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Urology  (Expert Forum)
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Urinary Infection or am I just crazy?
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.

Urinary Infection or am I just crazy?

by Dwierdo, Nov 24, 2004 12:00AM
About 4 months ago, I started getting feelings of having to urinate more often than normal. After going the feeling of having to go doesnt always go away.  I experieced some mild burning after urination around end of penis and urethra and pain in bladder area, also my penis leaks a little urine sometimes in between trips to bathroom.  
  Also shortly before these syptoms (symptoms) I both gave and recieved unprotected oral sex from a newer girlfriend who Im pretty sure has nothing but not 100%.  So I went to the doctor and told them of this, they ran a bunch of std tests, checked my urine, and did a visual exam.  Everything came back negative.  So they said it was probably a prostate infection.  I was put on Cipro for that. I was also put on Lisonopril-Hydrochlorothiazide for an unrelated high blood pressure issue, but it was at the same time of my initial urinary syptoms (symptoms).  Within a few days it seemed that the pain in my bladder area went away, but I continued to have urination issues and in addition got itchy little bumps under my forskin. The doc and they said it was a yeast infection probably caused by the recent anti-bacterial medicine.  They gave me some ketaconzole cream to apply.  After almost a month it seemed to have gotten better.  I stopped using the cream.I hadunprotected sex with my girlfriend, who has no symptoms of a yeast infection or any other disease, and within a few days, the infection came back.
    I went back to the doctor got some more cream used it for a month, the rash went away within the first week, but the feeling of increased urination, burning after going, and sensitivity to the head of my penis persists, ect..  I went to a urologist who checked my urine and did a prostate check and told me there didnt seem to be anything wrong. And since my rash had gone away there was no need to be concered or use cream, so just come back only if it got worse.
   Well its now been a month since I saw the urologist and about 4 months since this whole ordeal started.  The urologist seems adamant about there being no reason for further testing unless I get worse, even when I tell him that Im not happy with burning sensations ect..they dont seem normal and Im not a whiner.
  Things that seems to provide any comfort are washing and drying my penis after every urination, and changing my blood pressure pill to just the lisinopril since the other is a diuretic and is supposed to increase urination, therefore cause me more pain.  The burning and irritation is different each day, sometimes not at all, others just about all day, but mostly seems to be right after urination.
   In the past I havent had hygene issues, what other possibilities could this be?  What additional test could be taken? I had the std tests taken approx a week after my sexual encounter, is there a reason to have more taken? Are these just the post syptoms (symptoms) a regular yeast infection from hell? Could I be allergic to my girlfriends vagina? Could lisinopril cause this?
Thanks

by Kevin Pho, MD, Nov 27, 2004 12:00AM
Most of the basic tests have already been done - including tests for STDs.  Assuming an infection isn't present, there are some anatomical abnormalities that can cause burning, such as a urethral stricture or polyp.  If these disorders are being considered, the cystoscopy would be the definitive test.  

You can also consider a prostate abscess, which are not appropriately treated with antibiotics.  A transrectal ultrasound would provide the appropriate imaging to evaluate this.  

You may want to discuss these options 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.
Medical Weblog:
kevinmd_b
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