Prostate Issues: Questions About Symptoms and Tests

Prostate issues!

Hello Doctor, thank you for your previous response! However, it seems that the second email was missed.
I would like to ask you again.
I'm sorry! After my first inquiry, I followed your advice and went to the hospital for an examination the very next day.
I wrote this email to you immediately after my visit.
However, it seems that the doctor mentioned that if it were a sudden issue, it would be unlikely to affect the prostate.
The doctor advised me not to engage in such activities with my girlfriend.
Next, they arranged for a urine test, which showed 3-5 (unsure of the unit) hemoglobin, indicating bleeding that was not visible to the naked eye.
The doctor then said they needed to extract prostatic fluid and proceeded to massage the prostate.
I felt very uncomfortable during the procedure, and the doctor remarked, "Wow, you’ve used it all up" (I felt very embarrassed at that moment) because no fluid could be extracted.
The doctor then said it was okay and instructed me to collect 5cc of prostatic fluid from the initial part of my urine stream and then to collect 10cc from the midstream.
After that, I was to discard the remaining urine.
(Both the 5cc of prostatic fluid and the 10cc of urine were to be cultured to check for any bacteria.)
Now, the issue is that the 5cc I collected looked like urine to me; it didn’t have the thick consistency of prostatic fluid! The doctor told me that since they couldn’t extract it, they wouldn’t prescribe any medication for now and asked me to return on Tuesday to discuss the results.
My question is: since there is blood in my urine, is it really okay not to take anti-inflammatory medication? Also, since they couldn’t extract the fluid, should I ask the doctor to try again on Tuesday to obtain the prostatic fluid for testing? (Because I really feel that the 5cc is urine; during the extraction, I had a strong urge to urinate, which was quite uncomfortable.)
Additionally, could the prostatic fluid be depleted to the point that it causes bleeding when trying to extract it? If that’s the case, it should heal on its own, right? What conditions can lead to prostatitis? Regarding the colonoscopy, there were some blood streaks on the tip of the massager; could this be what the doctor referred to as fibrosis? (I’ve been applying medication for internal hemorrhoids, fearing inflammation in that area.) Also, is the infertility check the same as a sperm analysis? Can these tests determine if there is any blockage? Should I wait 1-2 months after stabilizing before undergoing these tests? Since the doctor hasn’t prescribed any medication for me, I’m currently taking vitamin C, vitamin B, and zinc.
Is that okay? I’m also eating a very light diet.

Lastly, at this stage, how long do I need to rest before I can masturbate to check for any issues with my sperm? I apologize for having so many questions, but I would greatly appreciate your help in answering them! I was really shocked when the doctor mentioned infertility; I even cried that night while trying to sleep.
Thank you, Doctor!

Wei, 20~29 year old female. Ask Date: 2012/02/09

Dr. Xu Weikai reply Urology

Hello, the examination of prostatic fluid is generally performed by analyzing the secretions obtained after a prostate massage by the physician.
Typically, the fluid is collected from the anterior urethra, or by gently squeezing the ventral surface of the urethra with a finger to obtain the secretions.
As for bleeding, it indicates injury, which could be caused by infection or external trauma.
To check for obstruction, the primary concern is to assess whether it affects fertility.
Since obstruction tests can be quite complicated, a semen analysis can serve as a partial substitute to indirectly confirm the condition.
This can be done 1-2 months later.
Regarding abstinence, it is recommended to refrain from ejaculation for one month to allow the injury to heal.
If there are any unclear points, feel free to ask again for further discussion and research.
Responses from the internet should only be used as a reference; it is essential to seek medical care at a healthcare facility if necessary.
This message is from Dr.
Hsu Wei-Kai, Chief of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2012/02/09

More Info

Understanding prostate issues can be quite complex, especially when symptoms and diagnostic procedures are involved. Based on your description, it seems you are experiencing a range of symptoms that could be related to prostate health, and you have undergone some preliminary testing. Let’s break down your concerns and provide clarity on each aspect.

Symptoms and Diagnostic Procedures
1. Urinary Symptoms and Hematuria: You mentioned that your urinalysis showed 3-5 (presumably red blood cells per high power field) which indicates hematuria, or blood in the urine. This can be caused by various factors, including urinary tract infections, kidney stones, or prostate issues. It is essential to follow up with your healthcare provider regarding this finding, as it may require further investigation.

2. Prostate Examination: The discomfort you experienced during the prostate examination is not uncommon. The prostate can be sensitive, and the procedure to express prostatic fluid can sometimes be uncomfortable. If the doctor was unable to obtain a sample, it may be worth discussing the possibility of repeating the procedure, especially if you feel that the sample you provided was not representative of prostatic fluid.

3. Prostatic Fluid and Urine Confusion: It’s understandable to be concerned that the fluid you provided was urine rather than prostatic fluid. Prostatic fluid typically has a different consistency and appearance. If you are uncertain, it’s reasonable to ask your doctor for clarification and possibly a repeat test to ensure accurate results.

4. Antibiotics and Inflammation: Regarding your concern about not being prescribed antibiotics despite the presence of blood, your doctor may be waiting for the culture results from the urine and prostatic fluid to determine if there is a bacterial infection that requires treatment. If the cultures come back negative, antibiotics may not be necessary. However, if you experience worsening symptoms, it’s important to communicate this to your healthcare provider.

5. Prostate Inflammation: Prostatitis, or inflammation of the prostate, can present with various symptoms, including pain during urination, pelvic pain, and sometimes flu-like symptoms. Chronic prostatitis can be particularly challenging to diagnose and treat, as it may not always involve an infection.

Fertility Concerns and Testing
1. Fertility Testing: You asked whether infertility testing and sperm analysis are the same. While they are related, they are not identical. A sperm analysis evaluates the health and viability of sperm, while infertility testing may include a broader range of assessments, including hormonal evaluations and imaging studies to check for blockages in the reproductive tract.

2. Blockages and Sperm Health: If there are concerns about blockages, a urologist can perform specific tests, such as a semen analysis, to assess sperm count, motility, and morphology. If there are abnormalities, further imaging or tests may be necessary to identify any blockages.

Lifestyle and Recovery
1. Diet and Supplements: You mentioned taking vitamin C, B vitamins, and zinc. These can support overall health, but they are not substitutes for medical treatment. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins is beneficial for your overall health and may support prostate health.

2. Rest and Recovery: After any medical procedure or during a period of health concern, it’s wise to allow your body time to recover. If you are considering resuming sexual activity or masturbation, it’s best to discuss this with your healthcare provider, who can give you personalized advice based on your current health status.

3. Emotional Well-being: It’s completely normal to feel anxious about health issues, especially those related to fertility and sexual health. If you find that these concerns are affecting your mental health, consider speaking with a mental health professional who can provide support.

Conclusion
In summary, it’s crucial to maintain open communication with your healthcare provider regarding your symptoms, test results, and any concerns you may have. Follow-up appointments are essential for monitoring your condition and adjusting treatment as necessary. Remember, you are not alone in this, and there are many resources available to help you navigate these challenges.

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