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Urology (Expert Forum)
Pain in Uretha
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.
Pain in Uretha
by EverReady, Mar 16, 2004 12:00AM
Just over six weeks ago I had an unprotected oral sexual encounter (I am a 47 year old male) 3-days following this encounter I experienced a slight burning sensation when urinating. Went to the doctor and was given a urine test which was negative for any bacteria. There was no discharge present so no treatment was given. 3 days later a slight discharge appeared and so I returned. I was immediately treated with an injection of Ceftriaxone (Rocephin) for possible Gonnerea infection and a course of Vibramycin 100mg twice a day for 7 days for Chlamydia etc. The discharge cleared up completely, but the mild burning and general sensation of discomfort did not. I returned and another urine test showed negative for everything.
I then visited a urologist (week 3) and had a complete physical examination including a digital rectal examination of the prostate and a urinalysis. He declared that all was normal and the urinalysis was negative, no bacteria, just a very slight rise in WBC, although still within the norms. The urologist suggested I might have a mild underlying infection and I was given a course of Levofloxacin (Cravit) 250mg twice a day for 7 days. The symptoms persisted and I returned (week 4) and was given another 7 day course of Cravit. However 14 days of this antibiotic have not cleared up the infection and the symptoms persist (a general dull ache in the urethra which seems to be centered on the last inch or so which feels like an inflamation). During this time I have experienced no other symptoms i.e., no lesions, blisters, bumps, redness, itching or fever.
I am assuming I have some sort of non specific urethitis and would much appreciate any advice on my next course of action as I am now, getting anxious.
I then visited a urologist (week 3) and had a complete physical examination including a digital rectal examination of the prostate and a urinalysis. He declared that all was normal and the urinalysis was negative, no bacteria, just a very slight rise in WBC, although still within the norms. The urologist suggested I might have a mild underlying infection and I was given a course of Levofloxacin (Cravit) 250mg twice a day for 7 days. The symptoms persisted and I returned (week 4) and was given another 7 day course of Cravit. However 14 days of this antibiotic have not cleared up the infection and the symptoms persist (a general dull ache in the urethra which seems to be centered on the last inch or so which feels like an inflamation). During this time I have experienced no other symptoms i.e., no lesions, blisters, bumps, redness, itching or fever.
I am assuming I have some sort of non specific urethitis and would much appreciate any advice on my next course of action as I am now, getting anxious.
Doctor's Answer
by Kevin Pho, MD, Mar 17, 2004 12:00AM
, Mar 17, 2004 12:00AM
One consideration would be a prostate infection that may have arisen from the urethritis. Prostate infections can be difficult to treat, requiring extended course of antibiotics (sometimes 4-12 weeks). If there is evidence of a prostate abscess, then surgical therapy may be warranted. A transrectal ultrasound can be considered to evaluate for this.
As for the next course, I would suggest obtaining prostatic secretions to analyze and culture to ensure there is no bacteria that is resistant to the antibiotics. A transrectal ultrasound can be considered to evaluate the prostate.
If infection has been completely ruled out, you may want to consider anatomical abnormalities that can be evaluated via a cystoscopy.
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.
As for the next course, I would suggest obtaining prostatic secretions to analyze and culture to ensure there is no bacteria that is resistant to the antibiotics. A transrectal ultrasound can be considered to evaluate the prostate.
If infection has been completely ruled out, you may want to consider anatomical abnormalities that can be evaluated via a cystoscopy.
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
by mattyboy, Mar 22, 2004 12:00AM
To: Urology - General
0
by goldenraf, May 28, 2004 12:00AM
To: Urology - General
0
by joe faditz, Jun 14, 2004 12:00AM
To: Urology - General
0
