MEN'S HEALTH MATTERSTonsillectomy doesn't cause damage to the immune system, but does leave one more prone to infection
Q I AM A 20-year-old student. I have missed lots of classes over the past year with bad sore throats. My GP thinks I might need a tonsillectomy, but I have heard that this is very painful. What should I do?
AThe tonsils are collections of lymphoid tissue located in the oropharynx (throat). They are part of the body's immunological system (system that helps to fight infection) but their precise role remains controversial.
It is clear, however, that tonsillectomy does not cause damage to the immune system, and does not leave one more prone to infection or tumour formation.
Acute tonsillitis is often caused by streptococcus, staphylococcus or haemophilus (bacteria).
Typical patients may have an acute sore throat, fever, malaise and swollen neck glands. Individual episodes can last for several days.
Tonsillitis is a very common problem and can usually be managed by the patient or GP. Patients should take plenty of clear fluids and control fever with over-the-counter paracetamol. Your GP may prescribe penicillin if your symptoms are particularly severe.
Ear, Nose and Throat (ENT) surgeons may consider tonsillectomy if the episodes are recurring on a frequent basis. Five episodes per year for two consecutive years in a child or three episodes per year for two consecutive years in an adult are reasonable indications for surgery.
The operation is carried out under general anaesthetic and takes about 30 minutes. Patients are usually admitted on the day of surgery and discharged home the following morning.
Day case tonsillectomy is a safe option if the patient stays in hospital for five hours after surgery, lives nearby and has good support at home.
You can expect to experience some pain for seven to 10 days after your operation, but this is usually no more severe than a mild episode of genuine tonsillitis.
You will need to miss classes for one to two weeks after your surgery.
About 2-3 per cent of patients will experience a significant bleed from the tonsil bed within two weeks of surgery.
If this is more than a couple of mouthfuls of blood, you will need readmission to hospital, where the problem is usually very easy to manage.
Q I am 38 years old and saw my doctor because of severe urinary frequency and pain passing urine.
He treated me with antibiotics, but I still have discomfort behind my scrotum.
He told me that I had a bout of prostatitis. What is this and what is the likelihood of long-term problems?
AAcute prostatitis is an acute inflammation of the prostate gland, usually caused by a bacterial infection.
Men with acute prostatitis often present with chills, fever, pain in the lower back and genital area, urinary frequency and urgency often at night. They may also have burning or painful urination, body aches, and a demonstrable infection of the urinary tract.
Acute prostatitis is relatively easy to diagnose due to its symptoms that suggest infection. The organism (bacteria) may be found in blood or urine, and sometimes in both. Common bacteria are Escherichia coli (e coli) and Klebsiella.
Antibiotics are the first line of treatment in acute prostatitis, which usually resolves in a very short time. Appropriate antibiotics will be used, based on the bacteria causing the infection and those that have a good penetration of the prostate gland.
The majority of patients can be treated at home with bed rest, analgesics, stool softeners and hydration. However, in some patients, acute prostatitis may warrant hospitalisation for intravenous antibiotics.
Systemic infection from prostatitis is rare, but may occur in patients with a compromised immune system.
Patients who are unable to pass their urine will require a tube (catheter) to be passed into the bladder for a few days. Lack of clinical response to antibiotics (which rarely occurs) should raise the suspicion of an abscess and prompt an imaging study such as a transrectal ultrasound scan.
Full recovery without sequelae is the norm.
This weekly column is edited by Thomas Lynch, consultant urological surgeon, St James's Hospital, Dublin with a contribution from Mr John Kinsella, consultant ear nose and throat and head and neck surgeon
If you have a health question you would like addressed, e-mail healthsupplement@irish-times.ie.We regret we cannot enter into individual correspondence