UTI? Prostatitis

[VictorSP]

Hello! I have had prostatitis (diagnosed as chronic non-bacterial) for several years and I get occasional flare-ups still. About 2 months ago, I was masturbated by a female massage worker - she just used her hands and some oil. Then, last week I had another flare up, feeling like I needed to pee more, and generally uncomfortable in my pelvis region. Because I was feeling bad about the massage incident, I went in to see a urologist. He said that infection of any kind through the kind of contact I had is not possible, but when he ran a urine test, I had WBC of 3-6/hpf. My urine was quite yellow and sometimes I can see tiny white floating bits in it. Again, he said that normal urine can have floaty white bits. The urologist said the WBC is not too high and that I probably don't have an infection - but he prescribed a short course anyway and sent urine off for a culture (should have the results back in a few days). I was terribly worried though and later in the day I went to see another doctor at another clinic. I had been drinking water all day. The second doctor also did a urine test and it came through clear. He told me not to worry - said given the contact I had any kind of infection was extremely unlikely if not impossible. He told me to watch symptoms and if anything gets worse to come back. He also said that if an infection does turn up, it is more likely to have turned up as wbc in the urine from the prostate problems, rather than a new external infection. I was reassured, but now I am worrying again. I don't want to go on antibiotics if I don't have to - I know they play havoc with my stomach. But should I be worried about the WBC in the first test? And is it possible that if I do have an infection, that it came from the prostate? Thank you!

[Edward W Hook, MD]

This will be your last answer. Please believe your 10 week result.  It is reliable. EWH

[VictorSP]

I have started to feel anxious about my encounter again. When I think back, I remember that I had a rash on my hands - around the fingers and on the palms - a couple of months ago. It was itchy, and I have had eczema in the area before, including quite recently. The little round sore on the side of my ankle is still there too. I think that makes about 5 weeks for that. I saw a dermatologist again about the sore (though I didn't mention my encounter) and she said it looked like an ageing spot - possibly after a skin infection or skin trauma. She gave me a cream and said it may take a long time to clear up. I am just wondering beyond all these symptoms that my anxiety makes me notice more, if the RPR test is the final measure. Can I just relax, knowing that I had the test at around 10 weeks? Is it reliable?

Thank you. And sorry to be such a pain!

[Edward W Hook, MD]

I think you are overly concerned.  Your massage was ano risk exposure and the absence of risk is supported and confirmed by repeated assessments of a variety of health care providers as well as negative tests.  It is past time for youto stop worrying about your trip to the massage parlor.  You did not get an STD.  EWH

[VictorSP]

Just to follow up, I have some more concerns about the massage incident and my ensuing symptoms. My prostatitis symptoms have basically returned to normal - partly thanks to your reassurance. So, many thanks for that! But about a week or 10 days after the incident (which happened in the first week of January), I noticed a bump next to my anus. It was a bit painful and since I had what appeared to be a sweat rash after a very hot walk also in my armpits and chest, I went to a dermatologist to check it out. She said the rash was from sweat and the bump was a follicle. She gave me a cream which cleared up the bump in a week or maybe two. My itchy chest and other itching in the anus continued for a while longer, but that cleared up too eventually - which is why I didn't mention it to you last time. In the meantime, in mid March (about 10 weeks after the incident), I had tests for HIV, Syphilis (RPR) and Hep B/C. All came back negative. Now, three months after the initial incident, I have a small (less than a centimetre) round red sore on the side of my left heel, which itches a bit. I was concerned again, thinking about sores and bumps and syphillis. Went to see a dermatologist who said it looks like a little bacterial infection. She gave me a cream to put on it. That was two days ago. I didn't mention my concerns to her. The little sore is still there. I know I shouldn't, but I read about primary and secondary syphilis sores and connected them to what I am experiencing. Given my exposure and the tests I had at 10 weeks, what is your assessment of my situation (and sanity!).

Thank you!

[Edward W Hook, MD]

Prostatitis could cause the WBCs and a few can be normal as well.

I'll see if I can findo out what's up withthe URology site.  EWH

[VictorSP]

Thanks for that. I am just wondering if WBCs can turn up spontaneously in urine without an external cause (eg. STD). For example, can prostatitis itself cause WBCs in urine samples? I am also wondering if you know what has happened to the urology board... no replies there for about a week. Is Doctor Liroff scheduled to be back soon?

[Edward W Hook, MD]

I see that you posted your question simultaneously on the Urology site and this site.  While we get a fair number of questions about prostatitis on this site, the fact is that most prostatitis is not STD-related and, particularly with chronic, non-bacterial prostatitis, the advice you get about its management from the Urology forum is more current than for me to weigh in.  I will however comment on the issue of the relationship between  your receipt of masturbation by the masseuse and this episode.  While the prostate and other organs which produce ejaculate are inter-related and problems in one part of the anatomy might affect others, that you experience was two months ago provides assurance that your current problems are unrelated to your interaction with your masseuse.  Either your urine WBCs nor your current symptoms are due to an STD related to the encounter you describe.

Hope this helps.  EWH