Hi doctor, I am 27 years old. I have been suffering from bladder and lower back pain for about six months now. I have been to the doctor several times and each time the test was negative for infection. I used to get relief from symptoms once I take the antibiotics, but the pain will recur. I do not have frequent urgency to urinate. My urine is clear, and there is no burning sensation associated with urination. I suffer from chronic constipation, and my primary physician feels it might be from stool backed up in that area and prescribed me Linzess. I have been taking for two days and still have back pain. The pain never gets unbearable, usually a level 2-4 on pain scale. After all research, I feel it may be prostatitis. I am terrified to see a urologist in fear of rectal exam as I have a phobia of this. I had several blood panels done, kidney and liver function tests everything is perfect. My x-ray indicated lower back spasms and backed up stools. No kidney or bladder problems. I am becoming very upset because I read there is no effective way to treat non-bacterial prostatitis. Is there a way my urologist can test for this without a digital rectal exam? I also have some dull testicle pain from time to time. This is becoming such an annoyance and ruining my daily life. Any help will be thoroughly appreciated.
Hi. As you suspect the symptoms might be due to chronic prostatitis or a similar entity chronic prostatic pain syndrome. It needs a per rectal examination. Per rectal examination is not that painful as you suspect. Urine culture after a per rectal examination will turn to be positive if it is chronic prostatitis. It needs a 4-week course of Trimethoprim, alpha-blocker drugs, and anti-inflammatory drugs. It has to be treated with Trimethoprim or Levofloxacin. Secondary to UTI (urinary tract infection). Chronic prostatic pain syndrome.