Get E-Book on COVID-19

Q. I am getting pain in penis and tingling sensation in testicles. Please help.

Answered by
Dr. Raman Tanwar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 10, 2016 and last reviewed on: Jun 20, 2019

Hi doctor,

I am a 27 year old sexually active male. I have been with the same girl for the past 10 years and we are loyal in the relationship. I am having a ton of issues and pain in my lower region. The symptoms are lower back pain, pain in my pubic region, pain and tingling in my testicles, burning with and without urination and pain within the penis. I have been to three different walk-in clinics and had three different antibiotics, including Levaquin, Bactrim and Cipro. I went to a urologist and was told to have pelvic pain syndrome. I have had similar issues in the past. I dealt with a prostate infection a few years ago and that was treated with antibiotics. But, this time nothing is working. Most urine cultures show no bacteria. My thoughts are possibly pudendal neuralgia or interstitial cystitis, as my mom has IC. Do you advise sonogram or endoscopy or medications?

Dr. Raman Tanwar

Andrology General Surgery Urology
#

Hi,

Welcome to icliniq.com.

Your symptoms do point towards chronic prostatitis. With negative culture and positive pus cells, it is likely that you are suffering from CPPS IIIA, which is non-bacterial inflammatory chronic prostatitis. Now, this is a difficult condition to manage and requires long-term therapy. I would suggest that you follow up with a urologist on a long term basis. Therapy takes some time and different medications work for different patients.

IC (interstitial cystitis- painful bladder) is also a possible condition, but CPPS is more common in males than IC. You do not meet all criteria for IC as per the classic definitions. So, I would keep CPPS as the first differential. I am mentioning some tests that you may want to get done to clarify the situation in a better way.


The Probable causes:

Recurrent infections.

Investigations to be done:

Urine anti-proliferative factor, EPS Culture (expressed prostatic secretions) after prostatic massage, uroflowmetry with post-void residual urine assessment and cystoscopy.

Differential diagnosis:

1. CPPS IIIA.
2. BPS (bladder pain syndrome) / IC.

Treatment plan:

I suggest combination of Amitriptyline, alpha blockers, NSAIDS (nonsteroidal anti-inflammatory drugs) and Gabapentin. Dietary modifications will be necessary. Consult your specialist doctor, discuss with him or her and take the medicine with consent.

Preventive measures:

Stay away from spices, coffee and anything that you feel trigger the symptoms or aggravate them.

Regarding follow up:

Revert back with the reports to a urologist online.---> https://www.icliniq.com/ask-a-doctor-online/urologist


Was this answer helpful?

 | 

Thank you doctor,

I really appreciate your answer and the extra information. I am going to follow up with a urologist. Is kidney stone or bladder stone a possible cause of this? Do you think getting a sonogram of my bladder, kidneys and scrotum would be beneficial in trying to rule out?

Dr. Raman Tanwar

Andrology General Surgery Urology
#

Hi,

Welcome back to icliniq.com.

  • Bladder stones are a possibility, but less likely. Kidney stones are very unlikely to cause such symptoms.
  • You may do well by getting an ultrasound done and I do recommend it.
  • The post-void residual assessment that I mentioned is done by sonography only and it may be a good chance to assess bladder stone. It is likely that your sonography may show the changes of cystitis.
  • I will appreciate if you can send over the reports to me so that I can help you further. The therapy would obviously be best under the guidance of urologist.

Revert back with the reports to a urologist online --> https://www.icliniq.com/ask-a-doctor-online/urologist


Was this answer helpful?

 | 

Related Questions:
Is it normal to have nausea and stomach pain after taking Panadol?
How to clear kidney stones?
I am experiencing pain while urinating but all tests are normal. What could be the reason?
Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


Can Aleve and Goody's powder cause stomach upset?

Query: Hi doctor, I recently had a migraine, so I took two tablets of Aleve. It did not work, so I took Goody's powder, but the pain was still there, so I took another one. The migraine pain has gone, but my stomach seems to be upset.  Read Full »

Why am I getting recurrent kidney stones with stomach pain?

Query: Hello doctor, I have many health problems. My gallbladder was removed two years back and now I feel pain in the left as well as right side of the stomach below ribs. I am also suffering from repeated kidney stones at the left side and also in my both arms, I feel some bulges sort of thing. Please s...  Read Full »

Also Read


Crohn's Disease
Crohn's disease causes inflammation of the digestive tract, which results in symptoms like severe diarrhea, stomach pain...  Read more»
I was diagnosed with Celiac disease a year back. Can you suggest any medicine?
Having celiac fromnlast 10 year dignosis recently ayear ago since then i am gluten free still cant absorb food feeling w...  Read more»
My head is shivering from 20 days, and it feels like head trauma. What is the cause?
Hello sir, My head is shivering like anything , feeling like trauma is head. And its start anytime in a day and when s...  Read more»

Ask your health query to a doctor online?

Ask an Urologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.