Prostate Discomfort

Hi Dr.  Thank you for this incredibly important and helpful forum.  

I was treated for gonorrhea and chlamydia after showing symptoms such as a dull ache in the testicles, urethra burning and frequent urination about 5 days after a sexual encounter.  I was treated with 500mg Cipro, 10 days Doxycycline and then a follow up of 2g Azithromycin a day after finishing the doxy.  The pain was completely gone and I felt perfectly normal for 2 weeks.  I then started having similar symptoms (no other sexual contact) and I now have a dull ache in my prostate.  Could this just be residual inflammation or is it possible I could still have a bacterial infection after the arsenal of antibiotics I was on?  Thanks for any suggestions.

[H. Hunter Handsfield, M.D.]

You were somewhat over-treated for gonorrhea and chlamydia, so you can be sure those infections are gone.

The American Urological Association now refers to "male pelvic pain syndrome" rather than prostatitis.  Well, more accurately, not all pain in the pelvic floor (rectal area, lower abdomen, etc) that used to be thought to be due to prostatitis actually is associated with prostate inflammation, but it could be.  Residual inflammation indeed is a more likely explanation than an active infection.  If your discomfort persists for more than a couple more weeks, return to your health care provider.  But it likely will clear up.  (But if you get discharge from the urethra--which I don't think you will--don't wait, get it checked out right away.)

Good luck--  HHH, MD

[Norv12]

Thanks for your reply doctor.  The pain in the prostate has subsided.  Last night, I had swollen lymph nodes in my groin followed by sharp pain in my left testicle.  The pain was much less severe in the morning.  Is it possible that I may have had a strain of gonorrhea (acquired in Las Vegas) resistant to the antibiotics I took?  I would assume since the symptoms disappeared for 2 weeks after my treatment, this would not be the case.  I have no pain during urination, discharge or physical abnormalities in the genital area.  Thanks in advance for any opinion.

[H. Hunter Handsfield, M.D.]

Your symptoms do not suggest gonorrhea, and it would be extraordinarily rare for gonorrhea to persist after the treatment you had.

No fair starting a new message string on the same topic; I deleted it.  Only a limited number of new questions are permitted each day, and unnecessary messages prevent others from getting on the board.

HHH, MD