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Urology  (Expert Forum)
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Still Dont Know
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.

Still Dont Know

by Dwierdo, Jan 20, 2005 12:00AM
I am a 24 year old sexually active uncircumcised male. About 6 mths ago I had unprotected oral sex with an ex-girlfriend (both gave and recieved), within a few days of this started having problems with burning around the head of my penis and in my bladder area, also frequency urinating.  My urine came up clean so my doctor gave me cipro thinking it was a prostate infection.  Also checked me for several stds.  This was a week after encounter with girl.  All of the tests came back neg. but I then got a yeast infection, took ketaconzole for it. The yeasty rash and itching went away in about a week, but the burning around the head of my penis and or bladder area didnt.  
   The pain seems to go in waves where sometimes are better than others but over all it seems to be there, it doesnt hurt to pee, but usually after I go its a little worse than it was.  I also dont pee my pants but frequently when I go to the bathroom I notice leakage of pee in my underwear. Not lots, but enough to be uncomfortable.  It seems to help a little if I wash it and dry after but sometimes that just seems to aggravate the situation too.  
I have gotten little info from my GP or my urologist. Other than what I feel is the run around cause they dont seem to know what the deal is.  They have done STD tests in the beginning, otherwise, urinalyisis, cytology, cytoscopy, prostate check, and visual exams.  They seem to find nothing.  Everything with my anatomy(according to them) is normal.
   I took some pyridium for a while and that seemed to help but doc told me I shouldnt take that for very long. Im thinking of going back to the urologist (been 3 1/2 wks) again but what do I ask of him? He seems to think that I worry too much.  I know that some stds take time to incubate, like aids for instance, am I just spinning my wheels to get re-tested for that since its been 6 mth since I was last tested for that stuff?
   Im not normally a hypochondriac ,especially when going to the doctor ends in a stanger sticking foreign objects in small orifices, but what else could this be that would last this long with no visible signs.  I have good hygene and have never had problems like this before.  
Any leads or comments would be appreciated!

by Kevin Pho, MD, Jan 21, 2005 12:00AM
You have had a pretty thorough examination, including cystoscopy, cytology etc.  

One consideration would be some kind of abscess around the prostate.  This can cause the urinary symptoms that you have been describing.  Also, chronic prostate infections can be notoriously difficult to treat, and may require an extended course of antibiotics.

One imaging test to consider would be a transrectal ultrasound, which can be considered 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.
Medical Weblog:
kevinmd_b
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