Penis pain(discomfort)

Hello Doc, I'm a 39 year old male and I have been having this problem on and off for 7 months. I have a penis itch and sometimes burning sensation right under my penis head. It sometimes feels is in the outside and sometimes it feels that it is in the urethra. A couple of months ago I also starting feeling a pain in the based of my penis and it ran all the way down to my scotum. I have been to my main doctor and my uroligist for several times and they have given me manu antibiotics (Doxycycline, cipro,Zithromax,Levaquin, Uretron) the symptons get better but they return after having sex with my wife. I also got checked for STD's (HIV,Gono, Chlamydia,Herpes Hepitatis,Syfilis) and they came back negative. My urinalysis also come out normal, white blood cells fine, so no infection has been found. I notice this began after a very long and hard erection and it almost felt like something inside popped but it did not hurt. Yesterday I had a very bad pain, like a needle poking my penis and it is always in the same spot constantly.

I also had done a pelvic and testicular sonogram, and it indicated that I had a mild enlargement of my prostate and mild enlargement onf the right epydimital head and some liquid on my left testical.
My regualr doctor suggested it could be Prostatitis and send me to the uroligist. The urologist said the pain did not seem prostate related , he check me out, check my prostate (rectal exam) and gave me some pain killers. it work for a week or two but it came back. Doctor what could it be, he is sound like prostatitis, what kind of antibiotics are given and what length of time. Usually the Antibiotics i have been on is for 10 to 14 days. Please advice on what you think it might be. Thanks

[Kevin Pho, MD]

The workup has been thorough thus far, and I agree with what has been done thus far.  

The prostate continues to be a possibility, and infection here can be difficult to diagnose.  A transrectal ultrasound can look for any abscesses.  I would also consider a prostatic massage, and sending any fluid off for culture and analysis.  

If prostatitis continues to be suspected, extended courses of antibiotics can be given, sometimes 4-12 weeks worth.

These options can 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.
www.kevinmd.com