually call it tamsulosin, but figured people are more familiar with the brand vs generic name. As i look at it, adding a W does make a sort of sense though, eh? The implication is it helps urine flow, not Aunt Flo.

The portion of the prostate gland that lines the urethra has "prostatic ducts" that connect to the urethra. The ducts are surrounded by cells that produce prostate fluid for the ducts, smooth muscle encompasses all that and during ejaculation the muscle squeezes the duct and squirts prostatic fluid into the urethra via the duct. There's epithelial cells betwixt the duct and urethra, sorta a permeable membrane. i think of it like a sponge with muscle, though it is more complex, it gives me a visual.

Bacteria are small and can cross that membrane. Pushing a catheter into the urethra and into the bladder slides right through the portion of the urethra lined by the prostate with the ducts that lead into and out of the prostate gland. Inserting a catheter is a sterile procedure. When i do it for a patient, i clean the penis with a whole package of wipes first, about ten wipes. One wipe, throw away. Mechanically removing pathogens. Then clean the tip of the penis 3x with iodine. There's a sterile field, the catheter is sterile, you put on sterile gloves right before inserting the catheter, one hand holds the penis, the other the lubed catheter that has just come out of a sterile wrapper. If any bacteria comes in contact with any of those points, the penis, the hand, the catheter can introduce the bacteria into the urethra as it is inserted... and goes right past the prostate and ducts on it's way to the bladder.

We have bacteria living all over us. Infection happens when bacteria get a strong foothold that overwhelms the bodies defense system. Bacteria congregate together (biofilm), i think of it as an army vs a few soldiers, and attacks and overcomes our bodies defense system (infection). We sometimes use an ally from another country (antibiotics) to overcome the invaders to where our bodies defense system can once again obtain the upper hand.

That's over simplification, but it's pretty fascinating how it all works. Ultimately, our body heals itself, or does not. Drugs like antibiotics really just aid that process, but are pretty non specific and kill beneficial bacteria in the body as well, so their use is can often be like killing an ant with an elephant gun.

Wow - wish nurses were as thorough when I had mine done in hospital. I got the worst infection of my life as a result.

Wow, yeah, sorry that happened. Honestly, i was very careful when i inserted one into me, but i seem particularly susceptible. There are guys who straight cath routinely several times a day at home, and i guarantee many are not following strict sterile procedure, and many do not get infections, so i do wonder if some do not build some sort of resistance? my only STD's have been from receiving oral sex and i'm a total bottom who is mostly anally receptive. It's not an exaggeration to say i have sex anally receptive 100x more (really more) than oral, but for some reason, my penis is susceptible and i get a prostate/urethral infection.

When i was younger, i got an infection from oral sex and the doctor did a very long prostate massage before obtaining a UA. i wonder to this day if He was really indulging Himself, but i'll never really know. i think it likely that prostate massage for a UA is pretty rare, and really unnecessary, i've never seen it in the 11 years i've been a nurse and we obtain UA's all the time. Often using a straight cath, which bypasses the prostate altogether. Chances are, if one has an infection in that region, it's not going to be isolated to just the prostate.

I had this antibiotic and still have some left that was Soo strong my stomach intestines and asshole ( no kidding) was burning. Took it for 2 1/2 months and it knocked it out. I told the doc NEVER AGAIN