Infection Possibilities?

Dear Doctor,
I am a 50 year old male. I have had a left testicular ache and (what feels like )anterior urethral itching on and off for the past 150 days. These symptoms started 12 hours after masturbating 3x in one evening while on a business trip.(It feels like a burning tear and a consistant dull ache). To date, there have not been any lesions, D/C or rash noted. I do have an intermittant slight burn on ejaculation and urination too. I feel the itch moreso when my bladder needs to be emptied too.
During the last 150 days, I have been Dx'd with a left varicocele by US. I do have a urethral diverticuli but otherwise normal cystoscopy. I have had negative G/C panels by UA and negative HIV/Syph by blood. My Urine culture did show less than 3000 Serratia Marcecans too.(Not sure how this correlates though)
I have been on the following meds.
Rocephin 125mg IM
Zithromax 1 to 1 1/2g + x 3
0floxacin 400mg PO
Doxycycline 100mg BID x 14d
Flagy 2g PO
Bicillin 2.4 m/u IM
Ciprofloxacin 500mg BID x 21d
Bactrim 500mg BID x 16d
Pyridium 200mg BID x 2d
I then went for a 1 hour bike ride 2 days ago and the Itching/ Burning has intensified along with the consistant ache.
(I am currently on Doxy-Mono 100mg bid for 10 days for this.)
I do wear supportive underwear now as well.
My question, What is the likelyhood I have some infection?
Does persistant Urethritis/ recurrent epididymitis come to mind?
What other avenues would you look into if you were treating me? Do I need a prostate massage and culture, a uretral swab and culture????
Thanks for your input.
Hope all is well.
Barney.

[Kevin Pho, MD]

You have been treated with a variety of infections.  I would investigate the prostate as this time.  Prostate infections can be difficult to treat and may require extended courses of antibiotics.  

I would consider a transrectal ultrasound to look for any abscesses.  If present, it would have to be drained surgically.  At times, extended course of antibiotics are needed - sometimes 8 to 12 weeks.  

I agree with a prostatic massage and culture to further evaluate the symptoms.

These options can be discussed with your personal physician or 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_

[Barney1]

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