The Prostatitis Foundation
 
Beginner's Guide To Do-It-Yourself Prostate Drainage

By Ron K

RonK's Disclaimer:

I am not a doctor and am relating only my own personal experience and opinions. Do-it-yourself prostate drainage is an experimental technique which is helping some sufferers. I take no responsibility if you try this and hurt yourself somehow. Neither, I'm sure does the Prostatitis Foundation. If you experience a fever or other serious illness within 24 hours of a drainage you should see a doctor immediately.

This article covers the following frequently asked questions:
What is prostate drainage?
Why would I want to do it myself?
Can anybody do it?
My arms are too short. Is there any other way?
What benefits can I expect?
Can't I get the same benefits from just taking antibiotics?
Couldn't I just ejaculate normally instead of having my prostate drained?
Is the improvement permanent?
What are the possible drawbacks to do-it-yourself drainage? Can I hurt myself?
How do I know I am doing it right?
How exactly does Dr. AEF. do it?
What do I need in the way of supplies and where do I get them?
Do I need any preparation?
Ejaculation? Do you mean I have to masturbate?
Can't I just skip the ejaculation?
How do you do it?
How long will it take before I see some results?
What happens if I miss a day or two?
How will I know when I'm cured?
How often should I do the drainage?
Why can't my uro do it for me?
Can I email you if I have any other questions?
2003 Update
What is prostate drainage?
Prostate drainage is an essential part of Dr. AE Feliciano's treatment for prostatitis. This drainage must be done every two days or the whole treatment may fail. The rest of the treatment consists of several cultures of seminal fluid to determine the cause(s) of the infection and to determine the best antibiotic or antifungal to take, followed by a course of the appropriate antibiotic or antifungal.
Prostate drainage is an advanced version of the digital rectal exam (DRE). The doctor inserts his gloved finger into your rectum and presses on portions of the prostate in an attempt to drain all of the trapped fluid.
Why would I want to do it myself?
Ideally, you don't. It would be nice if every uro was as skilled and knowledgeable as Dr. AEF (and open on weekends). However, there's only one of him and it's a long expensive plane ride to the Philippines. Until the treatment becomes widespread this may be the only option.
Also, are you really looking forward to spending a good chunk of every other day in the waiting room of your friendly uro just so he can do a five minute massage on you? Of course, there is also the matter of his fee which your insurance company is not too interested in paying for yet.
Can anybody do it?
No. You need to be fairly flexible and have long enough arms. Short stubby fingers might also be a problem. You also have to have enough courage to do it. It's kind of frightening the first time but gets to be routine after a while.
My arms are too short. Is there any other way?
There might be. Dr. Tarfusser uses his ultrasonic probe to reach where he can't. You might experiment with something like a long thin dildo if you can find one stiff enough. If it is too flexible that wouldn't work and you wouldn't want to use something that could break. It would also need to be easily sterilized.
You can also try to talk your wife or significant other into helping you. (Good way to find out if they really love you!)
What benefits can I expect?
There is no guarantee that do-it-yourself drainage will help, especially without the cultures and the antibiotics/antifungals, however, if done properly it may result in draining the clogged up pockets in the prostate (called acini). This draining of the swollen acini is necessary in order to allow the replacement of the infection saturated fluid with fresh antibiotic/antifungal laden fluid.
My own experience, even without the use of any antibiotics has been that regular drainage has resulted in a reduction or elimination of all symptoms. My prostate has actually shrunk in size since I began the regular drainages and I find that I no longer have any sitting pain or discomfort when urinating. Urine flow has also improved. The spot left by "the last drop" on my underwear has shrunk from bigger than a silver dollar down to smaller than a dime.
Can't I get the same benefits from just taking antibiotics?
No. The antibiotics cannot reach the infection when the acini are clogged. Only when they are drained regularly does the antibiotic get where it needs to go in sufficient quantities to do some good. Without the drainage all you do is breed your own supply of antibiotic resistant bacteria.
Couldn't I just ejaculate normally instead of having my prostate drained?
No. Once the acini clog up, a normal ejaculation does not drain them. If it did we wouldn't all be suffering from prostatitis.
Is the improvement permanent?
We don't know yet. Dr. AEF.'s full treatment appears to completely cure the patient. Do-it-yourself may only help to ease the symptoms until Dr. AEF.'s treatment becomes more easily available. You may need to continue on a regular schedule until then. It is too soon to tell.
What are the possible drawbacks to do-it-yourself drainage? Can I hurt myself?
The major drawback so far has been a slightly sore wrist due to the extreme angle required but this goes away quickly and after a while your wrist adjusts. It is conceivable that you could possible spread the infection to your urinary tract but so far that has not happened. See the warning in the disclaimer. There is a small chance that you could cut yourself with a fingernail but if you keep them short and wear a glove this should not happen.
You will probably feel an increase in the burning sensation in the region between your prostate and your penis after a drainage. There may also be some itching at the tip. This is caused by the high alkalinity of the infected fluid. Always urinate immediately after the drainage to wash the fluid away. I take 1000 mg of Vitamin C every twelve hours in order to make the urine more acidic to help neutralize the alkaline fluid.
Some people have reported that this seems to make their burning sensation worse Perhaps their infection actually turns it acidic instead (though supposedly this has only been seen in dogs and not humans). Anyway, if Vitamin C doesn't help I would experiment with antacids to see if that helped but it may just be that the urethra has been so irritated by the infection that the salt in the urine is enough to make it burn. Only solution then is to cut back on salt and take plenty of fluids.
There may be a short term reduction in flow but this usually clears in an hour or so.
Per Dr. AEF. drainage of the prostate has no negative effect on the prostate, though a bruised feeling is common at first. I suppose if you really tried you might do something dreadful like puncture your colon but this would take some doing.
Another poster (Scott) has been told to do this same drainage by his uro so at least one doctor thinks that it's not too dangerous. The worst I've had was a slight bruised feeling which faded quickly. No worse than what I got from some DREs.
How do I know I am doing it right?
You can feel the movement of fluid. If you get enough fluid movement you will see a few drops at the end of your penis but don't feel that you are a failure if you don't. It's a long way from the acini to the tip of your penis. If the burning sensation increases after a drainage then that is also a good sign that you have managed to get some out. Don't worry. You will get better and braver with practice.
How exactly does Dr. AEF. do it?
The following is from a post by Dave T. one of the first sufferers in our group to be cured by Dr. AEF written in response to my question.
How did Dr. AEF. drainage you? Was there anything special? Was it from one side to another? Did much fluid come out? Did he push hard to eradicate all fluid or was it a gradual process in which if a blockage didn't come out today, he didn't worry because it would come out later, etc. Can the prostate be damaged by drainage?
His drainage starts by inserting his right hand index finger and finding the middle of the prostate. (There must be either a ridge or indentation there that he can feel.) Then he prepares to counteract the pressure of the push on the prostate by putting his left had around your waist and onto your belly beneath the navel. He moves his finder to the right to the side of the lobe and pushes down as hard as he can. (He only uses 50% of his strength at first on sensitive prostates and then works up to 100% as your sensitivity lessons. As you can surmise, he pushes very hard.)
While holding down his finger down as forcefully as he can he slowly moves it towards the center. I never timed this but I would guess that the total pressing time is around 7 or 8 seconds. Then he finds the middle again and performs the same procedure on the left side. If you can stand it a second time he may repeat one or both sides depending upon whether the prostate feels hard (meaning it still contains fluid) or if too little prostatic fluid is extracted. (In my case he would often redo the left side saying that it needed more work.) The entire drainage procedure takes no more than a minute. He stops to collect a drop of prostatic fluid on a slide after each side is drained.
He is so good at feeling the prostate that he can detect when he is opening up blockages. And sometimes you can even feel them opening up yourself. (It's incredible!)
The pain isn't as bad as the above description would make it sound. In my case, I kind of groaned barely audibly during the first week or so of treatment while he was pressing. It was *nothing* near the type of pain that would make you scream out. The pain never got any worse as he went from 50% to 100% pressure during the first week. As your prostate heals and you get used to the drainage the pain reduces to nearly nothing. By the third week it was a piece of cake.
If you want to read more of Dave's postings, many are linked from the " Philippine Treatment " page at the prostatitis website
What do I need in the way of supplies and where do I get them?
Disposable gloves and KY jelly are a must. Gloves so you won't have to worry about scratching yourself with a fingernail or introducing new germs and so there is less mess, KY because Vaseline is almost impossible to wash off and isn't really as slippery. I use Kleenex to catch any discharge and to clean up with afterwards. Of course you also want to keep your fingernail cut back so as not to risk tearing the glove.
You can get everything you need at most pharmacies. I get my supplies at Wal-mart and use their Equate brand jelly.
Do I need any preparation?
I find that a hot bath followed by an ejaculation is the best preparation. The ejaculation clears out most of the fluid which is not trapped. The hot bath seems to open up more of the prostate and causes the ejaculation to produce as much fluid as possible. I also recommend 1000mg of Vitamin C every 12 hours starting at least the day before. This is to counteract the alkalinity of the discharge and also to make the urine less hospitable to bacteria.
I used to feel that a bowel movement just before the bath was necessary but I've since learned that it is not. The area where your finger goes appears to stay fairly clear all of the time.
Ejaculation? Do you mean I have to masturbate?
Not if you have an available partner, but if you don't, that's about the only way I know to ejaculate. Be warned that if you have a partner the infection can be passed back and forth so you should use a condom. If you have problems with masturbating a trip to your friendly neighborhood adult bookstore can help inspire you.
Can't I just skip the ejaculation?
Sure, Dr. AEF. doesn't require that his patient's ejaculate first. Ejaculation just lets you concentrate on the stuff that won't come out on its own. I think it works better this way but it's up to you.
How do you do it?
I find it's easiest for me to lay down on the bed on my left side (I'm right handed) and try to work my index finger into position. I generally start by bringing my right knee up towards my chest and then straightening up after entry. Note that the hand goes behind your back, not through your legs. (You can try it that way if you like but I don't think you will get good results.)
I usually start by massaging the opening a little and then inserting a finger in the easiest way with a little back and forth movement until I can feel that I have dilated enough. Then I insert my index finger so that the fingernail side is up toward my head. (This is the hardest part. You have to bend your wrist backwards as far as it will go to get it in.) You need to get the finger inserted this way. It's a lot easier the other way but then you don't have the strength or the reach that you need. This is really the hardest part and may be impossible for some people but I have long arms and it's not too bad though it does put some strain on my wrist.
Once you get your finger in place you will have no problem finding the culprit. It's that bump on the floor about an inch and a half in. Don't be surprised if it's bigger than an walnut. Mine was about the size of a small apple. Ideally you should be able to feel a depression in the middle but often because of the infection it will not be apparent. It may or may not hurt to touch it. This depends on how badly swollen it is. If it does hurt you may want to take some ibuprofen an hour before trying the drainage. If it really hurts and feels warm see a doctor before going any further.
Don't be in a hurry and don't press too hard at first. Move your finger around and learn your way around. Press lightly in each area and you will probably find an area where you can feel some fluid. This is the "boggy" feeling you may have heard your uro refer to.
You may also find some really hard areas. These are probably areas where the acini are so swollen that there is no give left. If the whole prostate is not infected you may also find a spongy area which is softer than hard area but doesn't feel like there is any fluid. This is what your whole prostate should feel like.
You may also find hard lumps. These are probably calcifications. (The body tries to isolate the infection by covering it with calcium sort of like the oyster does with sand to make a pearl. Luckily they don't get as hard as a pearl and can pass out of the prostate without pain.)
You should probably start with the boggy areas as these seem to be the easiest to drain. Press down gently using the pad of the first joint of your finger or the side of your finger. Don't use the tip. Kind of stroke it toward the center or the back. Take your time and don't scare yourself by pressing too hard. It's more important the first time that you get used to the idea. You may feel some movement internally. If you do, concentrate on that area for a while. Slow continuous pressure is better than sharp hard pressure.
With time you will learn your way around and it will get easier and you can apply more pressure and follow Dr. AEF.'s technique more closely. Don't be disappointed if you don't get any drops out of your penis. It's a long way from the prostate so takes quite a bit of fluid to get that far. I find that I have more luck pressing around the base on the left side and at the back so I assume that is where most of the my clogging is.
If you have really long fingers and are really determined you can also reach the seminal vas. Off to the left and right of the big bump and as far back as you can reach you may find a fluid filled area which can be drained in the same way. It also drains through the prostate and gets blocked because of the infection. If you can drain this area you might be able to reduce that pain or discomfort in your testicles.
Afterwards be sure to urinate immediately so as to wash out any infectious material you may have knocked loose. You don't want it lying around. Keep drinking a lot of liquid so as to keep washing out the infection. If the burning gets really bad try some more Vitamin C or some ibuprofen.
How long will it take before I see some results?
I noticed an improvement within 3 drainages but it will depend on your own prostate and your own skill. It's been almost 4 weeks now but I have seen a big change in my prostate. Where it was once swollen up like a ball it now has an almost normal left lobe and the central depression is there again. The right side is still hard so I'm not done yet but every day I get a little better.
What happens if I miss a day or two?
From my own experience you don't want to do that. I went four days without a drainage and lost a lot of my progress.
How will I know when I'm cured?
The only sure way is to have a culture done after a drainage. I would think that if your prostate has returned to normal and you haven't had any symptoms for at least two weeks that you might be over the worst of it. Even then I would recommend a periodic drainage just to be sure that the infection has not returned.
How often should I do the drainage?
At least every other day. You can do it more often if you like. It won't hurt anything. On weekends when I have the time I actually do two drainages every day.
Why can't my uro do it for me?
He could but he was taught that drainage is about on a par with bleeding the patient to get out the bad humors. It will take some time before we can reeducate the medical powers that be. This includes not only the teaching hospitals but also the insurance companies.
Can I email you if I have any other questions?
Sure. But first make sure you first read through Dave's stuff (Manila Reports). He's the best source of general information on Dr. AEF.'s methods. Dr. AEF. has also written an article which has just been posted. It's pretty technical but worth wading though especially if you are planning to do it yourself. I can be reached at: ronk@planet.ho.att.com
2003 Update
I guess the original DIY article was written back in 1996 and it's now 2003. Thought I'd add a little update on my condition. I'm still doing the massage but am down to about once a week or maybe every 10 days. My prostate feels totally normal to my doctor. The only symptom I still have is a tendency to a split stream but that usually goes away for a while after a massage. I recently had a complete rectal examination with camera and there was no damage or other sign that I'd been there. So I'd have to say it's a safe effective treatment – at least for me.

Over the years I have made a few changes in the procedure. I've switched to Walgreen's brand gloves size Large since they fit better than the Wal-Mart gloves (one size doesn't fit all) which seemed to shrink when they changed suppliers. Still use Wal-Mart's version of KY Jelly. I've tried other types of lubricant like Astroglide but they are not slippery enough. I now do the massage standing up with one leg up on a toilet or sink. Goes faster and seems a little easier and I can apply more pressure. I stroke the area a few times to relax it then dilate by inserting my thumb. (I can just barely reach the beginning of my prostate with the thumb. It has a little more power than my finger and does a better job on the small section it can reach.) I pull out the thumb and then insert my pointer finger (the one next to the thumb) with the thumb pointed up then press with the side of my finger. I find that dilation with the thumb makes it easier to get the finger in and doesn't tire the finger as much. I know most doctors are taught to use their middle finger since it is longest but I have tried both and the pointer finger has better reach – at least for me.

I recently started taking guaifenisen for a sinus condition. Shortly after my first dose of 800 mg (2 400 mg pills) I noticed a feeling similar to the burning I get after a good massage. I think it managed to loosen up a few blocked acini all by itself so it might actually make the drainage a bit more productive by thinning out the mucus. I got it off the web from one of the links at http://guaifenisen.com without a prescription. (http://www.healthpx.com/hpe/) It seems it is supposedly a good treatment for a variety of other diseases. For those of you not familiar with it, it is an expectorant found in many over the counter cough syrups.

For what it's worth I tried Saw Palmetto extract and it definitely increased the amount of fluid that comes out but it makes my prostate feel uncomfortably full so I don't take it. For those of you who measure the success of the massage by the amount of fluid you get out you might appreciate it. My feeling is that it definitely increases the amount of prostate secretion but if your acini are not draining as they should this might not be a good thing.

---Ron

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