penile pain

A year and 2 months ago a urologist discovered a growth at my urethra meatus, part in the opening, part just bulging out.
He recommended [practically frightened me into] a biopsy.
Despite seeing other doctors who told me it was most likely benign, I submitted to the biopsy.  Benign.  But I have not healed, or, rather, it appears I have but I still have pain at the site and throughout the entire system.  Not always, but it always returns.  A thorough exam by another urologist {the original guy just didn't seem to care and we mutually parted not under the best of relational circumstances} revealed nothing gross or wrong--other than wbcs in protatic fluid.  But this dicomfiting sensation is present or seems about to be present.  Relieved somewhat to significantly by neurontin (now up to 2 X 600=1200/day with xanax) and nueropressure treatments, as in deep massage of gluteus and surrounding areas, reflexology [albeit various].  Also although there is no real incontinence, there is now sudden urgency.  There is ability to ejaculate, although the erections are "weak" and not as often as before.
  It seemed to improve for awhile, or still seems to then starts up again.  I used to have very bad "jolts," spasms through the urethra tract and at the surgical site; I still get them although they are not as bad and not as lengthy.
Again, "new, certainly better" urologist finds nothing abnormal; family doc/internist thinks it will all calm down in time as the nerves "find" their way into appropriate "behavior." Dermatologist is stumped by the ridge-around the opening, a raised level of skin.  Full nurological exam revealed nothing gross, but Xrays reveal arthritis on the right side of hip and coccyx--lumbar [I do have back pain and sciatica pain, but this really doesn't bother me very much, other than whatever influence on my focus issue].  This site and pain is on the right side of the glans (glands) opening, and during the 'weak' erections it is the right side that seems to be lacking, so to speak.  Rarely, but recurring, when being patient and emptying bladder fully there is afterwards about a 20 second full systemic harsh pain then alleviation.  
I am 61.  My internist says I don't have diabetes although I was diagnosed with it 3 years ago, but since have reduced blood symptoms through diet, exercise, weight loss.
Do not smoke, and drink little to hardly at all.  No abusive substances.  Full medical exam and opthomologic exams reveal nothing remarkable excepting the arthritis and enlarged liver/spleen, and follow-up ultra-sound revealed nothing remarkable again.
Does this sound like neuropathy, nerve damage, other?  A very close exam to me at least seems like the tiny line of the surgery can still be seen, although now the glans (glands) otherwise than described appears normal or nearly so.  Can anything else other than time and things mentioned assist?

[Kevin Pho, MD]

Certainly a prior biopsy can lead to chronic irritation leading the the symptoms you are describing.  However, before attributing it to that, you want to ensure there is no infection present - especially with the WBC in the prostatic fluid.  A urine test to evaluate for infection, as well as tests for gonorrhea and chlamydia all should be considered.  I would also ensure there is no prostatic infection present (i.e. you can send off the prostatic fluid for culture and analysis).  A transrectal ultrasound can be done to make sure no prostatic abscess is present.  

If there is further concern about nerve damage, a neurology referral can be considered.  

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.

Kevin, M.D.
Medical Weblog:
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