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"Old guys" more often than not are familiar the sensation of needing to urinate without being able to urinate. By the time men are 85 or so, over 90 percent have prostate problems due to a cumulative problem called benign prostatic hyperplasia, or BPH.

At the age of 18, however, men are much more likely to have a different kind of prostate problem called bacterial prostatitis. Some doctors report that up to 10 percent of men under 25 have the problem at one time or another.

Some men will have no symptoms at all, while some men will experience most or all of the following:

  • Failure to urinate. This is the most common symptom.
  • A kind of whoa-what's-back-there feeling during ejaculation. It can feel like semen is being squeezed from the inside out. There can be pain in the prostate, or in the penis itself.
  • Fever.
  • Blood in the urine may occur, but it's very rare.

Prostate infections are usually acquired through what the medical textbooks will term meatal innoculation. That's another way of saying that germs (usually E. coli) from your partner's feces (or if you wear overly large, dirty underwear) enter the urethra at the tip of your penis and travel up to your prostate. When they get to your prostate, they tend to start traveling sideways rather than farther up your urinary tract. They get inside the glands that release semen, that surround the prostate horizontally, and your immune system tries to stop them from going any farther by creating inflammation. That inflammation is the reason you can't "go" when you want to "go."

Prostate infections can also occur as a result of having to use a catheter, but this is more common in men over 50.

If there's anything good about bacterial prostatitis, it is that it is "acute" in 95 percent of cases. Only 5 percent of infections go on to become chronic. If they do, however, you can have difficulty peeing and worse for the rest of your life. That doesn't have to happen.

There are some things you can do on your own:

  • Take a product called a stool softener. The idea is to make bowel movement easier. The less straining you do when you are on the toilet, the less pressure you put on your prostate. In the US and Canada, a stool softener called Surfak is available over the counter. In the UK and other Commonwealth countries, you may see it as Colace.
  • Drink more water. That may seem to be an odd recommendation if you can't urinate. However, unless you have severe prostate inflammation, it will make it easier to urinate when you finally have to go to the bathroom.
  • Take one Aspirin a day. It will stop minor pain, and it will also reduce swelling in the prostate. You just need the one Aspirin a day. More is not necessarily better.
  • The next time you and your partner decide to do anal intercourse, wear a condom.

The only way to get rid of the infection is antibiotics. (There actually are some Chinese and/or Japanese herbs that work for this problem, but it's easier to see a conventional doctor to get antibiotics.) However, your doctor will have to determine which antibiotics work best for you. There's a problem called antibiotic resistance that gives microbes the ability to survive antibiotic treatment, but it's not universal. Your doctor will know which drugs still work for the bacteria most likely to be transmitted in your area.

There is one other set of recommendations that will help that you aren't likely to find in medical books. It also helps to get over any problems you may have with "bashful bladder." One way to do this is to practice starting and stopping your stream during urination. This will also strengthen your pelvic muscles so you can urinate more easily when you have a prostate infection. The other way to do this is, and I'm not making this up, to wear minimal clothing when you exercise in public. Your urinary tract gets the message it's OK to release urine, too.

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