Urological problems Doctors think its in my head!

  Dear Doctor,
  I am a 30 year old married male. I am a very stressed out and
  anxious person. For 7 months now I have been experiencing some
  very unpleasant urological problems. In short, I have had constant
  burning in my urethra and pain in my testicle. Urination and
  ejaculation can be very uncomfortable. I have seen many
  doctors and urologist who have performed many different tests and
  cultures (ie. chlamydia, gonorrhea, UTI's, cystoscpy, ultrasounds
  and many more) all which came back negative. I have been treated with
  many different types of antibiotics, none which were successful.
  This condition has effected my sex life with my wife and also has
  led me to a state of depression. However, I do agree with my doctor
  that stress and anxiety does intensify my present condition, but
  I believe that it is NOT the cause of it.
  For the past several months my doctor has prescribed 150mg of
  Wellbutrin twice a day. This has really been helpful for me
  and has allowed me to better accept my condition. Overall, my life has
  returned to normal even though my symptoms still persist.
  To help me with my stress and anxiety levels, I have been seeing
  a therapist along with a psychiatrist, I have been receiving
  psychotherapy through my primary, and now I am trying boi-feedback.
  I am also taking Serzone at bedtime to help me sleep. I was previously
  taking xanax, but was afraid I would come dependent on it.
  I have made a tremendous improvement mentally, but like I said,
  I am still experiencing this discomfort. These symptoms are very much
  real and no doctor can give me an explanation without making me feel
  as if I am imagining it.
  Is is really possible that a person can imagine this?
  Can you give me any advice of what my next step should be. At this
  point, I have done everything that was advised to me.
  The therapy has really helped me to get me life back, but has not
  helped me physically. Any response will be greatly appreciated.
  Thank You,
  Chris

[HFHS.MD-AJ]

_
Dear Chris,
It is unclear if your symptoms are organic, or psychological, or a combination of both. It is important to continue to work with your urologist as he continues to evaluate your symptoms. Constant burning and pain in the urethra and testicles is an unusual presentation of a psychiatric illness. However, there are psychiatric disorders that present with primarily physical symptoms. If your physical symptoms have continued for longer than 6 months, and can not be explained by any medical condition or investigation, it is possible that you have a somatoform disorder, which includes a number of psychiatric illnesses with primarily physical symptoms. Somatoform disorders are seen in about 5 percent of patients attending general medical clinics, and may co-exist with depressive and anxiety disorders. The good news is that group therapy can be very helpful. In addition, there are a number of non-addictive medications that can successfully treat your anxiety and depression.
I hope you find this information helpful. It is provided for general medical educational purposes only, and should not replace consultation with your doctor for diagnostic and treatment options pertaining to your problems.
*Keywords: somatoform, hypochondriasis, anxiety, depression