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Pain after sex/orgasm

User
Posted 02 Nov 2024 at 17:09

Hi 

my symptoms started 10 months ago with increased urgency and frequency of urination and pain/stinging at the tip of the penis and some irritation feeling in what felt like the urethra. The pee hole also felt sensitive and stinging. 
My gp over a course of a few weeks of visits did urine tests, swabs a full set of Sti checks all of which came back normal he also did a dre and psa test all normal. He then wrote to urology who suggested a course of antibiotics which I completed and my symptoms did subside, the urgency and frequency issues have gone, but I did then develop the pressure/ golf ball feeling in my perineum and an intermittent ache along the shaft of the penis, testicles and mildly at the tip. 
I returned to the doctor who prescribed another course of antibiotics ( I think both were ciproflaxin)  again after a while the symptoms subsided but would come and go. 
I feel as though the symptoms are triggered by ejaculation.  My pain immediately could be likened to muscle strain- aching, mild pain, tighteness. This is around my groin, testicles, tip of penis. Around two days after the pain seems to more pronounced. 
I have had no problems with pain or flow of urine and issues sexually. 
my gp first diagnosed urethritis and then changed it to chronic prostatitis after the communication with urology. 
my question is, do these symptoms involving sex seem common to others? Do you think the diagnosis sounds correct? 
what should be my next steps. 


many thanks 

User
Posted 03 Nov 2024 at 07:34

Hi Dave,

I'm not medially trained but your diagnosis of chronic prostatitis sounds about right. And I believe it can be difficult to treat. You could possibly cut out the middle man and ask for a referral to a urologist?

I remember one urologist giving a talk at a support group meeting about massaging the prostate to treat prostatitis. I think he's retired now but maybe there are others out there. 

Hopefully someone more knowledgeable will see this and add a comment.

Good luck. 

Kev.

User
Posted 03 Nov 2024 at 07:44
Symptoms certainly sound like prostatitis, I was told by my GP that there is no evidence that prostatitis can morph into PCA but more persistent cases can become antibiotic resistant.

Hope another course of antibiotics clears it up for you.

User
Posted 03 Nov 2024 at 08:29

Yes, absolutely classic symptoms of prostatitis (inflammation of the prostate). When your prostate generates pain, your brain is unable to identify the source of the pain, and it often gets referred to tip if the penis, testicles, and back passage, when there's nothing wrong with them. Painful ejaculation and painful digital rectal exam are also classic.

It sounds like, if it's bacterial, it's resistant to Ciprofloxacin, or you didn't take it for long enough. Ciprofloxacin (and some other antibiotics) are also anti-inflammatory, and that can give some temporary relief, even if it isn't able to kill the bacteria, but then the symptoms return quickly afterwards because the infection is still there.

Prostatitis infection rarely shows up in urine or semen samples, because it tends to block off the areas of the prostate where it is. Proper diagnosis really requires expressed prostatic fluid to be obtained and sent for culturing to identify any bacteria (a urology procedure), and to find which antibiotic it's sensitive to (rather than resistant to), so you can then be prescribed the right antibiotic. There are relatively few antibiotics which can get into the prostate because it has a barrier (like the blood/brain barrier) that prevents many antibiotics from getting in to it, and it tends to need to longer course of antibiotics. It is difficult to find urologists who genuinely specialise in prostatitis (even though all say they do). All that most GP's can do is somewhat randomly try different antibiotics and they might not prescribe them for long enough, which can lead to antibiotic resistance without resolving any infection.

Prostatitis isn't always caused by bacterial infection in any case.

You could join The FOPS Q&A support meeting on Wednesday evening on Zoom, as one of our regular urologists is a specialist in prostatitis. See my profile for details.

 

Edited by member 03 Nov 2024 at 08:33  | Reason: Not specified

 
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