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Patient's Query
Hello doctor,
Two months back, my doctor diagnosed me with UTI. I had symptoms such as frequent urge to urinate and pain in the penis while having intercourse. I was prescribed Orelox 200 mg, Canesten cream, Luliconazole and Mupirocin cream. It got better after that, but the pain has returned. Last month the pharmacist gave me Canesten cream to be applied twice daily, but it did not relieve my symptoms. The next day I had to travel for a holiday for three weeks. While on holiday, I consulted a dermatologist online, and he diagnosed the problem as candidal balanitis and prescribed Luliconazole and Mupirocin cream twice daily and Canditral 200 capsule. I felt temporary relief, but the pain returns if masturbation is done. The pain is inside the hole at the top of the penis, which is aching and sore at rest. I get a burning sensation after masturbating. The penis is very sensitive to touch. I have not had sexual intercourse since the last month. When I returned after my holidays, I saw my doctor, who said I have no STDs or balanitis. I usually do not drink, but in mid of the last month, I had a few alcoholic drinks, and the next day the tip of my penis was burning. I have again been prescribed Orelox 200 mg for five days, but it has not helped me. My urine test results were normal.
Hello,
Welcome to icliniq.com.
This seems to be prostatitis. It can be caused by sexual contact mostly. And treatment is with long-term antibiotics and alpha-blockers. I suggest you consult a specialist and take the following medicines with his or her consent. Tablet Ciprofloxacin 500 mg twice daily for four weeks and tablet Tamsulosin 0.4 mg once at night for 30 days. Short-term five days antibiotics will only give some relief then symptoms will come back as it is not enough for prostate inflammation. The pain, as you described, will be on the tip of the penis. I hope you will feel better. If you have any more queries, please let me know.
Patient's Query
Hello doctor,
Thank you for your reply. How is prostatitis normally diagnosed? My urologist inserted a glove and a lubricated finger into my rectum to check the prostate and said it was fine. It was uncomfortable but not painful. Is there another way to test for it? Also, is Orelox antibiotic not used for prostatitis? If so, can you recommend some other antibiotic other than Cipro? I forgot to mention that I also have an underlying condition called small fiber neuropathy (diagnosed nine years ago). Fluoroquinolones were not recommended as they can worsen neuropathy in the long term. Do you also recommend I do a CT scan to check for kidney stones? My father, his brother, and his parents all have a family history of kidney stones.
Hello,
Welcome back to icliniq.com.
Chronic prostatitis is a clinical condition diagnosed on history examination and semen culture. Patients have a history of deep pelvic pain dysuria, frequent urination, and painful ejaculation. Examining the prostate with a gloved finger can give a clue but does not exclude chronic prostatitis if it is normal. Semen culture can be used to decreed the type as well as the choice of antibiotic in case it is positive. Your history is positive for chronic prostatitis; thus, I did not advise semen culture as you took antibiotics multiple times it is likely to have a negative culture. Treatment can be by using Orelox (Cefpodoxime) 200 mg as it is effective but should be used for four weeks. If the ultrasound KUB (kidney, ureter, and bladder) did not show stones or hydronephrosis, there is no need to do a CT (computerized tomography) scan.
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