Side, pelvic and testicle aches

[Dreynolds]

25 yr old male, 160lbs, 5'9", no family history of urological problems.  About 3 years ago I had what I thought was a mild UTI.  Went to GP.  Urinalysis came up neg. as did DRE.  Symptoms were very mild so he prescribed a one-time dose of Tequin.  Symptoms cleared up.  Then about 1.5 years later, had another "flare up".  This time, symptoms were ache in lower back that would radiate around to flank and pelvic area.  Also, dull ache in testicle and sometimes in shaft of penis.  Went to Gp, urnialysis showed trace amts. of bacteria, no culture was done.  Prescribed Bactrim. Symptoms didn't go away.  2nd urinalysis came up clean.  Doc thought problem might be prostate,  DRE was negative.  Prescribe Tequin again because it worked before.  Symptoms went away.  Then about a year later, same symptoms reappeared...dull ache in sides, back, testicle, pelvic area and small dribbing after urination.  Urinalysis came up negative as did culture.  Could not afford to go to Urologist at the time.  Symptoms went away on own after about 1 month.  Now I get "flare ups" that come and go of similar symptoms that seem to be aggrevated by coffee, stress or ejaculation.  Most recent flare up started around 1 hour after ejaculation.  I know I need to go to a urologist, but my insurance doesn't begin for another 2 months and I currently can't afford to go to one.  1.) What could this be? chronic prostatis?  chronic pelvic pain?  2.) Do the neg. urinalysises rule out kidney infections/stones and UTI?  Pain is not sharp and I do not really have urination problems of any kind.  Thanks for the help!!

[Kevin Pho, MD]

To answer your questions:
1) Yes, chronic prostatitis is possible.

2) A negative urinalysis would make infection less likely, however this is not a 100% sensitive test.  

I would consider a prostatic massage at this point, and send off any prostatic fluid for culture and analysis.  

A transrectal ultrasound can also be considered to look for abscesses.  If present, antibiotics would not be effective in treating this.  

If the tests contine to be negative, a cystoscopy can be considered to evaluate the lower GU tract for any anatomical abnormalities.  

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_

[Dreynolds]

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