Hello doctor, I have a prostate congestion issue that comes and goes from 2 years. Lately I am having a slower urine stream even slower than the times I had my prostate congestion before, also I am having uncomfortable feeling above my anus, itchy or uncofortable feeling at the tip of my penis, and some discharge from my penis. I had my tests done. Urine and semen culture, swab from the tip of my penis, and C/S for my urine and semen. Before the results doctors been telling me that I might have an STI and they gave me a one time injection with 4 tablests of antibiotics. When the results came it showed no sign of any bacteria in all my tests, the swab is clean no STD. I only had a higher WBC count in semen culture which was around 10-15, where the normal reading was 0-5. My doctor told me thay I have an infection in my prostate or inflammation. He gave me anti-biotics for 10 days and an alpha blocker medicine. He did not do physical check or ultra sound. I need a second opinion, I am afraid I have a cancer, it does not make sense to have an infection without bacteria discovered in all the tests?
Hi. It looks like prostatitis, chronic (attachment removed to protect patient identity). Often in this condition, diagnosis is clinical, most tests are negative. On rectal exam, sometimes prostate can feel tender. sonography can show swollen prostate. Uroflow may be reduced. There may be bacteria or WBC in semen. Also, post-prostatic massage urine culture may be positive. Even if all these are normal and there is clinical suspicion, you may be given treatment for prostatitis. Usual course is for 1.5 to 2 months. Symptoms can recur but usually are less severe than first attack. People get prostate cancer after age 50.