Scrub, Rinse, Repeat

A Surgeon’s View of on Patients, Doctors, and Health

Saved by Prostatitis

He was lucky: It was just prostatitis.

She must have been very attractive. Otherwise, why would he cheat on his wife?

I've known Cesar for more than 10 years. He first came to me for a rising PSA: Prostate-specific antigen, a serum protein that measures a man's risk of having prostate cancer. He has a family history of prostate cancer, so his risk is higher than average. So between the PSA and his relatives, he was worried. Biopsies were negative and for years we just followed.

It had been over 3 years since I had seen Cesar. He came in looking pallid and drawn. Even his super neat banker's suit and colorful tie did not average out the look of distress.

Cesar told me his urethra hurt. Tha's a funny thing. Urethras don't hurt. They burn. So it was a funny way of describing what he had.

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Other than a hurting urethra, he had no complaints: No fever, no bleeding, no nothing. Except a night that stayed on his mind.

Cesar travels a lot. Usually to Russia, a land blessed with abundant feminine beauty. Cesar loves his wife. He's been married to her for many years. He has no idea how it happened, that after dinner with business associates, he found himself naked and unprotected between this temptress' enveloping legs. Yet there he was, having sex with a stranger.

The physical exam was normal. I found nothing. But that means little. I'm a prostate cancer and chronic prostatitis kind of urologist; neither is an infectious disease. Actually, I never did like the whole thing about infectious diseases and sexually transmitted diseases. Except once, at a fancy dinner at the New York Academy of Sciences, I got a chuckle when my wife stopped eating when the guest professor showed slide after slide of venereal warts. Ha ha, aren't condyloma endearing?

So off Cesar went to see an infectious disease specialist. This one is good! Really good! He's the one who diagnosed that anthrax case a few years ago. And saved his life. Cesar would be in good hands. Although around Cesar we don't say "good hands" any more. It wouldn't be fair.

The infectious disease guy called me. Did Cesar tell me he had had unprotected sex not only with Miss Colombia Congeniality but also, upon his return, with his wife? Oops. No. He failed to mention. No wonder he looked so pale.

The infectious disease guy gave Cesar a shot in the rear. And a pill in his mouth. And an instruction: From now on, protected sex only, for at least 3 months, including with your wife!

Yeah, right. Hi, honey, I'm home. Wanna have sex? Oh, wait, just a minute. I want to put on a condom, which I haven't done in 20 years of living with you. Sure ... a wife would understand and not ask any questions.

This is where I got to play a kind of incidental hero. Cesar came back to be examined. He still looked awful. And he still had urethral pain. And he still loved his wife and wanted to stay married to her. As luck would have it, and it really was lucky, I found prostatitis. How? By pressing on his prostate and seeing him jump to the ceiling. Classic! Acute prostatitis, the disease of the sexually active. The good news, it's caused by plain old bacteria. The kind you find on your finger, in your teeth, and ... happily ... a wife's vagina. So hey, he coulda gotten it from her! Happy days!

This was terrific news. Cesar would need a month of oral antibiotics and to refrain from sex for at least 6 weeks. Doctor's orders. Honey will have to fend for herself. And under the circumstances, with a family history of cancer and one prostate biopsy already, she wouldn't ask too many questions. Heck, if it wasn't for the doctor's orders, Cesar probably would have gotten more action for sympathy than ever.

So the morals of our story are simple:

  • Don't cheat.
  • If you cheat, wear a condom.
  • If your urethra hurts after cheating, go see the doctor before you have sex with your wife, especially if you'd like to stay married.

Copyright © 2010 Arnon Krongrad, MD

Arnon Krongrad, M.D., specializes in surgery for prostate cancer and chronic prostatitis.

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