Multiple Problems

[cntry]

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, 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.