Pain/Discomfort at tip of penis

[IneedToTalk]

In October, I received oral sex from a female partner (that I'm monogamous with) who had just finished eating a meal five minutes earlier. I've received oral sex from her before, but never experienced what I'm about to tell you.  Within a few hours after receiving the oral sex, I began to feel pain/discomfort at the tip of my penis, but only after I urinated or ejaculated (more so when I ejaculate).  The pain/discomfort usually lasts anywhere from 30 minutes to an hour and then subsides to a point where I hardly realize it's there unless I think about it.  In November I went to my primary physician who tested me for STDs (Chlamydia, Gonorrhea, HIV, Herpes, etc)  all of which yielded negative results.  He then referred me to a Urologist who gave me a prostate exam, and said my prostate doesn't seem to be enlarged or swollen, however I could have an infection.  He prescribed me Cipro for 10 days (in November), which seemed to help when I was on it, however the symptoms came back within a week after the 10 day course.  He then prescribed me Cipro again for 20 days (December), stating that a prostate infection is hard to cure since antibiotics have a difficult time penetrating the prostate.  Again, the symptoms reappeared shortly thereafter.  He then prescribed me Levaquin for 14 days (January), stating that THIS antibiotic might help fight the infection better. Unfortunately, the pain/discomfort reappeared.  He gave me an ultrasound, and KUB x-ray, both of which were negative.  I'm not at a stressful point in my life, actually pretty stress free... nor do I suffer from anxiety.  My life is great, except for this pain/discomfort that's progressively gotten worse since October (we're in April now, 6 months).  What could be causing this pain, and how can I treat it?  If it is an infection, do I need a longer course of antibiotics?  And is there a procedure to find out exactly what bacteria it is so that we can effectively treat it?

[Stephen Liroff, MD]

You have been sensible in evaluating your symptoms, but obviously without success in getting to the bottom of it all. I am at a loss to explain the tie-in with fellatio, but I wonder if you might have infected semen. I would suggest a semen culture (ejaculate into a sterile urine container) In addition to the culture, request that a portion of the semen be smeared for Trichomonas. Also, ask your urologist to examine some prostate fluid for this, also.
If your semen is infected, then you may find that you need a different antibiotic or for an even longer period of time (months), and if you have trichomonas both you and your partner should be treated with metronidazole or tinidazole at the same time. She may do well with a single dose, but I would recommend that you take the drug for 7 days at least.
S.A.Liroff, M.D.

"This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition.”