Chronic Penis Tip Pain, Urinary and Erectile Symptoms – please advise

[NervousinNortheast]

I am a healthy, 34-year old, circumcised male with these symptoms for 60+ days: pain and discomfort in tip of penis, in and around opening and underneath; frequent urge to urinate, and drippy feel after urination; difficulty gaining erections, poor erectile strength and discomfort after ejaculation.  Just inside the opening there are small purple dots, or discolored, irritated skin.  Not aware of any discharge.  Urge to urinate itself feels like it originates in the tip of the penis, not bladder.  Worst time is 5-9 AM when pain can go to a 4.  I live overseas where STDs and HIV are abundant.  Sexually active with 3-4 women in the past few months, using condoms for vaginal sex but unprotected oral.  
First consulted GP and dermatologist.  Blood, urine and physical examination showed nothing.  I convinced one to give me a prescription for doxycycline, which made no difference. On return to US, I visited GUM clinic, where I gave blood again and had a urethral swab taken and a physical exam.  Negative.  Next visited urologist, who put me on Cippro and Flagyl, no effect.  Also did cytoscopy and ultrasound and checked prostate, said everything looked healthy.  Next dermatologist, who had treated me for molluscum, examined and thought the appearance was normal.  
So with real discomfort and after 5 doctors, 4 antibiotics (Zithromax too), creams (clotrimazole, cortisone, plain old Neosporin) and no diagnosis, I turn to you.  Urge to urinate has decreased a bit, but discomfort still there, focused on the tip and opening.  Erectile challenges continue as erection is weak and orgasm small and fast.  Urologist says wait six weeks with no more tests, no more drugs, and no more worrying, and that this should simply go away on its own.  
Much anxiety here.  Does anyone have ideas on what might cause this or how to resolve?  Thanks in advance.

[david323ww]

It sounds like you have chronic pelvic pain.  This is basically a muscle injury that lies inside your pelvis.  To fix the problem, its as simple as bringing relief to the muscle.  The pasrticular muscle that cuases pain at the penis tip is called the lavator Ani muscle.  The reason why you feel at your penis tip is b/c this muscle is close to your prostate; the prostate has a bunch of nerves next to it.  Therefore, the muscle injury hits the prostate area, next to the nerves, causing pain to shoot to your penis.  Check this site out www.penilepain.org  , saved my life.

[david323ww]

I suffered the same thing!  I think today may all be your lucky day.  Check out this website, www.penilepain.org

[atwitsend12123]

I have had the exact same symptoms for about five months now, and it is starting to drive me insane.  I (like yourself) have gone to many different urologist and many different dermatologist who tell me there is just simply nothing wrong with me.  I am in the process of going to a dermatologist specialist, but like the other am starting to lose hope.  One glaring point I must make is that I specifically remember the onset of the sensation, and it was directly after receiving (terrible) oral sex from a girl.  I felt it immediately afterwards, but believing that it was just an injury from the terrible episode.  I have researched my problem meticulously online and have found many others who believe this sensation is in some way related to oral sex they received.  Do you remember when this began and what may have started the sensation?    

[djrobt]

i have had this problem for years 20 to be exact and have had very test imaginable it comes and goes sometimes for 2 or 3 years then it comes back with  vengence it's not herpes or an std i do not no what it is but it has got me down i've changed my diet and tried not to eat sugary foods if anyone can help then please advise

[edwarrior]

Same symptoms here.  I'm 43 and suffer from the exact same symptoms you describe.  I have ed now that is unrelenting.  I get a am erection, but my penis never enlarges anywhere near what it used to.  I've tried all three ed pills with marginal results.  About 5 years ago viagra worked well, but now it seems to have no effect.  My doctor prescribed androderm patches, but I was getting a rash each time I used them so he switched me to depo testosterone injections.  I've taken 200mg every two weeks for two months now and sadly no real improvement.  I will be seeing my doc soon as I just had another blood test.  I am not too hopeful at this point, and frankly it is destroying my marriage.  When my beautiful wife (5'1" 100lb cutie) touches me....nothin.  I don't get wood from looking at hot women either, and I'm far from gay.  I love women and all their parts.  I'm turned on mentally, but my penis doesn't seem to work anymore.  I'm not depressed about anything else in my life, but ED is a big one.  I am convinced that I am not alone with this disorder and that modern medicine doesn't have an answer to this problem.  I haven't given up as I'm still working with my doctor, but when I read comments like "penile implants" or "pump therapy" it sounds like the doctors don't have any simple solutions.  I may try a penis pump, but I'm not very confident it is the answer.  The testosterone injection info lists uncontrolled and long lasting erections...If only it were true.  I hope you find a cure as I'm looking for the same.  Keep the faith brother.

[denf]

I have had the exact same symptoms for 4 yrs. Finally went to Dr. Ronald Wheeler at his prostatitis clinic in sarasota florida. Check out his web site.
He just started me on Uroxatral, 10 mg to relax my bladder neck. Six days into it
and i'm seeing a little let up in the pain. Also, he has a product out called
peenuts for inflamation of the prostate "prostatitis". Go to www.peenuts.com.
Good luck to you. Like Abe Lincoln said "if there is a hell I am in a worse place".                                                  ***@****

[Kevin Pho, MD]

I agree with the workup thus far, and it is unlikely that I can come up with something new that the 5 physicians you have seen haven't considered.  

Many of the major disorders would have been ruled out with the tests you have had.  I agree specifically with the cystoscopy which would rule out anatomical abnormalities like a urethral stricture or polyp.

Another dermatology opinion can be sought - preferably at a major academic medical center.  If this is an area that can be biopsied, that can give a more definitive diagnosis.  

These options can be discussed with your personal physician.

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_