A possible bacterial prostatitis from a STD infection?

[jazzman19us]

I'm a 26 year old male and I had unprotected sex one time with a female on February 14th and no intercourse seen then; 2 weeks later I started to have urinary issues and went to my physician and he gave me 1 gram of Zithromax and 10 days worth of Vibramycin to clear up any possible infection of gonnocual and chlamydia bacteria before the urine and blood tests came back, which was negative by the way, also about a month and a half later I stared having a problem of excessive frequent urination: so bad sometimes that I would go to the restroom to urinate and then 2 minutes later I would have to go again and again, a little bit of dribbling afterwards, it seems that I can't completely empty out my bladder and occasional testicular, urethral and rectum pain. The funny thing is I don't have pain with urination only after urination a dull achy feeling all throughout the urethra and groin area and all of these symptoms come and go, delayed ejaculation with little semen coming out with no pain probably from the inflammed prostate. I did a urine and blood test for everything again to see if the STD infection was still in my system and it all came back negative and had some anti-inflammatory medication prescribed to me and even got my prostate checked and the doctor said it was a little tender. I would love to have some insight and knowledge of what I might have because this sounds like a classic sign of prostatitis. This has been going on for the past 1 month and a half now.

Thanks

P.S. I forgot to mention and this is what scares me is I went to a urologist and they did a cystoscope on me and they didn't find anything inflammed in the whole area including the prostate.

[billyrubin]

If one has been definitively diagnosed with prostatitis and has symptoms, typical ones...would a very small amount of mucus be present during urination?  The only way to really see it is to examine the first several drops after beginning urination...but is almost always there.  It is clear and I don't think it can be considered as discharge since it seems only to come out during urination and not spontaneously.  Can you give me an opinion?  Also I understand from the posts by the std Dr.'s that it is highly unlikely that prostatitis is ever caused by an std, specifically NGU or GC.  Your thoughts or agreement would be great.  I am hoping to rule out any recurrent NGU from oral sex exposure prior to the prostatitis diagnosis.  I have had 30 days of levaquin and 60 days of Bactrim DS since and am still currently on the Bactrim and noticed the small amounts of clear mucus on every urination.  

Thanks.

[Vanessa Lacuesta]

Hi.

A urine culture with prostate secretion culture may help identify organisms which may be causing prostatitis. In your case, the cystoscopic exam did not show any prostatic inflammation. Your symptoms do suggest that this may be a lower urinary tract infection. If the symptoms persist then other tests may be done to consider other forms of infections such as viral or fungal infections. This may be unlikely, however tests may be done to rule them out.

You may ask your physician with regards to the right pain relievers to use. Sitz baths have helped relieve pain in some patients. But of course , this is only supportive therapy. You may ask your physician about prostatodynia or chronic nonbacterial prostatitis (CNP)."Like many such poorly understood conditions, CNP/CPPS remains a challenging syndrome. Patients usually have symptoms consistent with prostatitis, such as painful ejaculation or pain in the penis, testicles or scrotum. They may complain of low back pain, rectal or perineal pain, or even pain along the inner aspects of the thighs. They often have irritative or obstructive urinary symptoms and decreased libido or impotence. As a rule, these patients do not have recurrent urinary tract infections. The physical examination is usually unremarkable, but patients may have a tender prostate."

Source:JAMES J. STEVERMER, M.D., M.S.P.H., and
SUSAN K. EASLEY, M.D. Treatment of prostatitis.Am Fam Physician 2000;61:3015-22,3025-6.Retrieved from http://www.aafp.org/afp/20000515/3015.html on May 18,2008.

[jazzman19us]

A dirty catch and mid stream urinalysis was done and everything came back normal. What other tests can be done to test for prostatitis? I never did the 3 part urine test.

thanks for the reply

[Vanessa Lacuesta]

Hi.

Prostate infection and inflammation may present in a spectrum of conditions. There is an acute prostatitis wherein tenderness and redness may be noted in the area between the anus and scrotum. Your tests may also show bacteria. There is chronic prostatitis which may not present with acute pain and other symptoms but results may show an infection. There is also what they call chronic abacterial prostatitis wherein the person may have the symptoms but the tests will not show anything. At the end of this, is prostatodynia or chronic pelvic pain syndrome, wherein tests will not show any infection or inflammation but the symptoms are present.

Your case may be prostatitis. Antibiotics and pain relievers are mainstays of therapy. However, there is no definite guideline for managing chronic prostatitis. You may discuss this with your physician as there are supportive forms of therapy that may be available.

Was a urinalysis and urine culture done?

What were the results?