Erections, ejaculate, nerves, prostate infection...

[nfqbc]

Hi Doctor,

I wrote to you back in april regarding a change in my ejaculate as well as my testicles being constantly moving.  I have since travelled to the united states to visit a urologist who believes me to have a prostate infection and started treating me with ciprofloxacin, which I have been taking for a month now.

I have two more weeks on the medication and so far there is no improvement...in fact I may say things are worse.  I no longer get spontaneous erections during the day or wake up with one in the morning.  The tingling/moving is worse than ever.  I used to have a very strong pc muscle but now I can barely contract it at all.  The other day after I ejaculated, right afterwards I felt like I had to ejaculate again and urine squirted out.  For a good hour afterwards it was quite painful...especially when I urinated.  To me it seems if my nerves are all malfunctioning.

My questions to you is if you agree with this urologists diagnosis....prostate infection still a possibility?  If so, why has the meds not helped at all.  It's very expensive for me to do so...but should I go back to see this doctor again?  Any other ideas in light of my new developments?  Thanks again.

[Stephen Liroff, MD]

No, a placebo response is not a gauge of the cause of a symptom. It is true that the question of nocturnal erections is used to try and separate the emotional from the physical causes of impotence, but it is not an absolute means of distinguishing between the two. There is no one symptom that makes the diagnosis.
When you search for a counselor, consider a sex therapist.
S.A.Liroff, M.D.

[nfqbc]

Thank you once again for reviewing my symptoms....I apologize if I've become an annoyance.  I am going to seek counseling asap.  My mind was convinced I had prostatitis, therefore should I have not felt a placebo effect of some kind?  Also, since one of the tests for psychologically caused erectile dysfunction is whether or not nighttime erections still occur, shouldn't I still be experiencing these?

[Stephen Liroff, MD]

Your symptoms are not those of prostatitis and going back over your history, I am further convinced  that there is an emotional cause for what you are experiencing. You are not imagining what is happening, your symptoms are very real,  but the cause is not physical. Treating the physical (antibiotics, etc.) is not getting at the true issue. The longer you let the symptoms persist, the more difficult it is to resolve them. You need to seek emotional counseling for this.
S.A.Liroff, M.D.