What could be the reason for the burning sensation at the tip of the penis?

Hi doctor,

I am a 33-year-old male with a normal BMI. I do not take any medication except topical Minoxidil for hair loss. I have increased urinary urgency or frequency, pain or burning sensation at the tip of my penis (which becomes worse after urination), a weak urine stream, and aching testicles.

I also have tailbone pain that worsens at night. I take the tablet Ibuprofen and stretching exercises to relieve the pain.

These symptoms started over a month ago. Initially, I had intermittent deep pelvic pain with ejaculation and mild testicular pain (bilaterally). I had a bad case of diarrhea (drinking contaminated water) three months ago, which lasted for three days. I also had urinary urgency, frequency, and burning in the tip of my penis. A few days later, I took an online consultation as I was concerned about UTI, and did a seven-day course of Cipro (500 mg, twice a day). The symptoms improved but were not cured totally.

After a week, the symptoms worsened. It was bad, especially at night. I went to see a urologist a couple of days later and did tests that included blood work, urinalysis, PSA, cultures, and ultrasound. All of my results were normal. I was advised a 14-day course of Levofloxacin (500 mg per day) and Azithromycin (500 mg, thrice a week). Again, I think this helped but never resolved my symptoms.

Towards the end of that month, I started having some issues with my urine stream. I can still empty the bladder, but the urine stream is weak, and difficult to start. I also have pain or burning after urinating, which is the most uncomfortable part. It becomes bad at night.

I was abstaining from alcohol and coffee for a month as I was unsure if these substances irritated my urethra. I drank a few pints of beer last night and felt that perhaps my urine flow was better or less painful. Please help.

Thank you.

Hi doctor,

Thank you very much for the reply!

I, too, was wondering if it was prostatitis. I got both a urine culture and a semen culture done. Both were negative. I have attached the pictures. I have completed a course of both Cipro (seven days) and Tevanic (14 days). Do you think these were maybe the wrong choice?

Thanks.