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Urology (Expert Forum)
C B P sufferer please advise im in dispair.
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
C B P sufferer please advise im in dispair.
by SouthernComfortUK, Nov 29, 2005 12:00AM
first discomfort felt in March. It began with a pinching feeling in the head of the penis, quite constant and worsened over a 7 day period.
Visited my local again and described symptoms, was given a swab test for Chlamydia as a precaution – Doxycycline 100mgs for a week
I Returned to my GP as pain was far worse then before. A constant sharp pain felt almost entirely in the head of the penis as if there was something blocked there, continuously pushing forward. Laying on my righthand side deffinitely aggrivates it. Most nights I was shivering with a cold sweat and had pins and needles all over. I took ibuprofen for pain, but it seems to do nothing. The Chlamydia had not yet been returned, so as a precautionary measure my GP provides me Ciprofloxacin, just in case. Pain is making it difficult to walk, yet I can urinate with no problems, and there is no relaxation of the pain in any way just after urinating. I also noticed a little back pain in my lower back. Also the head of the penis fills razor sharp when touched.
On the 2nd of April still in an awful amount of pain I visit the ER. They provide me with Paracytamol and Diclofenac Sodium (50 mgs) and do a brief physical examination and standard X-Ray for Kidney stones, this was negative, along with Urine tests
On the 5th of April Chlamydia test were returned as normal. They performed a further swab test and urine test. All came back as negative – Urine Chlamydia and Culture Ghonorrea
Between the 9th and 17th the pain seemed to have gone, however on pressing the head of my penis whilst cleaning I got a sharp pain and within a matter of minutes the pain retuned. I was going away on holiday on the 19th; my G.P presscribed a 7 days Trimethoprim, so I took this, along with pain killers but to no effect. I also tried for two days a course of Phenazopyridine Hydrochloride as suggested by the pharmacist - aggrivated it
May: I went to a urologist for a cystoscopy which came back that I had Chronic Bacterial Prostititus. Carried on for 6 weeks on Cirpoxin (2x500 a day), and then a reduced 500mg once a day for three months. As of today I am a little better, but not fixed. The Doctor suggested another Cystoscopy and told me to stop taking cyproxin for a couple of weeks so he could get a good sample. Oddly since stopping i am certainly having more good days then bad, maybe 4 good, 3 bad, but still small discomfort every day. The results from this test come back on saturday.
1) why is it going on so long - will i have to live with this on & off my whole life
2) Why does symtons include 'pins and needles' in all of my left leg on a bad day, along with pain in the penis anytime i lift my left leg (ex when showering)or wash it
3) If Ciproxin is no good what alternives do i have?
4) the pain after ejaculation has caused me untold problems incl premature ejaculation, low self asteem
5) ive taken voltarol for pain relief (supository) this seems to help, but aggrivate my piles, anything else?
Feeling Screwed
UK
Visited my local again and described symptoms, was given a swab test for Chlamydia as a precaution – Doxycycline 100mgs for a week
I Returned to my GP as pain was far worse then before. A constant sharp pain felt almost entirely in the head of the penis as if there was something blocked there, continuously pushing forward. Laying on my righthand side deffinitely aggrivates it. Most nights I was shivering with a cold sweat and had pins and needles all over. I took ibuprofen for pain, but it seems to do nothing. The Chlamydia had not yet been returned, so as a precautionary measure my GP provides me Ciprofloxacin, just in case. Pain is making it difficult to walk, yet I can urinate with no problems, and there is no relaxation of the pain in any way just after urinating. I also noticed a little back pain in my lower back. Also the head of the penis fills razor sharp when touched.
On the 2nd of April still in an awful amount of pain I visit the ER. They provide me with Paracytamol and Diclofenac Sodium (50 mgs) and do a brief physical examination and standard X-Ray for Kidney stones, this was negative, along with Urine tests
On the 5th of April Chlamydia test were returned as normal. They performed a further swab test and urine test. All came back as negative – Urine Chlamydia and Culture Ghonorrea
Between the 9th and 17th the pain seemed to have gone, however on pressing the head of my penis whilst cleaning I got a sharp pain and within a matter of minutes the pain retuned. I was going away on holiday on the 19th; my G.P presscribed a 7 days Trimethoprim, so I took this, along with pain killers but to no effect. I also tried for two days a course of Phenazopyridine Hydrochloride as suggested by the pharmacist - aggrivated it
May: I went to a urologist for a cystoscopy which came back that I had Chronic Bacterial Prostititus. Carried on for 6 weeks on Cirpoxin (2x500 a day), and then a reduced 500mg once a day for three months. As of today I am a little better, but not fixed. The Doctor suggested another Cystoscopy and told me to stop taking cyproxin for a couple of weeks so he could get a good sample. Oddly since stopping i am certainly having more good days then bad, maybe 4 good, 3 bad, but still small discomfort every day. The results from this test come back on saturday.
1) why is it going on so long - will i have to live with this on & off my whole life
2) Why does symtons include 'pins and needles' in all of my left leg on a bad day, along with pain in the penis anytime i lift my left leg (ex when showering)or wash it
3) If Ciproxin is no good what alternives do i have?
4) the pain after ejaculation has caused me untold problems incl premature ejaculation, low self asteem
5) ive taken voltarol for pain relief (supository) this seems to help, but aggrivate my piles, anything else?
Feeling Screwed
UK
Doctor's Answer
by Kevin Pho, MD, Nov 30, 2005 12:00AM
, Nov 30, 2005 12:00AM
To answer your questions:
1) Chronic prostatitis can last despite 4-12 weeks of antibiotics. One consideration would be a prostatic abscess - which can be evaluated with a transrectal ultrasound.
2) Can't say for sure. It may be due to an enlarged prostate. However, I would consider a neurology evaluation to determine if there is any nerve compression.
3) Sending off cultures of the prostatic fluid (obtained during a digital rectal exam and prostatic massage) can narrow down the antibiotic choices.
4) You can consider a referral to a pain management specialist to further manage the pain. Other options can include medications like alpha-blockers, alpha-reductase inhibitors, or trans-urethral ablation of the prostate.
These options should be discussed with your urologist.
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.
kevinmd_b
1) Chronic prostatitis can last despite 4-12 weeks of antibiotics. One consideration would be a prostatic abscess - which can be evaluated with a transrectal ultrasound.
2) Can't say for sure. It may be due to an enlarged prostate. However, I would consider a neurology evaluation to determine if there is any nerve compression.
3) Sending off cultures of the prostatic fluid (obtained during a digital rectal exam and prostatic massage) can narrow down the antibiotic choices.
4) You can consider a referral to a pain management specialist to further manage the pain. Other options can include medications like alpha-blockers, alpha-reductase inhibitors, or trans-urethral ablation of the prostate.
These options should be discussed with your urologist.
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.
kevinmd_b
