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Persistent Inflamed & Irritated Meatus
Hello,

Thanks for any help anyone has to offer.

I've been suffering from an inflammed and irritated meatus for just over seven weeks now and I'm really confused as to what's causing it or how to fix it. I'm in a foreign country at the moment so access to healthcare and consequently explaining my problem in a foreign language hasn't been the easiest. For that reason, I'm writing here to see if anyone could lend some advice.

I suppose all of this started in late December when I received a sort of rough unprotected handjob from a sex worker. I believe she was using lube she had previously put in her anus to rub my penis. In other words, she was reaching to her anus to get the lube and then rubbing my penis with it. She rubbed the tip (meatus) with her thumb in a circular pattern, and did so pretty intensely although it didn't bother me too much at the time. A few days later I saw that the tip of my penis looked slightly different. It looked as if there were two pursed lips instead of a straight slit like before. But that was it. I had no other symptoms. I figured it was just a little traumatized after the handjob. But would go away.

Then in the month of January, I had quite a lot of unprotected sex with a girl who has since been tested and came out clean. In February, about two months later from my encounter with the sex worker and a few weeks after I stopped having regular sex in January, some real irritation started. I could best describe the condition as irritation and very slight inflamation of at the tip of the penis. It comes and goes in intensity but at its worst moments, it's very pink and burns slightly when I pee just at the tip of the urethra. The size of the pursed lips also vary depending on how bad the irritation is and also, along with the redness small bumps come and go. The bumps though however are ever so slight and usually disappear within a couple days together with the redness. They don't appear anything like warts or herpes sores. Spotted redness might be a better description. The other thing I noticed is that my urethra appears to be slightly wider and open, revealing the sensitive wet part of my urethra, almost as if my it's trying to breath. I think this might be why it gets irritated from rubbing against my clothing. I've also noticed more discharge than usual from my penis. I'm not sure if it's precum but basically, it's clear, has no scent, and a has the consistency of mucas and I've noticed more than usual when checking my underwear at the end of the day. The last thing that's different is that after I pee, I notice that there's a a little extra drip than usual, even after I clean up with toilet paper, the tip of my penis is moist.

Wearing boxers and walking (or any kind of movement really) aggravates it as I think my underwear ends up rubbing the tip of my penis. So I have switched completely to using tight underwear and stopped doing aerobic exercise. None of my symptoms resemble anything like the pictures of herpes or genital warts I have seen online and both the determatologist and urologist I have seen agree and dismissed the possibility of either. I was tested in February for HIV, syphilis, hepatitis B, gonorrhea, and chlamydia, and all of the tests came out negative. I also had two urine tests and both came out normal.

The dermatologist I saw first in February recommended soaking my penis in a warm mixture of water and sodium bicarbonate twice a day. It didn't help. The urologist I saw in March prescribed a cream that contains Gentamicin, Betamethasone, & Miconazole, which is supposed to clear up any irritation caused by a yeast or fungus infection. I used that twice a day for a couple weeks but the condition did not get any better and he then told me to stop using it. So basically, now I'm just wearing tight underwear, I don't use any lotion and am careful when washing it with dove soap ensuring that no soap gets into or near my urethra. I'm not having regular sex and when I masturbate do so in a gently manner only a couple times a week. However, I've noticed that the couple times I have had sex since this condition started, my penis was extra sensitive and I ejaculated rather quickly.

Part of me thinks that maybe it is an infection due to bacteria from the girls anus. Another part of me thinks maybe it's purely physical trauma. But I do notice that when I'm tired and have had a late night, the condition worsens which leads me to believe it's tied to the strength of my immune system. But really, this could be all in my head..I don't know.

So, if you've taken the time to read all the way to the end, thank you. I'd really appreciate any ideas on what might be causing this or what I could do in terms of treatment or other tests. Are there other STDs or STIs which could be the culprit that I haven't been tested for? Thanks so much in advance, I'm worried this might never go away.

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How long hv you had your issue...history? How it started etc..

Its good to talk on yr history if you really want ppl to help..

Most here are negs on standard STD tests..

As for me..i think the worst part..or medium worst part..is gone

Almost neglibke now, altho i think there is a tiny issue yet fully addressed..but no big deal anymore for me
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Bright yellow urine is probably caused by the vitamin B2/riboflavin in your multivitamin.  Anything in excess of what your body needs gets excreted in urine.  According to the article below the recommended amount for men is around 1.3mg per day.


http://www.menshealth.com/best-life/why-do-vitamins-turn-my-urine-neon-yellow

I noticed the same thing as you when I take vitamins. My multivitamin contains 3.5mg, so it makes sense that it turns my pee bright yellow.
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So women are about 30 times more likely to get a urinary tract infection than men.  That doesn't mean that it can't happen though.  The mouth is a jungle of all kinds of bacteria, including those found to cause UTIs, so it's definitely a possibility that it's a UTI.

I visited a walk-in clinic the other day:
I'm on day 2 of 3 500mg ciprofloxacin [extended release] and feel about 60% better today.  No urine culture test was performed, unfortunately, but a dipstick test revealed red blood cells and white blood cells in my urine.  It is important that you chug tons of water while being treated for a UTI.  This helps clear the bacteria out.  I've consumed at least 3 gallons today and have been pissing like a race horse.

Not sure what kind of bacteria I had since there was no culture test performed, but it should be noted that antibiotic-resistant strands of UTI bacteria are becoming more common.  A culture test will determine the susceptibility of the infectious bacteria to various antibiotics to let your doctor prescribe you the right one.

I anticipate that I'll need longer than a 3 day dose at this rate, especially since I think I had prostatitis during this episode.  The article below mentions that male UTIs should be considered complicated, and


Previous antibiotics I've been on were doxycycline 100mg twice daily for seven days, 2g azithromycin, 800mg cefixime, 250mg ceftriaxone inection, and 2g metronidazole.  These would have definitely cured chlamydia and gonnorhea, and almost definitely would have cured trichomoniasis; I tested negative for gonorrhea and chlamydia twice using NAAT tests, which are extremely reliable.  None of those antibiotics helped, except for the metronidazole which reduced the irritation for the duration of the next morning; however it should be noted that metronidazole has a direct anti-inflammatory effect which could explain the very temporary relief I had.

http://emedicine.medscape.com/article/231574-overview#a0101
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Sorry, I should clarify:  When I said that the mouth is full of all kinds of bacteria, I was making reference to the fact that many of us noted symptoms after receiving unprotected oral sex.
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This is something that a lot of people are going through. I am 1 year into this condition. It all started when I had sex with a girl. I did use a condom but by the time we were finished the condom was gone. So you can say it was unprotected sex. I got the itching symptoms 2 days after the encounter. I went to doctors and urologist and they both seemed useless. All the test came out negative and they dismissed me as well. Im not sure if you had this symptom but I also got a tingly feeling in both of my big toe's. You should look up reiter's syndrome.

I believe that I have found a solution. I'm sure you have a symptom where you go to urinate and you have a little more urine left at the end that drips out. I've had immediate results when I make sure that I completely empty the bladder of all urine and gently wipe the head with a tissue. Also I started to drink nothing but water and i stopped smoking marijuana. I noticed that after I smoked is when the symptoms were the worst! So if you're still dealing with this problem i encourage you to make sure that your bladder is completely empty and avoid ejaculation at all cost until the rash in your urethra disappears. Each and every time you ejaculate you feed that rash inside your urethra. If you look closely with a light you may see a whitish-blueish are on the left or right side. The semen and left over urine is what i believe is feeding the rash.

Guys I know what you are going through as this is your most prized possession! I will keep you updated! Good luck and hang in there. This will pass!
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I have the same symptoms with marijuana. Can you still smoke marijuana now?
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Hi everyone,

i will share my experience,hope it will help you.


Before 10 months i had symptoms on my penis that made me take it serious.
My main symptom was:
pain on penis after masturbation.

indeed this pain was there months before i noticed
my glans(10 months ago).
what i noticed was the swollen red irritated meatus and the red irritated glans.
This was worse after masturbation and after taking bath.

I am uncircumcised and had no sexual intercourse.
I went to doctors and had tests for prostate and urinary tract infections.they all came negative.
Some Doctors told me it wasn't anything that i should worry.
Others prescripted me topical corticosteroids,antimicrobial creams,antifungal creams and antifungal oral pills.

My symptoms were worse with the time,with irritation and itciness of glans and especially of the meatus.
Also there was prostate pain after ejaculation(for long time before this period) and had constant urge for urinating.

this condition was much worse some days and better some other days.

through some search on internet i settled on some things that it may was.

1)some sort of prostatitis(maybe non detected with common processes).

2)topical fungal infection.

3)candida overgrowth syndrome.

4)auto-immunal disease.

5)allergy to something that i used(for example bath soaps – underwear)

things that made it worse were :
1)humidity of penis(after bath)
2)bath soaps
3)anxiety-stress
4)food(gluten food and candies)
5)masturbation
6)maybe semen

i thought it was candida overgrowth and cause of that drugs didn't help for my cure.i had other symptoms like rectal itciness,cold hands,eczemas in adductor muscles,excess sweat feet,stuffy nose every morning,bloating,joint pain.

Things i did that helped me a lot were :



1) used only full 100% cotton underwear.

2) not use any form of bath soap(natural green soap only)

3)try changing my diet(you can find anti candida diet through internet)

4)thoroughly dry penis after bath.(even with hair dryer)

5)try to control stress-anxiety

6)drink lots of water(2,5-3 litres a day)

7)exercise(exercise helps detoxification of the body)

7)taking some supplements such as garlic,oregano oil,quercetin,saw palmetto,pau d arco.(NOT all together)

The supplement that made the big difference was candida clear(nowfoods).You can search and find some good anti candida supplements.

Now my symptoms have been a lot better.Some have eliminated.
Only thing that annoys me is the meatus that continues getting swollen after intercourse.However swelling is better than months before and redness of glans-pains has been eliminated.

I should admit i didn't make strict diet and much exercise(cause lack of time).
If you have something like this i should tell you that it is a long war.
You need to have strong patience.
Symptoms are getting better months after changing your lifestyle.

At last,i am not a doctor and can't take the medical responsibility of what i am saying.First of all you have to get your doctors advise and opinion of what you have.
Besides every condition is different.

Hope this helps you!
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I strongly recommend to read the following two articles. THE HOLY GRAIL: Plenty of individuals with impossible-to-detect-bacteria(yes, you) and non adequate treatment applied(Wrong antibiotic, wrong dose)...rbaker story

http://www.unboundmedicine.com/medline/citation/17511725/Treatment_of_men_with_urethritis_negative_for_Neisseria_gonorrhoeae_Chlamydia_trachomatis_Mycoplasma_genitalium_Mycoplasma_hominis_Ureaplasma_parvum_and_Ureaplasma_urealyticum_

http://www.unboundmedicine.com/medline/citation/19297275/The_significance_of_Chlamydia_trachomatis_in_urethritis_and_prostatitis___differences_in_therapeutic_approach___Croatian_experience_


Stop your delusion with other parasites and pathogens if you have not attacked the "ghost" bacteria properly first.

Choose the good one for you from these:

1. Lymecycline or mynocycline (7dayon-10off-7on)..rbaker again
2, levofloxacin, gatifloxacin, clarithromycin (Studyno.1)(7day-10off-7dayon)
2. Azithro russianway (http://russianpatents.com/patent/236/2361595.html)
4. Miramistin
5. Vilprophen(wilprafen, vilprophene) plus interferon or vobenzim
6. Ozone therapy(urologist needed)

All credits to Russian doctors.


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but what treatment did u do? did it work?
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Looks like this thread went quiet.  I'm experiencing the same issues and trips to 4 doctors including 2 Urologists have turned up nothing.  Does anyone have any updates on treatments that worked?
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im still here...i think i hv progressively got better..it got more normal now.
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i dont take weed or any of recreational stuff.. to my understanding this issue is more to do with compromised immune system and presence of abnormal cells.. probably triggered by hpv and certain infectious agents in the initial stages

the immune system ...in these case..more likely shows abnormal  tolerance towards abnormal/precancerous cells... so the abnormal cells persisted and causing persistent symptoms.. i think most cases hv this issue..

ive taken so many tests.. and antibiotics/antivirals .. all did not resolve or give me much progress

however, currently, my symptoms have considerably improved ie more normal

one thing that i noticed, when improvement was going on, it could resurface back if I wear tight undergarment.. it seems to suggest that restricting blood flow is sth that accentuate the problem

when blood supply is low, the term is hypoxia.  hypoxia is sth that bad cells [abnormal cells] like. however, as I progressed to the better, such issue is now negligible somewhat .. i can wear tight short/undergarment now..

so, i am no more on etc ABX.    

the following is  my regiment:

1. vitamin D - take with vitamin K2 [MenaQ7] .  Michael's Naturopathic Progams Vitamin D3 5000 IU with Vitamin K2 Tablets is one brand with both D/K.  Other brand includ Dr.Best [D3 5000IU and but K2 sold separately]

I take at least 2 per day.  You can read the importance of VitD for immune function.  I dont get cold/fever that easily with this surprisingly.  Usually one has to take this daily and in the early stages, you might feel numbing sensation to the affected area; it feels like it is targeting the area.. for my case.  Eventually, the sensation will dissipate .. and after 1-2 month on the same regimen, the sensation will dissipate ie lesser reaction .  Theres a lot of recent articles about how vitamin D helps with immunity.  Basically vitD could prevent abnormal "tolerance" of our body towards abnormal cells...so that it would eventually kick out the abnormal cells, instead of our body "tolerating" the bad cells.  I believe most ppl affected with this issue have some sort of Vitamin D metabolism abnormality, ie they produce less or absorb less vitamin D.. or maybe they produce less active Vit D in the body. With lesser active vitD in the blood, immunity is compromised to a certain extent. VitD supplement is best taken when ingesting diet containing fat.. except the sublingual one


2. Take Apple polyphenols [this is sold at Swansonvitamins]. Apple polyphenol contain phloretin; recent studies indicated that phloretin could starve abnormal cells [cancer and precancer cells] from getting glucose

3. Carnosine.  This amino acid taken daily. The abnormal cells also like hypoxic condition. Carnosine could kill abnormal cells [too long to describe]  which like hypoxic condition

4. Take modified citrus pectin [MCP].  Once a day is enough.. 4g.. in empty stomach. Ive taken econugenics brand - come in caps and 1lb tub [i bought theb 1lb tub]. Other brands may work as well, I dont know.  This is for detox. Many ppl with chronic diseases are usually burdened with heavy metals.  MCP could be enhanced by taking 500mg capsule of sodium alginate [this is to absorb heavy metals dislodged by MCP].  The alginate is only taken once a day -  too much of it is not good for your tummy.  

The MCP regimen = I took it daily for about 3 wks..this should reduce your body load of heavy metals.  After that., 2 times a week is ok I believe.

I did not coffee enema, which ppl said is good for liver cleansing - this is also important, as if your liver is not well, yr blood is "dirty" and hard for your immune system to work optimally. There are many regimens /routes of liver cleansing..could google that

If using the above suggestion, I think the improvement will gradually appear, at least 1 wk/2wk after that.

Hope the above helps
  

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4221994 tn?1389536802
Hello
I have not been on here in a long time...so I saw i had some msgs so checked back on. It's been almost a year since jan 07 2015... today is 4th jan 2016.

in summary, i found that the thing that helped the most was lymecycline (for me).
i took A LOT of lymecycline...... 1.5grams per day morning and evening dose before eating by an hour to maximize absorption... for 7 days....10 days off...then 7 days again.
then the kefir helped kill the candida.

that is what worked for me.
Now I have a clean meatus, no problems at all, nothing nothing nothing thank god, I thought this curse would never end...
Good luck friends.
from Beirut, Lebanon.
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4221994 tn?1389536802
Update: after binging on regular sugary foods this Christmas, my Candida Albicans returned in full force...and could no longer be ignored, the redness around my foreskin and pain in my lower right quadrant gradually came back....... so I'm drinking 1 table spoonful of ORGANIC APPLE VINEGAR per 1litre of water, and nothing sugar-based, it's a complete diabetic diet right now.... today is day 2, and the pain in my ileum has receded majorly.... turns out... Another way the yeast can become active is when your ileocecal valve is weakened. The ileocecal valve is located between your small-intestine and your large intestine. This valve is usually kept closed so that the food you've eaten stays in your small intestine long enough to be digested and absorbed fully. It also prevents the good microorganisms in your large intestine from getting into your small intestine, where their waste products could easily be absorbed.

Some of us on this forum have experienced pain in their ileocecal valve...

**interesting bit** my GP denied any possibility of anything (even Chlamydia) from jumping between the small intestine and large intestine and I later tested positive for Chlamydia after 24 negative tests, and denied any possibility of Chlamydia jumping from the ureter to the intestinal tract...I found many journals confirming that this indeed DOES occur...so my confidence in my GP went under.

Currently, I am drinking a very light vinegar drink, and my intestines feel great, my right lower quadrant no longer feels like it's on fire, I feel 'cleaner' I don't know how to describe this but the vinegar seems to have spread significantly throughout my system.

It takes two weeks to get reduce the Candida levels down to non-significant levels - the vinegar drink should not continue over 2 weeks as this can risk Ulcers due to the high acetic acid concentration remaining in the body causing all sorts of unpredictable results.

Candida is a pretty big side effect, but compared with Type K Chlamydia it's a joke.
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Rbaker..and those who believe it is fungal..could also do a swab..google "candida swab". if your symptom is due to fungal, the most common is candida..the staining fr the swab (meatus) can detect fungus. there must be a swarm of the fungus or candida if you believe it is the agent there..if you dont see a swarm of candida or fungus under the microscope through the swab/staining..then it is ridiculous to say its candida or fungus

I recently used Leflunomide, and I beleive it is the one answer missing. Most likely our issue was due to viral agent(s)..CmV being one major culprit I believe, HPV is relatively benign..not until cmv is inoculated ..I beleive Cmv porentiated HPv activity...thus the hpv infection (which is very common) became a symptomatic, chronic disease. CMV can passed  through oral contact..as CMV shedding hotspot is salivary gland.. CMV is recently reported to cause autoimmune disorder ..and various cancers.  Google "cmv autoimmune" "cmv leflunomide"
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Guys after dealing for 2 years with red meatus, appeared days after unprotected sex and having gone to different doctors and taken all the antibiotics in the world i just recently stumble in what i think might be a CURE .

I don't even begin to tell you what this thing did to me psychologically but now i see my meauts back to pink, normal and the weird feeling that came with it like prickly groin seem to be also going away!

The first urologist i went to, i think nailed it. He told me "you don't have an a STD, women sometimes have fungi" and gave me Econazole cream. It didn't work, even after i applied it for an entire month but  I always though it was doing something good at one point it did clear for a few days but then redness came back and no amount of cream ever made a difference anymore. I tried TeaTree oil and it cleared peeled and come back the next day. Garlic pill, oregano pills,
vitamins , zync diaper cream, coconut oil you name it i tried everything. nothing made a difference.
I never had the raised lips some of the guys talked about but i think that's just a different degree of inflammation . I'm not circumcised .

Then one day i bought MONISTAT 7 . It didn't work either
after a week so i left it alone. Time went by i even try to tape my penis open for a week so to dry the fungal infection .Nope.Wrote a journal to keep track of what i ate what i applied..went nowhere with that either i kept reading it trying to find clues after months of records..nothing.
Finally just to try another thing i read on the internet i decided to use MONISTAT in combination with APPLE CIDER VINEGAR applied DIRECTLY and UNDILUTED(other than the 5% that it comes in the bottle)
Breakthrough! So try this:

Soak a Q-tip it in the AppleCiderVinegar bottle, squeeze glans so to open the slit of urethra and apply the vinegar on meatus, glans and yes inside urethra let if flow in there. IT STINGS , BAD but just for a moment and leave it there to dry don't wash it go on with your day.
Do this in the morning and when you come back from work in the evening; possibly right after you pee so for a while nothing washes it off. NOW to compliment this at night before going to sleep take a pea size amount of MONISTAT 7 open your urethra and PUSH THE CREAM DOWN THE SLIT and apply allover the glans and foreskin if you have it. Go to sleep.
Next morning pee, shower ,dry(i used airdrier to dry glans) and reapply apple cider vinegar, then apply MONISTAT again and go to work. If you want you might reapply mid day.
Always make sure to dry urine after peeing with toilet paper squeeze the very last drop out dry and again until there's no more.
AFTER A COUPLE OF DAYS I NOTICED THE MIRACLE WAS HAPPENING. I'm not cured yet i know if i stop will come back i've been doing this for just a week but i finally think i found a weapon against this thing so give it a try and i really hope will help some of you.
The thing with the AZOLE family of antifungal agents is that they don't kill the fungus they inhibit the growth that means that you have to rely on the natural shedding of the skin to go back to healthy and that can take weeks! that's why you don't stop treatment until after you're healed and beyond !
Maybe the apple cider vinegar induce some kind of gentle chemical peel (i didn't actually peel) and it's also in itself an antifungal so..who the heck knows and cares it just seem to work!!
Good luck and don't worry it won't get worse, it won't infect anybody, it's probably just a stupid stubborn fungal infection and IT WILL GO AWAY.
Peace!
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Hey! So im dealing with the same thing, went to urologist and see otolaryngologist said it's probably alergic reaction gave me creams nothing worked even antibiotics. I will try what u suggested. Mine is reddish but after ejection thers a big round red circle surrounding the meatus, plus a felling of tingling and like few drops left after urine..im so frustrated
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I recently had anal sex with a female and she used lube. I now have similar symptoms (irritated meatus, meatus stuck together, burning when urinating, tested negative for all STDs). My symptoms started about a week and a half after my sexual encounter. (We had oral, vaginal and anal sex). It started as itching on tip of penis then really bad burning when urinating. Got on cipro, did not help. Have had symptoms for 8 days now. Now my L eye is bloodshot for the past 2 days and I am a little freaked out (conjuctivits?). Were there any more developments after the post for feces bacteria? Has anyone actually tested positive for fungus or feces bacteria?? Thanks
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I had same symptoms and same follow up as 90% of people in this forum and other forums online. Received oral sex (that was very rough) that caused Chlamydia week after. Treated clam succesfully  with the use of cream (not OTC, Ketoconazole2%) and a single tablet of Fluconazole, the redness persisted and it caused pain on friction with my clothes, needles and sharp pain (although not during urination) and very inflamed after sex of masturbation. Red lip of meatus seemed to grow.  That persisted for 2 months. After reading all the forums and freaking out about having a chronic condition here's my advice: STOP READING FORUMS and go to a doctor. I got prescribed Cephalexin antibiotic antibiotic 2 times a day and after 4 days my meatus started healing and the pain dissapeared almost 80%. I can see how the redness and rawness  of the meatus starts being covered by pink skin again. It was a bacterial infection although not and STD, its called NGU Uretritis. Internet is full of horror stories, Im sure the struggle of a lot of people is real but if you are reading this and freaking out like I did please understand that internet is full of horror stories. I thought I would have to live with this forever and now it's almost healed. So that can be your case too.
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In later posts you say all your STI test came back negative. Very confusing man :s can u be a bit more precise please?
I mean l've been walking around with the swollen meatus for a year (especially after masturbation, with lips). After this year l started asking myself the question whether such a meatus is normal or not. Got checked for all STI and negative. So, if l had Chlam, it'd still be visible in the tests, right? Anyway, l tried 1.5 gram zithromax and also a combo of itraconazole and miconazole nitrate as u can read if u go down. Nothing helped.
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sexually transmitted adenovirus has been shown in a number of case studies to be related to simultaneous meatal swelling, urethral irritation and conjunctivitis.  It is also mentioned in up-to-date urological manuals.  

Good luck getting any doctor to test for it, but it could be a real possibility if bacterial tests fail to turn up anything.
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Geez... prostatitis affects 10pct of men..90pct of that 10pct are called chronic abacterial prostatitis (CAP)...some are mild..some are serious... current uro field has NO IDEA at all as to the exact reason.... just becos Uro dont know what it is..does not mean there is nothing there..could be they are just ignorant of what it is really about.. eg did u know that only recently in 2014 scientists discovered that cmv is linked to autoimmune disease? (google cmv australia autoimmune) .. ppl hv always said autoimmune has sth to do with yr genetics what not..but in actuality...it is cmv is one main culprit..perhaps some ppl hv a type of genetics with lower resistance to cmv..  If Uros are at a loss on CAP..what is yr credentials to tell ppl that they should not try to understand the issue and get etc info fr the net to try and resolve it the best they can?
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Here is a rather old publication:  google PubMed 18615364.

For those who didnt catch about the term "chronic abacterial prostatitis" = the definition include IRRITATION of the lower genitourinary (GU) part of the male (any areas in the lower GU, eg bladder, testis, urethra, meatus, glans.. surrounding areas of the affected region)

Doc may or may not use such term to "diagnose" your condition.

If you are negative on STD test and still have lingering irritating issue despite taking various ABX for like months, it means you are a member of CAP club

And if you do PubMed search, there is still NO new update / review on the CAP  "treatment".  Any "treatment" done (currently) is only attempt to resolve or address any immediate troubling symptoms, as the actual issue underlying or triggering the problem is not entirely known by the Urologist/healthcare system

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I missed out one. Google pubmed 26951713. It is the latest publication on chronic prostatitis. Note the keyword sentence in the summary.  

"Many individual therapies have been evaluated in the treatment of CP/CPPS; antibiotics, anti-inflammatory medications (including bioflavonoids), neuromodulators, alpha blockers, pelvic floor physical therapy and cognitive behavior therapy. Each of these has been found to have varying success in alleviating symptoms"

Keywords:  ALLEVIATING SYMPTOMS. Currently, they (Uro) are only able to ALLEVIATE the symptoms.  They cant cure the disease, as they have no full knowledge of the pathogenesis ie what (agent(s)) caused it and how it turned out to be like that

Because they dont know the best treatment, thus, the statement prior to the above mentioned: "This often leads to a nihilistic approach to patients and clinical outcomes are poor."

So, dont be surprised if there will be more ppl being frustrated, as it is a fact that the current system is at a loss on the exact reason behind CAP
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CURED:

Here's my case: I'm not going to repeat my symptoms, but I've been following this thread for 3 months now when my nightmare started. Here's what worked for me after some trial and error and what I suspect it is.

What we have is a polybacterial infection of the prostate/urinary tract. It started when bacteria entered our system through sex (multiple reported getting infected through oral, like my case, specially oral sex with micro wounds from teeth or skin tear) Once the infection starts candida overgrowth appears as an opportunistic secondary infection that mask the main polybacterial infection. The secondary infection then moves up to the prostate or testicles , even if only the meatus is the more visible area of inflamation, meatus is connected to rest of urinary tract so you need to take care of the whole urinary tract not just the meatus. Here's what I did and worked for me. 1st. Took care of clam infection with fluconazole and ketoconazole antifungal cream. Once clam is removed attack the polybacteria fast before it develops a strong biofilm in your prostate and becames chronic. I took 2 weeks of Cephalexin 500mg twice daily, right at the end of the course I got treated for ghonorrea (4 doses of zpack and antibiotic injection of Ceftriaxone) this is important as most of this bacteria are resistant to an antibiotic, but they can't fight 2 or 3 combined. Now what REALLY helped me and it seemed the last resort was uva ursi, a diestetic suplement. Uva ursi is extracted form the leaves of a berry plant, but it works great for prostate infections as the main antiseptic ingredient has a lot of penetration into the prostate, destroys bacterias biofilms and its eliminatetd through urine intact, so it also helps with meatus. It also has antiinflamatory properties. Its toxic so you can do it for more than 2 weeks, but I took it 3 days before ending my antibitics and I noticed 80% improvements after 2nd day. You can combine Uva Ursi with some kidney supplements to help flush out everything out of your system. Also try to keep you urine alkaline as Uva ursi works better with it (avoid alcohol and cranberry juice). Last but not least, all other creams and things that I applied to meatus made it worst, its not a skin infection, its the mucose membarane, so stop applying things to it it will make it worst. The best thing you cna do is saline solutions, warm water and sea salt, twice a day, to keep meatus clean and soothed. Also you don't have to avoid masturbation, its good to avoid bacteria infecting semen or epididymis to keep things moving down there, but limit it to twice a week and very gentle, clean it well after. Good luck my friends!
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Did u really have Chlamydia? Did it show positive on the STI tests?
Did u have Chlamydia and ghonorrea?
I find your post very complicated and confusing... I've got an red thick meatus with lips around for about 1.5 years now, STI test negative, received a prostate massage and the liquid was checked: negative. Also my urine was checked 2x separately and negative...
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As a followup from above, I want to say that all my std test and urine test for bacterial infection came back negative, so its a bacteria that its either hard to culture and detect in tests, that hides in the prostate or its a common bacteria that its not considered harmful but it reaches to tissues that aren't supposed to colonize, so docs are clueless about it.
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Did your tests came back negative before u started this treatment? How the heck can u get these medicines then?

I really don't get it. At first the doc thought it was Chlam, so gave me 1.5 grams of Zithromax. (this when l was waiting for the STI test results), STI turned out negative, urine too, prostate massage too, so doc was clueless. On another forum someone was cured from this problem using itraconazole with miconazole cream. I tried that for 2 weeks (400 mg per dag) and smearing this miconzolazole nitrate 20 mg/g twice a day on the meatus, and it didn't help anything.

So are u saying that l should start from the very beginning and take azithromycine again, followed by these other AB's and injection??? Pretty insane.
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Has anyone tried metronidazole combined with miconazole cream?

Been having this red meatus lips (especially after masturbation) for 1.5 years now. All tests negative (tested urine twice; even once after a prostate massage; put a swab in my glans and brought it to the hospital...
ALL negative.)Tried Azitromycin, itraconazole with miconazole, daktarin, ...
Nothing seems te help... FML, seriously :(
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How did you go about getting prescribed all those meds?  I feel like it would be impossible to convince any of the docs I've seen to prescribe 1/2 those meds.
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Is this a reply to my message? :p
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No. Was to John 8181.  Not sure why it was not in line with his comment.  I replied to his first "Cured" post.
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On some other forum I found someone who was cured of this with the following treatment. Here is his post:
"Okay so,I am a genetic engineer from Greece,lives in New York.I had the exact issue..I have found the solution just recently.

You get %70 alcohol wipes from CVS,you wipe it gently everytime after you pee.Please WASH YOUR HANDS everytime before you do this.After that apply a body lotion that has NO SENSE in it.Meaning like strawbeery,Orange or any kind of flavor.Just regular body lotion.The redness will burst after a while like around 2 weeks.You will have those white bumps right around the pee hole.DO NOT PANIC! This means now the virus is out and it is about to die.Take a warm shower everyday.After the shower,again wipe the pee hole gently.Make sure those white stuff comes out and redness will appear,if it is severe it might bleed,do not panic! ,it is normal.and apply ABREVA on it including body lotion.Take a SOFT toilet paper and wrap your penis,and gently place it in your underwear.Wear brief slip underwears,and then your penis does not fling around during the day,and it gets less irritated.keep apply the same thing all the time after you pee.Because,once you pee ,Uric Acid makes the redness/wound open up easily.You might think Alcohol also opens up the wound,YES it is right but it cleans up the area!..That s all I can say.My wound is about to die.This might takes 3 to 4 weeks to clean up all.
All my STD / HIV tests are NEGATIVE.Doctors could not find a cure on it.Some thought fungus or some kind of virus.No ,it is just a bacteria that sits on your pee hole,because it is moist and gets fed by the vitamins and waste nutrions that has in your pee.Do not use Hydrocortizons because it also feeds the bacteria and keeps it moist (Hydro means water base).Please,yet again,you have to be really careful with your hands.Do not touch your penis without washing your hands.Do not use sanitizers for your hands,use regular soap,and also wipe your hands with Alcohol Wipes.Change your underwear everyday.Be sure,everything is clean.I know I sound like some kind of OCD but at the end ,you are just being happy after seeing the results.

P.S. Try not to have sex or masturbate during the treatment.You certainly decrease the irrtation by not having sex or masturbating.

You ll pray for me!

Thank you all "

Does anyone think this is a possibility to treat this problem?

Thanks
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Is this topic closed? Coz my replies aren't appearing here...
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Well, that guy said "This might takes 3 to 4 weeks to clean up all. "
That says it all. He is not 'cured' yet.

Some are adamant its fungus -- as I emphasized earlier, if it is fungus, you have to do a swab. The swab will tell you if it is really fungus. Because candida/fungus can be swabbed and watched under a simple ordinary microscope. If no fungus seen, then it is not fungus.  Typically, candidiasis, needs no swab because it causes thrush -- in the mouth /oral area it is called oral thrush.  White tongue is an obvious sign of candida colonisation

This issue,. is most likely related to virus[es] infection. It leads to development of dysplastic [abnormal] cells. That is why you have the lingering irritation.  Only broad antiviral would work on it.  

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I have tried 2 times per day 200 mg of itraconazole, combined with miconazole cream on the meatus twice a day. Nothing improved at all. So it is not a fungus.

To me it doesn't really irritate as in hurting. But the red lips / area around the meatus kills my self-confidence.

Do you think it is causing more trouble inside the body? Maybe in the urine bladder ?
My urine and prostate liquid were tested and nothing abnormal was found, but they probably checked for bacteria?
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* tried that antifungal treatment (thought it would solve the problem, as nothing was being found in the tests) with itraconazole and miconazole cream for 15 days. 400 mg per day is already a high dosage, which is pretty heavy for the liver. I was told that this itraconazole works for another 2 weeks in the body.
It can't be a fungus.
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What antiviral(s) could solve this problem then? Any idea?
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user09203 has reported success with with Leflunomide (LEF).  

pptjv, I believe you are on the other thread as well, but user09203 posted this about his progress with LEF:

Update
Here is my update

I think I can say the stable condition has definitely improved further..to a condition that is markedly resolving

The transient sensation does appear at times, but it is now significantly lesser in terms of frequency and fainter in intensity

Pretty hard to describe in words. Previously, there has been one major focal point, midway of the shaft on the left. And also the meatus, usually the left. When my condition was "stable", the topical cream didnt give much reaction anymore, but I think it did help to stabilize the condition (frequency of use was about once or twice every 2 wk).

Since I was on oral LEF recently, I did re-use the topical cream (diclofenac voltaren max + egcg + a pinch of ascorbly palmitate). And this time the same cream gave a different major reaction. The left side, midway urthra, and left side of the meatus felt sizzling hot. There was also some sensation on the right wall of the urethra [mid way] and a bit of sensation on the right wall of the meatus. This didnt happen previously. In all, there was inflammation, wasnt that terrible, but it does feel painful if I press those focal points where the reaction occurred

After one week I stopped using the cream but continued on oral LEF. The inflammation subsided and it did feel lighter down there significantly after I stopped the cream.

On week number 5, it seems I hv some itchiness on my right groin. Not sure what caused it ...But it is said side effect of LEF includes skin rash. Tea tee related cream seems to sort out the itchiness. Could also be when CMV is addressed by LEF, your body now starts "seeing" whatever other viral bugs that was previously "hidden " through CMV activity. HPV is very common and there are many types, it could be that, not sure though.

The other "new" thing [week 7] that I felt popping out is the bladder. I dont know if it was because of the lemon balm tea which I took, but there was some sensation there. Again, my hypothesis is that, when CMV is addressed, gradually, your body starts uncovering "stealthy bugs" that have been protected by CMV. Without CMV, it is not exposed and yr body starts addressing it. It could be that there are residual abnormal cells in the bladder, as previously I did have bladder irritation.


At such time, I have taken 2x100mg of itraconazole [oral] and immediately the issue was resolved. I believe that the combo of LEF and Itra did address the remaining hidden dysplastic cells there. After taking itra for 3 days [total 600 mg], I did not feel anymore sensation at all. And I also felt something new.

Previously, I always have felt after urinating, there will be a few drops of urine being 'stuck' at the base, felt like it did not come out totally. Had to force it out by squeezing the base. But now, that sensation is totally gone! I didnt feel that anymore. Could be that there was also some abnormal cells making up a minor plug at the base and that caused such sensation

I am currently pausing the LEF. Because I think it is better [as stated by patent WO 1999045908 A2, claim 9] to take it with orotic acid [aka orotate] supplement [awaiting supply]. I didnt feel any major irritation spike stopping LEF - after all, it has a rather long half life ..about 14 to 20 days

LEF has two activities: antiviral and immune suppressing activities. You dont really want the 2nd activity. That is why in the patent the author suggested taking "pyrimidine" supplement. LEF prevents synthesis of orotic acid [a pyrimidine, precursor to DNA] and that could cause immune suppression. So, orotic acid supplement [such as Magnesium orotate] may be ideal while using LEF

So, my opinion is that LEF + Itraconazole [200mg a day] and orotic might be the best combo. How long one has to take LEF, perhaps 3 months is a minimum . LEF is usually taken at 100mg for 3 days, thereafter 20mg a day. Itra could be a bit hard on the liver for some ppl, so, liver function and kidney function tests should be monitored. I think a minimum of 2 wk is required for itra at 200mg/day. Orotic acid is just a supplement and the dosage is a guess.. it could be excreted in the urine if you have too much of it. I think 1 to 2 g a day of orotate will work.

So, my opinion is that for the chronic issue to be resolved, one has to stop CMV and address the abnormal, dysplastic cells. LEF addressed the CMV and itra could pop any dysplastic cells [or yeast / fungus/ candida, if you believe that]

Depending on how many dysplastic cells one has [the longer chronic irritation history, likely many more dysplastic cells], or if you address the issue using the topical cream, the time needed to resolve the issue may differ.

So, my opition is that the combo of using LEF, Itra and orotic acid will work [as suggested by the patent WO 1999045908 A2]

HPV is very common, but I think the main driver of the issue is actually CMV. Once CMV is stopped, your own immune system may be able to address the resident HPV

From all this, I think we can conclude that the chronic issue is likely viral mediated. A rather broad antiviral agent, like LEF was never tried at all in most cases. Only broad antibacterial and narrow antiviral agents are usually used [eg acyclovir, specific for herpes, viral resistance is not uncommon] I think LEF is somewhat a special agent, because it stops susceptible viruses through inhibition of phosphorylation; there is likely many reactions in the virus, requiring phosphorylation and this means multiple sites of inhibition - not only a single point of inhibition, like acyclovir, and this may explain LEF effectiveness].

This solution may be controversial and unconventional. But i think it will work in non bacterial cases. Remember, only recently in 2014 CMV is found to cause autoimmune disorder [google cmv autoimmune australia]. Previously, nobody could expect such fact to be true...not even your infectious disease specialist. They only follow the book and use 'standard treatment' which they learnt, based only on established facts. But new knowledge will only be adopted in their practice maybe 5-10 years after discovery.

I will still post any significant new update/history for my case.
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Thank you for your post!
So it's about LEF and itra?
Strange thing is that l used 400 mg of itra every day for 15 days straight, and nothing helped. So do you think that, in my case, l should only use LEF? (itra didn't give ANY improvements, even in combination with miconazole cream)
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Although l don't think l have the same problem as this guy. My only symptom is the red swollen meatus, especially after masturbation. It forms some lips. No itching or pain etc.
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pptj,
1.You said in some of your posts, that you have not had any sex for like 1 yr. But, how long have had it  [Cant read all those msgs per se].

2. If you would mind telling the board [if not maybe you can just PM me ] of your sexual history ie like how many [approx] diff person have you had intimate sex [in your entire life ].  This has sth to do with HPV. Ppl say if you have sexual contact with 4 or more diff partner.. then HPV is a definite.  HPV viruse are of many types -- and the wart they cause [shape and size] can also vary

3. Itra is only to address the probable yeast and dysplastic cells. Although itra have shown anticancer activity, it does not address all of the cases ...all of the time.. since dysplastic cells can also have different types

4. Since you tested negative on standard STD test [including urine culture?]; most likely it isnt bacterial

Will respond once you answer. Tk care for now

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As a follow up to my earlier comment, i believe that if one takes LEF, it is best to take it with Orotic acid [eg. Magnesium orotate supplement]; 1 cap of 650mg, twice a day may be enough. After a month, I think 1 cap a day is ok.  If one takes LEF, watchout for the side effect: your milage may vary : reported side effect include diarrhea, loss of hair [baldness].  I noted that using LEF -w/o- Magnesium orotate, my nails do not grow somewhat..and it looks like the nail can easily detach itself from your finger ...not literally all of it..just at the tip.. it is still painful. When LEF is taken with Magnesium Orotate, the nails grew ok..and there is no pain ie detachment of the nails

Thats one of my current updates..more later

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I have had 3 sexual partners in my life so far. I am having this red meatus problem for more than a year now and l most likely got it from the last girl l had sex with, even if it only took 15 minutes... and just once with her. It must be from her.

I'll try to get LEF within a few weeks. I really hope the GP wants to prescribe me this based on the negative bacteria- and STD-tests... (also got a prostate massage and the liquid was checked, also negative) l did see that it does cost quite a lot of money... (LEF)
Did u get diarrhea from it?

What about the itraconazole? As l stated before, l have used itra for 15 days (morning: 2x200 mg and evening the same dosage) and also smeared miconazole cream on the glans and meatus twice per day. it didn't improve it all.
So what do u think? It's not worth to get this itra again? It is quite expensive and my meatus remained red. Especially after masturbating my meatus is very swollen and has kind of thick red lips.

Does the LEF online kill the virus? Not heal the skin and get rid off the swollen meatus? Coz l really want to get rid of that! Don't think taking itra again will help something. Already took a high dosage for 2 weeks (and afterwards it stays in your body for another 2 weeks l believe) and nothing changed visually.

Thanks in advance
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There seems to be a bug on this website, the link to picture of what it looks like (my meatus) on another forum keeps getting deleted when l post it here... Ugh.
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hi pptv,
i saw the pic you posted..the itra most probably have no effect on you...so my guess there is no point in incepreasing the dosage...also you dont have any pain it seems.. just cosmetic look issue... but it could be due to wart related hpv virus. LEF is to target etc unknown viruses..although it does not necessarily work on all viruses..i am not aware if it works on hpv..but it could target other viruses, like cmv..which can accentuate hpv activity (my hypothesis). i know generic LEF source, i will PM you perhaps. since you do not hv pain, issue, likely that your problem is different than mine..and LEF is rather an option i think for your case...but its good to strip off other potential viruses with LEF..so that the probable swelling can be addressed by using........ aldara! ie if your lipsy meatus is due to wart related hpv. aldara is to be used after 2 wk of LEF. Aldara is not a completely 100pct safe thing..small amt of ppl hv major bad side effect with it..but many praised aldara effectiveness. if your lipsy mestus is due to wart related hpv, then upon aldara use..the areas will gradually become angrier ie swollen. not a pleasant thing. then there may be ulceration, throbbing pain, itchiness..exudates etc redness. at the near end stage..necrotic bad tissue addressed by aldara will form pus like material.the cream is said to activate yr immune system to eradicate wart related abnormalities there.. hence the reaction. i read somewhere on the internet..that some ppl with meatus problem go for surgery and cut the meatus..not sure if its true though!

i have minor diarrhea with LEF..but seems to be even less pronounced when using it with MgOrotate
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How long have you been using LEF right now?
- did your meatus look like mine? (apart from the other symptoms you might have)
- do you think that this virus is harmful when not killed? That it could lead to prostate, urine bladder or cancer related things/problems in the long run?

I really wonder if the LEF itself could make my meatus look normal again... Would do 'anything' to make it look like normal again. I am worried that if a girl would see it, she wouldn't believe that it is 'nothing' to worry about as all test were negative...

Did you actually do a PCR-test, in which viruses like HPV and or CMV etc. are checked? And were u prescribed LEF based on the results of these tests? Or did you self-prescribe yourself these medicals?
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ive been using lef for at least 3 mo now. i am tapering off now ie taking lesser by the day after 3 mo. i have seen substantail changes ..so thats why i have reduce the intake..loke i take 20mg every 2-3 days...instead of 20mg everyday

my mestus does not look like the pic you posted..thus dissimilar to your case on the meatus...althoug at the height of my issue ..it was very irritating on the meatus..though no marked swelling

the actual cause of etc cancer inc bladder and genital regions..is still hypothetical.. it is most likely related to viruses such as hpv. cancer have stages.min the early stage..it is usually clinically silent..no marked symptoms..as years go by..you may experience other medium issues..and it may then progress more.. most cancer is not an overnight thing o..it is a disease that develops over time.. usually spaning five to decades of life

in all of the cancer cases..usually precancer cells will appear first..then it is anyones guess what time it will need to morph into full blown cancer..usually it takes years

so, if there are cancer causing viruses lingering in you..often called oncogenic virus..it could...in due time ..cause the precancer to morph into cancer

i dont knownif lef is necessary for yr case, it is my guess that multiple viruses presence ie not only hpv alone.. is usually needed to start to cause a problem

hpv and cmv test or etc viruses test arent typically done in specialist clinic or in the hospital.. in most countris i guess... eg cmv viral titer is done due to its significance in solid organ transplant

pcr for hpv could be done..but usually clinician dont do it, as the medical community take the assumption that it will disappear within 2years in most cases..also..as hov is very common.. i think they made that assumption


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Hey guys, I have finally been cured after 6 months of dealing with the symptoms such as swollen meatus, painful urination, and pain after ejaculation, and weird painful sensations in my groins that everyone seems to share. I know how uncomfortable and how much stress it causes, so I've come back to share how I have been cured in hopes it helps other people.

After trying about 8 different antibiotics, natural remedies, trying to eat 5 cloves of garlic per day, and seeing doctor after doctor with no sign of a cure, I found a doctor in my town who thought I might have prostatitis, but couldn't exactly find a test to prove I had it, after having multiple urine, blood and other tests come back negative. He finally did a prostate exam and I had an extreme amount of pain when he pushed on my prostate. He diagnosed me with acute prostatitis, and I was prescribed with norfloxacin for one month. After about 3-4 days I saw instant results, and by a month it is about 80% cured. Im going to do another month of norfloxacin just to be safe and ensure it is 100% gone.

I'm not sure that this is the cure for everyone, but I know I wish more people who had of been cured would have come back to share their success so we didn't have to suffer that long. Hopefully it helps someone
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user888c, what was the dosage of norfloxacin you were taking?

Also, when/how did you symptoms start?

Thanks for coming back and sharing your positive results.
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I would like to add to this as I have similar symptoms. Just got retested for everything (standard panel).  I'm more concerned about hsv-2. And will need to wait again for the results. But after reading this for 3 hours and saving several apparent cures.

My experience was just stupid and dumb.  On March 3rd of this year, I fingered, went down on (just using tongue not lots saliva or really eating her out), and then she got on top after sucking on my phalus for a few seconds then got on top and only got half my head in when I came. Also entirely in the dark so didnt see anything...though no nasty taste or fishy stinky odor. It was my first time and I am 28...she's been with 30 something guys. It also freaked me  out when she came out of the bathroom from peeing and said I made her bleed. Can you say cervical inflammation?  Yeah go me.  

So morning after, a mixture I'm sure of anxiety and bacterium, I had yellow watery diarrhea, choking sensation, and gagging. The next day, It tingled on the tip of my penis and and front top half of my tongue. Had yellow all over my tonsils, uvula and tongue...and more diarrhea.

After first test I got 500mg of Azithromycin and Gono shot at the HD.  After side effects wore off I felt good  for two weeks. Then got pain in the testes and burning after I urinate. Then March 29th got rechecked for chlamydia and gono culture...negative. But was given 10 days of doxocycline...it helped.  

Well recently we had a lot of crud going around the office.  I have a bad immune system. Got two stomach bugs and then got a sore throat that looked disgusting and looked viral (strep was negative).  People have said burning tongue, the sore throat is similar to herpes...but with my ****** immune system I would thing that would have happened first. My semen burns my skin now when I masturbate.  My last urine test picked up blood and white blood cells.

I will add my Meatus is swollen and spreads throughout the day.  burning in my scrotum, and just depressed.  

So I am going to see the results, may get tested for trich, then if anything try as many of these cures as I can.

Only question: Anyone have any mouth issues?
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I suspect you have viral infection..could be more than 1 type of virus
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Pretty sure guys it is a strand of hpv.  I got what I believe are orange like bumps on my throat and near my tonsils.ugh
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The norflox are likely just providing anti-inflammatory effects for the combo HPV/CMV although that is probably providing great temporary relief. I would take it until 100% then stop and see what happens.

I have been following this thread for quite some time and I think user97203 is right on the money with his thoughts on what may be causing what ails us. It
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I wonder how rbaker is doing these days?
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rbaker, I would also love to know about you :) Are you fine? Have you defeated all your problems? Thank you for all you have done in this forum
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Hi John,

I have seen multiple docs, dermatologist, urologists and havent had any help from them. All have prescribed anti-fungals and steriods with no relief. Many have said nothing is wrong with me and the last dermatologist tried to put me on anti-depressants. He claimed that this "pain" is all in my head, but have been dealing with this for a year now.

The redness is at the tip of the penis, more visible to me than the dermatologist. The pain is a chronic pain that hasn't gone away and has really made quality of life miserable.What do you recommend for further treatment?

Thank you all for your help!
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I have been dealing with this issue for about a year now...since I first noticed. But It can be that it was there sooner. Luckily for me I dont have much pain and if so that occasionally as other describe. Pinching on red inflated meatus, burning urethra and burning sensation in groin area shooting down left inner leg. All these sensations very mild and occasional, like once a month or so.
What have been working for me as relief is applying Tea Tree body lotion/ hair conditioner on my penis head. I am not circumcised.
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Lets just do a quick summary.
1. Most cases here with persistent pain, yet no bacterial agent detected, is likely CAP cases [chronic abacterial prostatitis]
2. Although some thought it is Yeast/candida, this is very unlikely. Current medical test allow you to do a urine culture for candida. Most candida infection is visible by eye - that is why you call it thrush .. vaginal thrush..and oral thrush.  Male thrush might be controversial, but a simple swab of the suspected thrush should be easy enough to confirm yeast/candida.. if the swab did not show any candida/yeast cells under microscope, then what you have is not yeast infection.  
3. Most cases here with chronic pain maybe diagnosed as CAP ..or the doc/Uro will say "its all in your head"
4. Some might also suggest Pudendal Neuralgia.. nerve issue. Although this may be a cause, it is usually due to trauma.  PNE..pudendal nerve entrapment is one of it.  However, most ppl with lingering CAP cases have the issue commence a few days or right after sexual contact [involving oral sex]
5. My impression is the chronic issue, which affected many CAP cases, is due to viral infection..most likely a herpes virus tribe [cmv] plus HPV.  CMV is notoriously known to be shed from the saliva [hot spot is salivary gland].  HPV in itself alone cannot cause any major issue, but when there is herpesviruses like CMV [and EBV]; the issue might get complicated.  This might explain the established fact which says HPV infection is common, and most overcome the virus without any problem.  Within 2 yr, one should be able to clear HPV. However, in the presence of other common viruses like EBV and CMV, there is no study /data to say the resident HPV will not cause any problem
6. Most ppl with CAP have been "treated" with  a number of broad ABX. And the problem did not resolve and this suggest it is not bacterial nature.
However, broad antiviral has never been prescribed, as viral infection is said to be incurable.  Although incurable, the broad antiviral agent should theoretically be able to help, to suppress the herpesvirus[es].
With the suppression of such herpes viruses, the inflammation and chronic issue can be addressed
If the herpesviruses or the offending  virus is not suppressed, then the CAP problem will persist and chronic inflammation/pain/abnormal sensation will linger.  In due time, the inflammation will cause the development of abnormal cells [aka dysplastic cells].  These cells are also called pre-cancer cells.  Cancer do not develop overnight. It takes a few years, and decades of life to morph the pre cancer cells to full blown cancer.  With inflammation, the pre-cancer cells likely take lesser number of years to morph into full blown cancer

I have posted two pics in my profile.  The pics shows the locations where precancer cells can appear.  These abnormal cells have appeared due to prolonged viral activity that induced such cells to form.  The longer inflammation occur, the higher the chance such abnormal cells will appear.

My belief is the spots or location where the pre cancer cells develop causes the abnormal sensation ie numbness, shooting pain etc.  When
the abnormal cells is addressed, then only the pain sensation can go away.

I have used LEF and it does make the [transient] pain substantially minimized. During chronic stage it was like 9/10 to 10/10.  Using ABXs, which is anti inflammatory, does not resolve the issue, and the pain was reduced at best 5-6/10, and can increase to 9/10 if ABX is stopped thereafter.

LEF was the best in terms of reducing the pain, as it is a rather broad antiviral, which can suppress the possible viral agent[s] multiplication.

If one has had the issue for a long time eg a few years, abnormal cells due to viral activity may have developed.  Such scenario requires the use of anti neoplastic agent such as aldara to destroy such the abnormal cells.  It is not a fun business to use aldara as many have reported the gruesome side effects, but the bad cells have to be eradicated for the situation to be resolved completely.  


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I been following you for about 6 months.
Can you report what is the condition of your meatus  now after using LEF.
How long have you been taking LEF and what dosage and how often?
Do you still have inflamed lips on your meatus?
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Here is my update somewhat.  Prior to this, I always believe that many men with CAP like issue likely have abnormal or dysplastic cells with them.  Only thing is what to do with it?  I have used EGCG/5FU cream and it does somewhat cause some reaction.  The EGCG/diclofenac and vitC [ascorbyl palmitate] did also reduced the sensation of pain.  However, there is still some transient pain which randomly occur at times.


The current medical system is at a loss with CAP or CAP like issue, so that they only address the symptoms causing the pain, or they will say its all in your head.
One can read PubMed and see update on CAP, where currently, it is still a mystery to Uro/Docs [google pubmed 26951713].  You might also at times, get a fancy label/name for your mysterious condition, such as "male genital dysaesthesia" where the Uro/Doc would just say you have sth that its incurable.




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As for my condition, when I first used [discovered] LEF broad antiviral activity, about 4 mo ago, I have started using it thereafter.  I started with half tab of 20mg [it was first time use : so as to check for drug allergy]

When it was ok, I used 20mg the next day, then 40mg the day thereafter.  AFter that, I used 20mg per day.  Actually based on usual dosage, patients are advised to take  100mg of LEF per day for 3 days ..this is somewhat called "loading phase", to load up the LEF levels to therapeutic
levels.  Thereafter it is 20mg/day to maintain the levels.  LEF has about 14-20 days half life

At the point of taking LEF, my condition was already manageable.  Far better than using ABX or meeting Uros/GP/Derm, who are at a loss as to what they should be doing.  I had only transient pain which appear randomly.  The pain intensity was like 2-3/10 [random sensation in the shaft/glans].  During such time, I was using EGCG/Diclofenac/Ascorbyl Palmitate topical mix, about once a week.

Since discovering LEF, I have stopped the topical mix above.  I I have noted that in the first month of LEF use, there was a substantial / marked reduction in the transient sensation, which occasionally appeared.  This 'leftover' sensation is sth that is not too bothersome, as it is manageable, but seeing that it is getting more 'quiet' down there now with LEF, made me believe that LEF is indeed working as I expected.

With LEF, I could say the strange sensation is rarer and it only have maximum strength of 1/10. I think the leftover sensation is the dysplastic cells; these cells is a result of prolonged viral activity that was left unchecked [by the Uros/GPs who said there is nothing there].

I do not have any marked meatus "lips" or inflammation on the meatus.  So, I cannot comment about such issue.  

However, although no marked inflammation on the meatus, during the chronic stage, the meatus was having sharp/painful  episodes-- there was shooting pain appearing at times in the meatus and the pain conduit somewhat travelled along the shaft to the meatus;.  there was also numbness and irritation, if the glans rubs my underwear/short; there can also be numb pain in the glans if I wear a rather tight undergarment.  AFter about 1.5 yr of being neglected by Uro/GP, I have a focal point pain, midway of the shaft.  I believe that focal point is where the dysplastic cells have accumulated [more]. If I stretched my shaft at such position, there is a minor bump, but the Urologist said he sees nothing there.  

Anyway, it is my opinion that LEF worked for me. After about 3 month use, I have resorted to aladra.  I have used aldara once before, about 1.5 yr ago.  There was a marked reaction; and I used it maybe for 1 - 2 wk, and stopped it.  After it healed, I used it again, to see if there is any residual bad cells, that can be detected by aldara.  However, there was no marked skin reaction anymore.  Only I felt unwell on aldara [as expected, due to aldara side effects]

So, abt 1.5 yr ago, I stopped aldara.  I also, occasionally, test again using aldara that I have, still nothing happened.

After I have recently used LEF for about 3 months... I have tested again using aldara [just to see what will happen]

To my surprise, this time, there was another marked skin reaction.

This time, aldara seems to dig the midway part of my shaft, where I felt the focal pain previously.  It is like this time, aldara recognised that section, and was digging that part.  The  other strange thing that I felt is that -- this time I felt aldara was hitting the nail on the conduit of "strange sensation" which I had felt on the meatus / shaft previously.  It may be rather hard to elaborate on this, but it is like when you met a therapist, who gave you a massage.  You had some nagging pain on one part of your body, and it is pretty hard to localise it.  However, a very skillful therapist can find the spot, and although it might be painful when he hit such point, at the same time, you feel something is being unclogged .  You somehow also feel the conduit of pain being exposed, and the relief you got when such location is addressed.  

That was the sensation that I got recently when using aldara.  Now, one might question why only now aldara "see" such problem.  I would say that LEF addressed the virus[es] that was there.  

It is well known that viruses linger in our body, because they secrete toxins to fool our immune system.  This is how they persisted.  When one uses LEF, the titer of the virus[es] is substantially reduced, and so does the toxins it secreted to fool our immune system.

Since aldara relies on our immune system to eradicate bad cells, when the viruses are there, it is pretty hard for aldara to unleash its full potential, as the toxins released by the resident viruses will interfere with aldara's ability to stimulate our immune system to kill the bad cells.

That is why I believe, aldara did not address the focal point previously.  There was also a number of white patches on the glans [suggesting it was addressing erythroplasia of queyrat like lesion] and also on the mid part of the shaft [could be bowens disease dysplastic cells].  There is also about 5mm part of my coronal sulcus that reacted to aldara.  I could say that one can tell aldara is working -- by "monitoring' the sensation down there.  After about 10 mins to 1 hr, there will be some kind of  "hot" sensation at selected location where aldara detected the bad cells.  The sensation might linger for about 1-2 hr and would dissipate eventually.

FYI I have put a bit of aldara in the urethra, by mixing it with Foban cream.  Aldara is rather potent, and the cream volume too small to introduce into urethra. I had to mix it with something sticky like Foban.  Usually I mix 0.5ml Foban with 1/4 to 1/2 packet of aldara.  I used 1ml disposable syringe and purge the mix into the urethra.  It does work that way.  I did that because I suspected some bad cells could be in the urethra.  AFter all, the midway focal point was in the urethra somewhat.  

Right now, after two aldara sessions, after using LEF, there is a small region of my corona sulcus which is still healing.  I normally used Foban cream to prevent infection.  At the moment, I cannot say for sure the transient feeling have disappeared, as I am waiting for the corona sulcus to heal.  So, I will update somewhat later.  But it felt like the transient abnormal feeling have disappeared.

If anyone want to use LEF, Magnesium Orotate is a must [1 cap 650mg, once or twice a day].  It is obtainable from Swansonvitamins.  LEF blocks the synthesis of orotate in our body, and that can cause some issue.  With orotate supplementation as above, such problem will likely not occur.  I have noted that when I took LEF for the first month without Magnesium Orotate supplementation, I have some issue with my lung. I suspect it was lung inflammation.  It is a known fact that LEF side effects include lung inflammation.  With Mg Orotate, that issue disappeared.

I hope the above helps

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I wanted also to share additional info on aldara; if one uses it.  When it gets very bad ie the reactions, one can stop and let it heal.  And could resume treatment after the healing is done.  Aldara intense reaction may require temporary rest, and it means more than 1 session. During aldara use, one could get high fever, and very bad headache.  The headache could also be due to high blood pressure. This was not known to me, but aldara can cause HBP as a side effect.  It is because aldara stimulated yr body to release a lot of immune cells molecules [aka cytokines] that can make you feel very unwell.  If HBP is detected,  I think that is the time to stop aldara treatment and allow healing to take place.  After that a second session could be initiated, to see if there is any leftover bad cells lingering around.   For me, the HBP was relieved by using Hibiscus tea.  It worked like a charm for HBP

Aldara may also cause depression .. because it is known that aldara increases interferon levels in the body, to fight viral infection.  It has been reported that Interferon use for hepatitis c treatment causes the patients to have suicide ideation. Normally it starts with depression, eg having no motivation at all for etc.  However, I did not have suicide ideation I think, only depression like symptoms, which stopped about 2-3 days after stopping aldara
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I am giving some update today.

The coronal sulcus (dorsal part of the penis) have healed. After about 2-3 wk its appearance (ie. that skin reaction appeared after about 1-2 wk use of Aldara)

During the healing period, there was an accumulation of yellow slough (it somewhat forms a "cap" on the corona sulcus - size approx 1 cm width and 5mm wide, 3-4mm thickness).  I was a bit worried as to what was underneath that thing, it has a slimy top but hard to remove for debridement..and needs to be washed off occasionaly to remove some slimy materials.  I kept on putting Foban or Gentamicin cream (with occasionally use of Bionect spray) during the healing period to prevent infection.  Had to use saran wrap to prevent it being dried.  Bionect spray can cause dryness though.  

After nearly 2wk, the slough size turned smaller ...about 5mm width, 2.5mm wide and 3mm thickness).  One of the days, I got some morning wood and was playing around abit.. and it fell off..the yellow and relatively hard slough. And revealing a crater (not that big) but blood was dripping from it.  After a few mins, the dripping stopped. After that, applyling the same antibiotics/Bionect spray, the slough disappeared, but a minor plug is still there.  

I can feel some strange sensation when I have an erection occasionally. It could be that there was internal tissue necrosis from aldara rxn killing the bad cells, so that the plumbing (blood supply/tissue repair/nerves) are being repaired still.  So, it is hard to say if all of the bad cells (which I suspect) have been completely removed

The reason why I stopped aldara recently, for the first and 2nd use, is because of the intensity of the rxn.  I think the maximum time of use is only 2 wk.  I cannot fanthom how patients could stand/be advised to use aldara for a continuous 16 wk period (in some cases thats the advice fr clinician).  Maybe it is just me. The unwell feeling is not pleasant, especially the depression/fever.  Perhaps I should have used only 3x a week (alternative days).  Instead of 5x a week (5 days a week continuous usage)

I may use aldara again in 3wk time to see if there is any further reaction. Also, I need to monitor if there is any residual uncomfortable feeling down there.  Thats about the update now. But all in all, I think LEF did work [and also Aldara].  



  
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Aldara has been traditionally used for warts.

There are reports Aldara not being able to work 100% all of the time in cases of warts (See Pubmed 15656812 and 14660271 as examples); where cases may or may not respond to Aldara.

As I explained in the earlier posting(s), this could be due to the presence of other common virus(es). These viruses, although thought to be benign, can secrete various toxins to fool our immune system, so that it can persist in our body. If these viruses are not suppressed, etc therapy used to eradicate warts (eg Aldara), may not work 100%

Such toxins secreted by the virus(es) puts down our immune system (perhaps local immune suppression).

There is a very recent paper in PlosOne (PubMed 24586164), which reports how a very common virus ie EBV (a type of herpesvirus), is able to suppress our immune system ie via inhibition of TLR signalling.  

Importantly, Aldara works by inducing TLR7 signalling. When Aldara is used, TLR7 signalling is activated, and such signalling evoke our immune system to detect and eradicate viruses lingering in our body/cells.  

In the above paper, the authors mentioned that EBV produced a special protein called BPLF1, which can interfere with TLR signalling, by breaking the proteins participating in TLR signalling.  This causes TLR signaling disruption, and thus, may explain why aldara cannot perform its action efficiently all of the time, hence treatment failure in some of the cases.

I am beginning to wonder -- are there many cases of cancers, where various treatments have failed (including chemotherapy), have overlooked the essential role of the common viruses?  The common viruses might secrete various toxins that resulted to the cancer cells to become very tough to kill (the cancer cells become very resistant to cytotoxic effect of chemotherapeutic drugs). It might be important that these common viruses are addressed prior to immunotherapy or chemo treatment, although I would think the former is the best treatment route, rather than the latter, due to toxicity of chemo drugs.  Chemo drugs usually kill bad cells, yet the more sinister effect is that it damages the immune system seriously

Chemo treatment is usually very poisonous and statistics showed that it is usually fatal ie not worth the benefit (survival is not long/not good, yet the treatment cost is very high in terms of side effects and life expectancy)





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Here is a summary of the paper *(pubmed 24586164 )

"Epstein-Barr virus (EBV) is a human herpesvirus that persistently infects .90% of adults worldwide. One factor underlying the ability of EBV to establish such widespread and lifelong infections is its capacity to escape elimination by the human immune system. Among the first lines of defense against viral infection is the human Toll-like receptor (TLR) system. These receptors can detect the presence of viruses and initiate an intracellular protein signaling cascade that leads to the expression of immune
response genes.  ..................................................................................
our study provides insight into the way in which EBV can subvert the human immune response, as we show that BPLF1 can remove ubiquitin tags from proteins in the TLR signaling cascade. This inhibits TLR signaling and decreases the expression of immune response genes.
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