Complex male anatomy can lead to urinary infection in some men
Dear Dr. Roach: I am 79 years old and have had three separate incidences of epididymitis — not the same side, but all responding to Cipro. Why do old guys get these infections? — D.M.
Answer: Male genitourinary anatomy is complex. Here’s an overview:
Sperm are made in the testes. The epididymis is a structure in the testicle, sitting on top of each testis. Its job is to carry sperm from the testis through the vas deferens and ejaculatory ducts into the urethra.
However, in older men with enlarged prostate glands, there is extra pressure in the bladder while voiding, because the urethra goes right through the prostate gland, which makes most of the fluid in semen. The high pressure can cause the urine to flow backward through the urethra (the tube that carries urine and semen through the penis) into the epididymis — and even into the testes themselves, where urine does not belong. If the urine has even a few bacteria, these can cause infection in the epididymis and testes. Epididymitis (infection in the epididymis) and epididymo-orchitis (infection in the epididymis and the testis) are treated with Cipro
(or related antibiotics), because the antibiotics are concentrated in the urine.
Reducing bladder pressure — say, by treating an enlarged prostate — might reduce the likelihood of recurrent infections.
Dear Dr. Roach: Please tell me what happens to the blood drawn at labs and hospitals after the ordered testing is done. I’m very curious about its final outcome, and no one can answer my question. — L.K.
Answer: The blood usually is held in the laboratory for a period of time in case additional testing needs to be done on it, and then it is incinerated, which destroys any potentially infectious material. This often is done onsite in a large hospital or lab, under carefully regulated conditions. In some cases, it may be shipped for incineration. Very dangerous materials
(such as bacterial or viral cultures) will be sterilized first and then incinerated.