Cautionary note: This page does not express anything like a "scientific fact." It expresses, mostly, the opinion of the webmaster after three years' involvement in discussions about prostatitis.
Also see a file on Contraindications to Drainage, or another file about do-it-yourself drainage

1-03-2010
Chronic Bacterial Prostatitis - Message from Doctor Polacheck

For the past 12 years, I have been studying the cause of Chronic Prostatitis. Symptomatic patients have come to our Center from all 50 States of the United States, as well as from the Americas, Europe, Asia, Africa, the Pacific and Australia seeking a diagnosis (and then treatment). In order to make a specific etiologic diagnosis, a vigorous prostate massage was done daily for one week. The expressed prostatic secretions (EPS) were collected and cultured for bacteria and bacteria-like organisms. I would like to report the results from 600 consecutive patients: over 99 percent were found to have a bacteria or a bacteria-like organism, and many patients had multiple organisms. Therefore, this disorder should be properly called: Chronic Bacterial Prostatitis.

On the other hand, read one man's testimonial on drainage.

If a comedian ever mentions the prostate gland, it is usually in reference to the dreaded "DRE," or Digital Rectal Exam, where the doctor puts his gloved finger in a man's rectum to check out the health of his prostate gland. It's a basic part of a physical exam for men over 40, and comics act like it's the end of the world.

Drainage can help with symptoms even if bacterial infection is not a problem. The dreaded DRE, however, is a basic step to eliminating bacterial infections of the prostate. Infection may be a major factor, if not the sole cause, in many cases of prostatitis, even if cursory culturing does not show bacteria.

A very firm DRE, done with the intention of draining, or wringing out the prostate gland, we call "Drainage." Drainage has the effect of getting rid of built-up pus and dead cells, and shrinking the gland, relieving symptoms. Leakage of these "caustic contents" of the prostatic acini may be one cause of some of the sytmpoms of prostatitis. Drainage gets rid of the caustic contents, and causes the gland to refill with blood, helping antibiotics reach disease organisms. It can shrink the gland to the extent that symptoms go away, at least for a while.

It used to be, in the age before antibiotics (before about 1960 for prostatitis), doctors performed drainage, sometimes called "massage," when their patients had prostatitis. In some cases it was enough to cure them of the disease. But since drainage is always at least uncomfortable for the patient, and usually at least slightly embarrassing for both doctor and patient, and time consuming, it fell out of common practice with the advent of antibiotics. It's much easier to prescribe a pill and send the patient home.

There's another aspect of drainage that bears consideration. Some people's symptoms may be caused or aggravated by muscle tension or undesireable nervous system responses. One of the therapies for this includes pressing on pressure points within the pelvic area that are reached in the same way the prostate is reached during drainage, in other words, rectally. It has been suggested that some of the reported benefit of drainage is because of this stimulus. For more on this theory, see the muscle tension page and refer to the links in the left column of that page.

Your prostate gland is a complex structure of tiny acini, or sacs, in which bacteria can grow. Once they grow there, the swelling and inflammation caused by the infection closes off the sac, causing it not to "shed" bacteria, and protecting the bacteria inside from antibiotics and your body's own immune cells. (For more on this, see biofilms.html .) As more and more acini get closed off, your prostate begins to swell and interferes with your other normal urinary and sexual functions. Even if you don't currently have an infection, your body's immune system can cause your acini to clog and swell.

A few points about drainage:

• Drainage can be painful, especially when it is done for the first time. It is never comfortable.
• Drainage can become less painful and less uncomfortable the more often it is done.
• If you are doing drainage with antibiotics, doing it at least three times a week is optimal. Any amount of drainage can help, however.
• Drainage can be done by anybody. You don't need a doctor. You can have your partner or another person do drainage for you, as long as that person wears non-latex gloves and uses a safe lubricant. If you are long-armed and supple, you can even drain yourself. This website has do-it-yourself instructions and comments on non-doctor drainage.
• Drainage should only be done by a human finger. Objects are bad for drainage because there is no "feel." Some people, however, do drainage with objects and don't hurt themselves. We recommend against this.
• Drainage should not cause any harm to you. (See the cautionary note about epidydimitis patients.) After initial drainages, you may experience more burning than you had just before, because the stuff that comes out of the clogged acini is caustic. This side-effect will improve if you continue draining. Of course the person doing the drainage should have very short fingernails.

Drainage is essential to getting a good lab test to discover what bacteria you have. Without drainage, you may not find any bacteria. Of course there could be no bacteria there to find...

Comedians will still make fun of the DRE. We can laugh too. But for those of us who suffer from prostatitis, drainage can be a valuable tool.

I wish you the best of health, and the best of medical care.

Ken Smith

.........................................................................................
This information is forwarded to you by the Prostatitis Foundation. We do not provide medical advice. We distribute literature and information relevant to prostatitis. While we encourage all research we do not endorse any doctor, medicine or treatment protocol. Consult with your own physician.

© The Prostatitis Foundation
.........................................................................................