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Urology  (Expert Forum)
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233190?1193370436
Chronic pain
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.

Chronic pain

by chronicpain, Aug 13, 2003 12:00AM
For the last 10 months I have been involved sexually (unprotected)with one girl.  For the duration of the relationship I have been experiencing pain in my penis and testicles after intercourse, even in my lower right side of my back(which has never gone away).  I have never had these problems or symptoms before.  These episodes of pain don't occur after "every" act of intercourse, but more like once a month(but have occured twice a month) and last anywhere from a week to 10 days. The pain starts mildly about a day after intercourse and then becomes worse on about the third day.  The pain feels like it is "inside" my penis, and it is always concentrated on one side.  For example right now the pain is situated on the left side.  It starts at the base of the shaft and runs to the tip.  It almost feels like the vein is being pinched or something.  Also, the skin is really sensitive all along this left side, even the left testicle is sensitive.  The right side is fine(this time), but the left is really sensitive.  It feels like when you have a cold in your ear, your face on that side gets really sore and the skin is sensitive. Wierd. So on about the fourth or fifth day a red spot(rash)will appear on the painful side. In about a day the rash seems to turn to very small bumps.  I had these bumps checked before and nothing oozed from them or anything so the doctor couldn't really diagnose anything, but it's really hard to tell if they are blisters or not because they are so small. It appears they crust over sometimes.  What could this be?  I've been tested for STD's and all negative (she has also). Could I be allergic to my girlfriends vaginal fluid?(I don't know I read this somewhere)  I began washing my penis after intercourse and it seemed to be helping, until now, the problem is back again. What about yeast overgrowth?  Thanks

by Kevin Pho, MD, Aug 15, 2003 12:00AM
There are a variety of possibilities.  It would be difficult to say for sure without examining these bumps/lesions - a dermatology referral may be necessary.



I would consider prostatitis, which can give periodic discomfort without an obvious cause.  Test your urine and have a physician feel the prostate and express secretions for testing.  An empiric course of antibiotics may be considered.  



I note that you have been tested for STDs - make sure that gonorrhea, chlamydia and herpes have all be considered by your physician.



Regarding non-infectious causes, there are some anatomical abnormalities - such as urethral strictures or polyps that can cause discomfort.  A urology referral for a possible cystoscopy can be considered.



I would investigate these other causes before considering yeast overgrowth.



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.

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