Hello doctor, I am a 30-year-old married man and this is my story. Three months back testicle pain and difficulty reaching ejaculation for a few days. Also, a mild pain near the rectum or anus for a few days. A month later received unprotected oral sex from a woman. The very next month started to feel intense burning sensation in the penis (not when urinating, in fact, urinating relieved it). Also, intense pain located in glans to the right, between the corona and the meatus. No discharge. Took 1.0 g of Azithromycin and 1.0 g of Ciprofloxacin, just in case. Gonorrhea. chlamydia, mycoplasma, etc, and urine culture and stain grams all were negative. Two days later I had a lot of urinary urgencies. CT scan revealed inflamed bladder walls, small urine retention, and urinalysis shows WBC count of 2 to 4. I was started on Levofloxacin. Two weeks later the symptoms continued. Urine turned very thick. Urologist says it is urethritis (which I do not think so, because the burning is not when urinating, but mostly all the time) orders another CT scan and MRI. Everything comes out normal, except WBC count in urine 8 to 10. Culture and STD negative again. Two days later the doctor orders four weeks of Levofloxacin, Tamsulosin, and Solifenacin. Also, something for a fungal infection and a pill for if the penis pain was neurological. A week later another urine sample was taken. Everything was normal this time, including WBC count. STD panel negative. Three weeks later the doctor had diagnosed prostatitis and insists on continuing treatment. Symptoms persisted like frequent urination, constant intense burning in penis or bladder, painful ejaculation and a small amount of semen, thick urine, occasional testicle pain. No rash on the penis, no discharge, no lesions, no fever, no joint pain. Could this be really prostatitis? If it is, could it be bacterial from the oral sex episode? Is constant burning in pain more consistent with non-chlamydial NGU (or NSU) or prostatitis? Could it be related to the bladder more than the prostate? Please help.
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