Hi doctor, I have had a burning in the urethra now for over 11 months not resolved. The burning feeling is constant and is coming from the urethra part along the penis. The pain is worse after urination or ejaculation. I have had an ultrasound, DRE, urine tests, STD tests, PSA which are all normal. I have seen one urologist six months ago who diagnosed as either chronic prostatitis or pelvic nerve irritation. I have taken Celebrex 200 mg per day, no help. Lyrica 300mg twice per day, did help with pain initially, now not effective. Prazosin 1 mg per day, the only change is urine frequency and dribbling has stopped. Baclofen 5 mg twice per day, has helped with lower back and buttock pain. I am not sure what else to do, nothing is working for the burning in the penis. Any suggestions?
Hi. Your treatment has happened on the right line, as diagnosed by the urologist you have CPPS (chronic pelvic pain syndrome). This has many components like pain frequency dribbling lower back, buttocks pain which improved but still burning in the penis is persistent. This disease along with medication need regular perineal relaxation exercises. Perform pranayam, mainly practice moolbandh pranayam daily for 15 minutes in the morning and evening. Till the effect of these exercises improves, the sensitivity of your pelvic structures takes the following medication. Capsule Roliflo OD 2 mg (combination of Tolterodine 2 mg with Tamsulosin 0.4 mg) for 10 days. Isabgul powder (psyllium husk) 3 teaspoons HS drink one glass water over it. If Roliflo has started, then you need to stop Prazocin. If improvement is observed, we will adjust doses.