Kidney / bladder infection or possibly STI?

[CanadianSteve]

For the past of couple of weeks, I have been experiencing some pain in my lower back on the right side, a low level irritation in my pelvic region and in my urethra, and some slight pain in my perineum.

The pain in my lower back has gone from mild to sometimes intense. I have noticed that if I sit for too long, the pain gets worse, although the pain has also been bad at times regardless if I am sitting down or standing up.

The irritation in my urethra and my pelvic region comes and goes. There will days in which I will not notice anything, but then I feel the irritation the next day. It is never painful, but it is certainly distressing.

The pain in my perineum can be described as pins and needles. It is not consistent. There have also been instances where I feel small, sudden pain in my penis below the glans, but they go away quickly.

There is no pain if I ejaculate. However, I have sometimes noticed that that my urethra gets irritated when I start to masturbate - this has happened a couple of times. Again, no pain when I ejaculated.  

My urine comes out either clear or slightly yellow. It does not smell bad. There has been no pain when I urinate, although I have had some trouble fully passing urine  - the stream will stop but will start up again after a couple of seconds. And sometimes I have to squeeze out the last remaining drops.

There has been only one instance of clear discharge coming out from my penis. It was clear and did not have an odor. This happened about a half hour after I masturbated.

Also, about three days back, I was feeling sick - low energy, persistent need to sleep, low body temperature (97.5 F). This passed after a day.

Since the onset of these symptoms, I have been drinking as much water as I can to flush my system. I have also been drinking cranberry juice, and I have been taking pro-biotic pills. This has helped, but the problems have not completely gone away.

I suspect that this may be a kidney or bladder infection. The other possibility is that I have chlamydia from what I have read online. I have had a few partners since I last got tested, so it is possible that one of them passed something along.

I should mention I experienced similar symptoms back around October. I went to see my doctor and there was no sign of bacteria in my urine. I also did a full round of STD tests and everything came back negative. Eventually, the symptoms went away.

I have been under a lot of stress these past few months, so that may a contributing factor.

I do plan on seeing a doctor, but I am currently in between insurance plans, so that does complicate things. Any help / insight into the matter would be greatly appreciated.

[CanadianSteve]

Hello Doctor Santos,

Thank you for your message!

Since my post, I have seen two doctors about my symptoms. The first doctor did a urine analysis and discovered a some bacteria (most likely a UTI). He proscribed me a course of antibiotics (MacroBID) for a week. Unfortunately, the medication did to do the trick: the symptoms persisted. I consulted a second doctor yesterday who ordered a full urine analysis, as well as tests for chlamydia and gonorrhea just to make sure that they can be ruled out. I should be getting the tests results back in a week. He did a rectal exam to make sure that my prostate was not infected or inflamed (which it was not). He felt for any lumps on my testicles (none were discovered) and did a visual check to rule out herpes (I have not seen any sores develops since the start of my symptoms).

I explained to the doctor the reasons for why I have been experiencing a lot stress lately. He said that it may be culprit. Again, he wanted to find out what the test results say before making any final conclusions.

Regarding symptoms, I am still experiencing irritation in my pelvic region, albeit less frequently. Sometimes that irritation will shoot down into my legs. The irritation in my urethra does not occur as much as it did in the beginning. I still have some trouble passing urine, but again it is not as bad as it was a month ago. The skin around my penis still feels like pins and needles at times. I sometimes feel little flashes of heat around the genital area. I sometimes still feel irritation in my penis when I masturbate.

[Dr Santos]

Hi,
How are you? What other symptoms are present? I understand your concern regarding these symptoms and for definite diagnosis and to rule out urinary tract infection, urine test may need to be done. Direct clinical examination and additional diagnostic tests may also be requested to rule out differentials like prostate and neurological issues. Take care and do keep us posted.