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Urology (Expert Forum)
Help!!
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Help!!
by Ffargo101, Apr 07, 2003 12:00AM
About 2 years ago I went on a cocaine binge that lasted a few months. Durning that time I had a few encounters of safe anal sex. Kind of excessive tho. After the last encounter I had an infection.
Something didn’t feel right I had a pain in my right groin and my right testicle. I was not able to have a good erection. And it just felt like an infection. Pain over my pelvis.
(I had a history of prostatitis and given terocycoline in the past on a few occasions.)
I saw a doctor and was given cipro for a few weeks. Some of the symptoms got better. Then I went on levequin for 4 weeks and cipro for four weeks. But to this day 2 years later I have a difficult time having an erection. I have no sex drive. My semen dribbles out. I have a slight burning pain in the tip of my penis (at times) which at times follows the course of the urethra to my anus. I feel it in my anus also. I am now 38 years old.
The urologist didn’t really do any tests. He just checked the urine on the office visit and gave me more antibiotics. I had an ultrasound which showed a lot of calcifications on the prostate.
My testosterone is normal like 1170 or something outta 1200. I get night time erections. Lastly I have an abnormal ejaculation, which seems to happen if I do not hold it back, before erect and is anti-climatic. I have a hard time getting an erection by my self. IF I ejaculate then it seems like the semen is less viscose. It seems think and is difficult to push out if I haven’t ejaculated in a few days. It is work to have an ejaculation.
Something didn’t feel right I had a pain in my right groin and my right testicle. I was not able to have a good erection. And it just felt like an infection. Pain over my pelvis.
(I had a history of prostatitis and given terocycoline in the past on a few occasions.)
I saw a doctor and was given cipro for a few weeks. Some of the symptoms got better. Then I went on levequin for 4 weeks and cipro for four weeks. But to this day 2 years later I have a difficult time having an erection. I have no sex drive. My semen dribbles out. I have a slight burning pain in the tip of my penis (at times) which at times follows the course of the urethra to my anus. I feel it in my anus also. I am now 38 years old.
The urologist didn’t really do any tests. He just checked the urine on the office visit and gave me more antibiotics. I had an ultrasound which showed a lot of calcifications on the prostate.
My testosterone is normal like 1170 or something outta 1200. I get night time erections. Lastly I have an abnormal ejaculation, which seems to happen if I do not hold it back, before erect and is anti-climatic. I have a hard time getting an erection by my self. IF I ejaculate then it seems like the semen is less viscose. It seems think and is difficult to push out if I haven’t ejaculated in a few days. It is work to have an ejaculation.
Doctor's Answer
by Kevin Pho, MD, Apr 08, 2003 12:00AM
, Apr 08, 2003 12:00AM
Hello - thanks for asking your question.
There are several prostatitis syndromes to consider. Of course, one would be acute prostatitis. This is normally treated with antibiotics - cipro and levaquin are appropriate antibiotics for this.
However, chronic prostatitis requires 4-12 weeks of antibiotics. Diagnosis is done be sampling and culturing urine and prostatic secretions before and after prostatic message. Make sure that the bacteria is sensitive to the antibiotics you are prescribed.
Another consideration would be a prostatic abscess. You may want to consider a pelvic CT to evaluate for this. An anal abscess should also be considered given the history of anal sex and discomfort - again, a CT scan would evaluate for this.
If you are having testicular symptoms, then a scrotal ultrasound would be prudent to evaluate for epididymitis.
If not already done, tests for chlamydia, gonorrhea and other STDs should be performed since the antibiotic regimen may differ from what you have already taken.
Any infection can interfere with ejaculation. You should appropriately treat the infection first (checking for the diseases I mentioned above) and then consider other causes of ejaculatory problems.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
There are several prostatitis syndromes to consider. Of course, one would be acute prostatitis. This is normally treated with antibiotics - cipro and levaquin are appropriate antibiotics for this.
However, chronic prostatitis requires 4-12 weeks of antibiotics. Diagnosis is done be sampling and culturing urine and prostatic secretions before and after prostatic message. Make sure that the bacteria is sensitive to the antibiotics you are prescribed.
Another consideration would be a prostatic abscess. You may want to consider a pelvic CT to evaluate for this. An anal abscess should also be considered given the history of anal sex and discomfort - again, a CT scan would evaluate for this.
If you are having testicular symptoms, then a scrotal ultrasound would be prudent to evaluate for epididymitis.
If not already done, tests for chlamydia, gonorrhea and other STDs should be performed since the antibiotic regimen may differ from what you have already taken.
Any infection can interfere with ejaculation. You should appropriately treat the infection first (checking for the diseases I mentioned above) and then consider other causes of ejaculatory problems.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (2)
by Ffargo101, Apr 07, 2003 12:00AM
To: Misc. (Urology)
0
by Ffargo101, Apr 07, 2003 12:00AM
To: Misc. (Urology)
0
