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QUESTION: How common is a male urinary infestation from a partner or the bedroom environment? Assuming sdi tests factor out a virus and antibiotics factor  out a bacterial infection?

If someone has prostatitis and antibiotics generally make it feel better  but without them it generally doesn't seem to get worst pain-wise after a while. When can one assume  they simply weren't on antibiotics long enough? If prostatitis is determined how does one convince their  urologist to prescribe a long enough amount of antibiotics to get the best possible  result?

ANSWER: James:

Please clarify what you mean by a "male urinary infestation".  If you mean a urinary tract infection or STD, then you can pretty much eliminate sexual contacts as a source.  In general, male UTIs are relatively uncommon but we see them fairly often in a urology speciality practice.

It is not possible to give a verifiable generality about antibiotics in prostatitis.  In general, we typically give an antibiotic for at least 4-6 weeks, and then continue it for as long as it appears things are improving.  Once we hit a plateau with no further progress, it is reasonable to switch antibiotics.

As far as how to convince your urologist to treat your infection long enough, I have no specific suggestions except to do your own research and try to share this information with him.

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QUESTION: By infestation I mean something larger than bacterial. Like a super small insect. I've been tested for STIs and assuming that getting tested for many things only once and making no sexual contact since I assume that is factored out. And having been on two different antibiotics I want to assume all bacteria is killed because the pain remains the same but doesn't really get worst. Urologist or at least their assistant seems reluctant to give me every antibiotic in the book to see what works so I assume that is off the table. If prostatitis is the case I don't know how to convince them it is the only thing it could be but I seem to lack  half the symptoms including painful urinating  or ejaculation.

If someone has prostatitis or something  similar should they ejaculate  often or as little  as possible? Before the pains I masturbated every other day to ejaculation. So far now it has been a couple weeks. What is the normal? I am thinking I might have over done it in my life.

ANSWER: James:

I am not aware of any "infestation" that affects the prostate.  Such might not be impossible, but would be quite unlikely at least in the US.  

In most cases, we recommend frequent ejaculations to help drain prostatic fluid.

There are several standard antibiotics that typically work including fluroquinolones (cipro) tetracyclines (doxycycline), and sulfa/trimethoprim.  

You don't need to have all the symptoms to make the diagnosis.

Try sitting in a hot tub and some of the other therapies I previously recommended.

---------- FOLLOW-UP ----------

QUESTION: Can you recommend a brand and type of car seat that can make driving less painful? I drive everyday and often. Is there a big risk of prostatitis spreading to cause more serious harm in other parts of the body? Is prostatitis usually curable in a years time or shorter? I've only had sex with one person so far in my life and I hate feeling so resentful towards them.

Answer
James:

We cannot give any specific recommendation for a car seat, but the idea is to have a thin or open central area with additional support surrounding it so a standard cushion or gel/memory foam product is not necessarily going to help much depending on the design.

Prostatitis is curable in the majority of patients.  that also means that there are some that continue long term despite treatment.

There is only a minimal risk of prostatitis spreading to other organs.

You shouldn't blame your sexual partner as many men develop prostatitis without ever having sex.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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