Testical and penis pain

Over the last 9 months or so I have been bothered by nagging pain in my testicular region as well as in my penis, my groin area and occassionally my lower back/side.  The pain is more nuisance pain as opposed to gut wrenching pain.  I have been tested and seen both my regular doctor as well as a urologist.  Three tests were done; a urinalysis, a urine culture and a DNA swab test (no STD's present).  All three tests came back negative suggesting everything was o.k.  At the time of my last test (the urine culture) I was given Cipro while we waited for the results, again when they came back they were as mentioned above negative.  However even with all three tests suggesting everything is o.k. I still have this same dull ache in my penis and testicles and it is getting very frustrating.  At night I get very hard and prolonged erections (in many cases the erection lasts for hours - and my penis is sore from beign erect all those hours).  These erection are accompanied by a need to urinate.  Once I urinate the erection goes flaccid and then usually a few hours later it is erect again and I have to urinate.  During the day my urination is fairly frequent and my bladder never seems to be completey drained.  I also get some dribbling during urination. So even though I have been tested and tested -things still feel extremely uncomfortable in the my groin region.  I take Lipitor and Propecia, though both my doctor and the urologist said these would not be an issue relative to the symptoms I have laid out.  I don't overreact typically to medical conditions but you know when you body is feelign the way it is supposed to and mine isn't.  From searching the net and reading some threads on this site I know problems in the genital region can be hard to diagnose even when tests come back negative.  I guess my question is what is my next step to solve this problem ? X-rays of the region (prostate, testicles, etc) ? Other tests ?  I am going to schedule another appointment with my urologist and would like to have other questions and options to pose to him.  I am just extremly frustrated as this condition came up out of nowhere and now seems to dominate my life as it is not the best area to have pain in.  Thank you.

[Kevin Pho, MD]

Evaluation of the prostate would be a reasonable next step.  This can include expressing some prostatic fluid for analysis and culture to ensure there is no infection present there.  I would also consider a transrectal ultrasound which can image the prostate for any abscesses.

These options can be discussed with your personal physician or in conjunction with a urology referral.

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.
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