Hi doctor, I am a 26 year old unmarried male. My height is 6'2" and weight is 73 kg. For the past three months, I have pain in the left side of my glans penis. At the same time, I have a continuous pain on the left side of the anus. The pain around the anus is not severe, but it is enough to bother and depress me. Sometimes, the pain increases, but eases if I wake up from sleep. The pain in the glans penis area often increases during erection and more if I masturbate. I am also getting pain in the left side shaft of the penis and in the area between the anus and the scrotum. My glans penis becomes severely red and painful during or immediately after erection and the redness decreases after some time. I have consulted with a urologist. He recommended a semen culture test and the report suggested a heavy growth of K.pneumoniae for which I was given an antibiotic Levofloxacin 500 course of seven days. The pain around my anus did not get eased and so he extended the medicine for 14 more days. But, my pain is still present. For the penis pain, he examined and said that my foreskin is tight, which is causing the pain and recommended circumcision. I agree that the skin is tight and my glans gets swollen during erection and skin is almost impossible to pull down. But, the problem is that during erection the skin is still in its position and I do not attempt to pull it down even then the pain in the glans starts. I remember that around three months back, I masturbated and tried to pull my foreskin down. When I pulled half it got swollen and then I ejaculated. This problem started from that time. So, I am afraid if something went wrong at that time. All other reports are normal such as KUB x-ray, ultrasound and urine routine. I do not know what to do and I am really depressed. Please suggest me something and help me out.
Hi. From your history and findings I am suspicious of chronic prostatitis, which is a longstanding infection of the prostate. It is associated with pain in the perineal region, which is neither mild nor severe. It needs to be confirmed with a per rectal examination in which prostate is painful. It needs to be treated with tablet Septran 960 mg (combination of Sulfamethoxazole and Trimethoprim) twice a day for four to six weeks. Please beware of Sulfa allergy and in which case it has to be avoided. As far as the glans is concerned, you need not worry. It is just balanoposthitis or glans infection with foreskin involvement. If prepuce can be retracted, then it can be left as it is. For further information consult a urologist online -->