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Re: Possible Kidney/Urinary Stones or Any type of cancer

Posted By Chris on January 25, 1999 at 18:42:17:

In Reply to: Re: Possible Kidney/Urinary Stones or Any type of cancer posted by HFHS M.D.-JJ on January 24, 1999 at 11:09:08:

Dear Doctor,
I am a 30 year old married male and very concerned. For the past several months
I have been experiencing a constant burning sensation in my urethra area.
This sensation for the first several months has been constant.
Other symptoms include constant urges to urinate, a clear disharge,
a dull ache in my left testicle that radiates up into my groin and
abdomanal area (at times this ache turns into PAIN, ie. during sexual
intercourse.) I have no problem getting or maintaining erections.
I have seen several urologist and performed many different test.
I had a cystoscopy, urinalysis, cultures, blood work all which came back negative.
I also had an ultrasound done on my testicles and a varicocele and
hydrocele were revealed. I was assured that these were not the causes.
I have been treated with several different types of antibiotics
(Cipro, etc.), none which worked. I just finished my last dose of
Doxycycline and my symptoms have greatly improved however, the burning
occurs during and after ejaculation and also when I have to urinate.
The urges to urinate are still present.
My question to you since my doctors have come up with no valid
reason (infection, epidyimitis, STD's, ect.) are these symptoms
of any kind of cancer or kidney/urinary stones? Should I pursue
these issues by getting an IVP or any other type of test?
I also have experienced some involuntary weight lose (9 lbs.).
Any advice would be greatly appreciated.
Thank You.  
Dear Chris,
The combination of dysuria (burning with urinating), urgency, and clear discharge that you describe are frequently seen in individuals with urethritis.  Urethritis is divided into the gonococcal and nongonococcal types.  Chlamydia can cause a non gonococcal urethritis that will respond to Doxycycline.  Prostatitis is an inflammation of the prostate gland which may be due to infection and is frequently associated with pain on ejaculation that may radiate to the testicles, back/rectum, or groin area.  Prostatitis can be considered an extension of undertreated or untreated urethritis if the organisms are able to enter the prostatic ducts and tubules.  
Based on the symptoms you describe, and the fact that your symptoms improved with Doxycycline, it is possible that you may have had urethritis or prostatitis which has not been completely treated and may require further therapy.  Chlamydia is detected by an antigen study of a urethral swab, and I have not heard anything to that effect in the workup that you have already undergone.  Although urethral cancer may present with some of the symptoms you describe, the fact that no lesions were detected on cystoscopy makes this unlikely.  Kidney stones usually do not cause the symptoms you describe, except when they are far down the ureter about to pass into the bladder.  However, usually there are associated symptoms
i.e. flank pain, and the symptoms do not improve with antibiotics.  An IVP would probably not yield much information.  I would recommend that you see your urologist or another urologist for a second opinion to see whether further therapy is warranted.  Keep in mind that I can not evaluate you on the internet, and that a complete history and physical examination (and possible tests) would be necessary and best done by your own physician.  Wish you the best.
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
*Keyword: urethritis, prostatitis, urethral cancer

Dear Doctor,
Thank you for your response. You mentioned the terms gonococcal and nongonococcal,
are they both transmitted sexually? I have been in a monogamous realationship fot
11 years, so we have to rule out any STD. However, I did have two urethral
swab cultures done (the doctor used a long cotton swab and inserted it into
my urethra to collect fluid, etc.) both came back negative. I didn't ask
what he was checking for, he told me later that everything was fine.
I guess if I had anything (STD's) it would show up here?
I had a follow up visit with my doctor a few days ago and he said he will
not do any more testing. It's not necessary. I do agree with him because I
feel he has been very thorough. He feels that it was prostatitis in the
beginning, but now he is not sure what can be causing the symptoms. There
seems to be nothing anatomically wrong.
With this information, do you feel everything that can be done, has been done?
Should I pursue this any further? I am now receiving some psychotherapy
and biofeedback to help me cope and accept all this. I also have come to a
realization that STRESS has had a major effect with my condition
however, its not the cause.
What other tests or cultures could you advise that could detect any
organisms, bacteria, or virus that may be present in my prostatic ducts and
tubules? Should I consult with my physician regarding this?
Lastely, Can any of this be transmitted to my wife? She has no symptoms
and feels fine. We are also expecting a new baby in September.

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