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Patient's Query
Hello doctor,
I have had the following problem for a month or more, and I feel I am at my wit's end. I have a very sensitive penis (it almost feels like it is being tickled under the tip). This makes me feel like I need to urinate often. My penis has been checked, and there is no visible discharge, external damage, or inflammation. My urine is fairly normal - sometimes it is dark and smelly, but I think that is due to the antibiotics I have been taking. If I do not consume enough water, my penis feels like it is being stabbed. My testicles ache too. The problem is worse when I sit down or if I am traveling (the vibration movement makes me want to urinate). The problem is also worse in the afternoon or evening. I am able to sleep through the pain most of the time. The problem also seems to be worse after ejaculation.
I have had some tests performed: STI full check-up - all clear, blood and urine samples were taken - no sign of infection, and prostate checked - large for my age (30) but healthy. I have taken a course on Ciprofloxacin and Doxycycline - for a suspected prognosis of prostatitis or urethritis. Neither of which have worked. I am booked in for an ultrasound scan at some point in the future, but I am struggling. The pain and discomfort are immense, making work or university more difficult.
Please help. Is there anything I can take or any action I can perform to help myself improve?
Hello,
Welcome to icliniq.com.
This is chronic prostatitis, and it can be with or without bacterial infection. This condition is prolonged and can be treated with long-term antibiotics in addition to alpha-blockers and anti-inflammatory medications. I suggest semen culture first, then take tablet Levofloxacin 500 mg once daily for four weeks, tablet Tamsulosin 0.4 mg once before bed for four weeks, and tablet Celecoxib 200 mg twice daily for four weeks. Please follow up after the culture result and after four weeks as well. If you have any more queries, please let me know.
Kind regards.
Patient's Query
Hello doctor,
Thank you for the reply.
I am still awaiting my appointment for an ultrasound. Is there a way to fast-track my diagnosis to get the above treatment? How long does the treatment last? I am really worried that I will be in pain for a long time. It is affecting my day-to-day enjoyment of life.
Kind regards.
Hello,
Welcome back to icliniq.com.
Chronic prostatitis is mainly a clinical diagnosis, as per your history. It is almost certain. Doing ultrasound and semen culture is to support only and to exclude other rare issues just in case. I have suggested the treatment. You can start immediately after giving a sample for culture.
Kind regards.
Patient's Query
Hi doctor,
I just wanted to update you that I went to the out-of-hours doctor last night as I have been in a lot of pain. They rechecked my prostate, along with everything else. Their diagnosis is that I most likely have prostatitis. They prescribed me Ciprofloxacin 500 mg twice daily and Codeine 30 mg four times a day for ten days. I am also unsure of the admin involved in the NHS to organize a semen culture. Thank you.
Hello,
Welcome back to icliniq.com
Yes, your case is chronic prostatitis. I am sorry about the prescription as I am licensed in another country. Semen culture would be beneficial if taken before you start antibiotics. You can share my consultation with a doctor in your country and ask if he could prescribe it for you. Thank you.
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