Multiple Problems

I am a 28 year old male about 6'5" and my wieght fluctuates between 260 and 290 pounds. I can never seem to stay at an even or normal weight. I don't consider myself to be fat, but I know I am overwheight by standards. I have had burning in urination for a number of years now. I have been diagnosed with infections of sorts over the years but the burning never left. I have tested for many types of std's and stones, and they recently took extensive x-rays of my mid-section. I had even one incident where blood came out in my semen during sex. I also feel different from day to day. Sometimes I am very energectic and others I feel like I can't get going. I do use nicotine( dipping), and I drink alcohol about 3 times a month. I have tried taking creatine and protiens, but my energy and weight fluctuates dramaticaly from week to week. I also get bloated at times, but it seems to come and go. For awhile I thought maybe something was wrong with my Kidneys, but the docs. say they are fine. I have had a prostate check twice in the last 8 months. I can function like this, but it is very frustrating to deal with. The burning is bad sometimes, and bearable others. Mostly I would just like to feel normal on a daily basis, and figure out what is going on in my urinary system. One other thing I can say is my moods change with my symptoms. Any suggestion would be appreciated. Thank You.

[Kevin Pho, MD]

Hello - thanks for asking your question.  

You are describing a symptom known as dysuria (painful urination).  You state you have been tests for STDs and stones, X-rays of the midsection and your physician says your kidneys are fine.  

One symptom you describe is blood in the semen (known as hematospermia).  

I am assuming the by STDs, the tests for chlaymdia, syphillis (syphilis), or gonorrhea are all negative.  If not, then tests for these are important.  

One consideration would be prostatitis.  Chronic prostatitis requires 4-12 weeks of antibiotics.  To test for this, urine and prostatic secretions are cultured and sampled before and after prostatic message.  

Also consider epididymitis - a scrotal ultrasound may be considered to evaluate this.  

A last consideration would be either a urethral polyp, a mass, or another anatomic abnormality.  If you continue to have dysuria, I would consider referral to a urologist.  A cystoscopy to evaluate the anatomy and to see if any masses are present would be a reasonable option.  

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.