Hello doctor, I am a 29 year old male, who has prostatitis. My prostatitis symptoms flared up four months ago, after eight months of partial remission. Last week, my pain got worse with cramping over my pubic bone. Now, the discomfort and cramping comes in multiple places simultaneously (perineum, penis, rectum, and over the pubic bone), they get me very tired and stressed, and I tend to feel cold. I also feel pressure at the base of the penis and some pressure and itching in the urethra and outside the penis. I had not experienced pain in so many places before. I am quite concerned about this and do not know what is causing this. What will be the next line of action? In the past four months, I also noticed that from time to time, the veins in my urethra get darker and inflate slightly, changing the color of my urethra especially, if I sit down for a long time on an uncomfortable seat, is this normal? What could cause this? Does my MRI of pelvis show any abnormalities? I have also attached two figures of the urethra, and the images may not show the true color of the veins. Prostatitis symptoms like penile pain, pain during and after ejaculation, pain while starting urination, perineum pain, rectal pain, and lower back pain, started more than three years ago. Few months after a sexual encounter, I had a sharp feeling in the tip of the penis. The medications that I took are Cipro, Doxycycline, and Septrin. While taking these antibiotics, I only felt a slight improvement, and immediately symptoms returned after stopping the medication. I had to stop all antibiotics, due to adverse side effects (stomach related). Symptoms such as pain after ejaculation, pain in the perineum, and penile discomfort returned immediately after few days. But, after 3 to 4 weeks they became negligible. For next six months, my prostatitis related issues were minimal but it would flare up if I did any sports. During this time I had severe stomach issues (bloating, constipation, food sensitivities). As my stomach issues improved and as I got active, on one occasion while having sex I felt the same pinch in the tip of the penis, following this, in the course of two months all my symptoms were back. After this, I went through the discomfort for four months, during this time I realized that my semen's color has changed to yellow. Following this, I managed to reduce my discomfort by diet and avoiding sitting on normal chairs. Four months ago, my symptoms started again after a day of sitting on a normal chair for an hour followed by a sexual encounter, this time the symptoms did not leave. At this time, I started having pain after walking and also the sensation of an unemptied bladder a lot. I started undergoing internal pelvic floor therapy, which reduced some of my lower back pain; however, my pelvic floor became very sensitive, on two occasions some physical activities started horrible spasms in my pelvis for days. Four weeks ago, I sensed a pain over my pubic bone. However, last week after trying some Magnesium supplements, this pain increased. The next day after an ejaculation, my urethra was very sore, and at night the pain over the pubic bone came about, and it was awful. The day after, I was in a lot of pain, I could not stand up from the pain. Since then I feel multiple places spasm at the same time in my pelvis, pubic bone, the base of the penis, and lower abdomen, which triggers horrible sensation in my body. Please help me.
Hi. I am really sorry to know about your problems. I have gone through your MRI images and other reports (attachment removed to protect patient identity), and all reports are normal. I hope I have answered your queries and guided you. Please get back to me in case you need any further clarifications. For more information consult an andrologist online -->