Urethra, bladder irritation????

[joiningtheunfortunatecrowd]

Hi Doc... This will be a little long, and I apologize.  I'm not even sure where this all started any more.  I had protected and then unprotected sex with a girl I had been dating nearly about 10 months ago now.  Turns out she had been around quite a bit, but is adamant she was tested for EVERYTHING and clean (I'm inclined to believe her since she was so brutally honest with everything else).  1-2 weeks after the unprotected sex I started to get a fairly strong burning sensation inside my penis.  Never had any discharge, bumps, or anything.  My scrotum also became very red/irritated, which I put cortizone cream on and seemed to have cured myself.  I was given a single dose of Zithromax, which knocked the irritation back, but it came back within a couple days.  He then gave me 10 days of Cipro which eliminated it all together.  I was tested for HIV for the heck of it and got swabbed for chlamydia/gonorhea which were all negative. He didn't see the need for any other tests.  I felt 100% at this point.

Fast forward... I've been with an old girlfriend now for about 6 months (she's clean... only been with virgins).  We started having unprotected sex about 5 months ago and all was fine.  1 month later I got a mild burning sensation in the tip of my penis.  It got a little worse and then it seemed to go away on its own (never went to the doctor).  Around this same time, we had sex while she was getting over a yeast infection/UTI.  She now has no symptoms of anything. I however, have been having a somewhat intermittent series of problems since.  

My timeline:

Went to the doctor 3-4 months ago with increased Urethritis symptoms (except mine were sort of reversed... urination made it feel better).  Ejaculation was somewhat painful. I got swabbed again for chla/gono and was again negative.  Was given Doxycycline for 15 days.  Started to improve, but quickly got worse again.  Was then given Cipro for 30 days.  Symptoms had almost completely disappeared at the end.  As soon as I got off it, had a sharp pain inside my penis, urinated, and a small chunk of white mucus came out.  Went back to the doctor... this time to a urologist.  First visit he gave me Urised and flagyl (in case it was fungal).  Symptoms got worse... burning increased.  Went back again and am currently on about day 6-7 of another 30 day course of Cipro...  

My symptoms now are different.  The level or irritation increases as my bladder fills up.  I can feel the irritation inside my bladder (kind of burns), but the sensation at the tip of my penis also increases.  It also increases if I flex my PC? muscles...  My urethra still feels irritated.  Ejaculation usually burns/is painful.  I can already tell this urologist is kind of at a loss.  

What do I have going on here?!?!

Thank you SO much for your time.

[Kevin Pho, MD]

Infection still would be the most reasonable assumption.  STDs have already been tested for.  You can consider a more thorough evaluate of the prostate - via a digital rectal exam and prostatic massage.  Any prostatic fluid expressed should be sent off for analysis and culture.  

You can also consider a transrectal ultrasound to image the prostate and look for any abscesses.  

If infection has been ruled out, you can consider a cystoscopy to evaluate the lower GU tract for any evidence of anatomical abnormalities - like a urethral stricture or polyp.

These options can be discussed with your personal physician or 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.
kevinmd_b

[joiningtheunfortunatecrowd]

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[saltyboy]

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A related discussion, Chronic bladder irritation was started.