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Pain and Inflammation - Urethra / tip of glans
Hello. About 6 months ago I experienced tremendous pain during ejaculation (from normal masturbation). It started with what seemed to be a very large delivery of sperm - I noticed the first pain when seemingly the sperm was leaving the vas deferens and entering the urethra. It felt like it barely made it thru. The next sensation was more pain as the semen exits the urethra. Thereafter I had tremendous pain at the tip and down the shaft of the penis (as if a chain reaction via the nerve endings). The glans had a patch of area just behind the opening of the urethra on top that was noticeably irritated and red. When I urinated a few mins later it burned. I called for an appt with a uro but couldn't get one for some time (21 days). The pain subsided in the shaft after just over 1 week, but the pain in the glans remained. I could barely stand the pain and noticed that contact made things worse. At times I had a continual sensation that I needed to urinate when in fact I did not. Pain and redness increased during urination. As a last resort I started placing a tube over my penis (e.g. toilet paper tube) and wearing briefs to abate the pain and irrit. This resulted in a period of 4 days of less and less pain and the increased ability to hold larger (normal) amounts of urine in my bladder before having to urinate (pressure must have caused irrit). This ended when I was having trouble with the tube and irritated the urethra/glans - very quickly as it continued to be highly sensitive. When I went to see the uro he examined me and initially wrote down urethritis. He did a swab and a urinalysis. Both came back negative. He prescribed Cortosporin ointment and advised me to continue to take ibuprofen. After a month I had my follow-up. Symptoms had not improved. He noted that the opening of my urethra was about half the size of a normal opening. (This was apparently caused from masturbating with shampoo as a youngster). After a cytoscopy he later performed a meatotomy. This seemed to be the magical cure as I was completely pain-free and the glans showed no sign of redness or irrit. Urinating and even mild masturbation did not bring back the irrit. What did, 23 days later, was a long walk. Uro referred me to a Dermatologist. He thought I had nerve trauma. Back with the uro again - he didn't know what to do. As a last resort he gave me the option of taking Vioxx, which I did. I took 25 mg for 30 days. I did not take it daily as I had headaches and a stiff neck but it helped reduce the pain and irrit. I also continued the Cortosporin, which also helped slightly. Later I went on Cipro for 10 days. This may have helped. Have been having sex every 2 days or so and notice funny tickling sensation on glans after ejac. Sex seems to help. Other info - 7 days before this started I had sex with a German friend. I was an active runner before - 20+ miles/wk. Now I can't do much and have constant pain. Pls help! Thank you!
MEDICAL PROFESSIONAL
Hello - thanks for asking your question.
You note chronic urethral pain. Cystoscopy and meatotomy were performed. Urinalysis and a "swab" (I assume it was for STDs?)was negative. You have taken Vioxx and Cipro.
With a cystoscopy and meatotomy, this would have ruled out any anatomical abnormality such as urethral strictures or polyps. I would definitely make sure there is no infectious cause and possibly repeat tests for Chlamydia or gonorrhea. Make sure that there is no evidence for prostatitis (i.e. culturing prostatic secretions). Epedidymitis should also be ruled out - this can be performed via ultrasound.
There are other causes for discomfort, including a dermatatis or increased nerve sensitivity. If the dermatologist evaluation was non-revealing, you may want to inquire about a neurological evaluation. If there is increased nerve sensitivity, a neurologist may perfrom further testing to evaluate for this.
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.
Thanks,
Kevin, M.D.
You note chronic urethral pain. Cystoscopy and meatotomy were performed. Urinalysis and a "swab" (I assume it was for STDs?)was negative. You have taken Vioxx and Cipro.
With a cystoscopy and meatotomy, this would have ruled out any anatomical abnormality such as urethral strictures or polyps. I would definitely make sure there is no infectious cause and possibly repeat tests for Chlamydia or gonorrhea. Make sure that there is no evidence for prostatitis (i.e. culturing prostatic secretions). Epedidymitis should also be ruled out - this can be performed via ultrasound.
There are other causes for discomfort, including a dermatatis or increased nerve sensitivity. If the dermatologist evaluation was non-revealing, you may want to inquire about a neurological evaluation. If there is increased nerve sensitivity, a neurologist may perfrom further testing to evaluate for this.
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.
Thanks,
Kevin, M.D.
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