Prostatitis or Urethritis? Your Symptoms and Concerns

Prostatitis or urethritis?

Hello Doctor: A year ago, I had urethritis, which later developed into aseptic chronic prostatitis.
The symptoms have decreased, but I still experience pain near the pubic area and occasional urinary frequency.
On Monday, I went for an essential oil massage, where the attendant performed manual stimulation without removing my clothes or using a condom, and there was no oral sex involved.
Afterward, I took a shower and used a small towel that had been covering my body to wipe myself down.
However, when I got home, I started feeling discomfort in my urethra.
Since then, I have experienced several symptoms similar to urethritis, such as increased urinary frequency, itching at the urethral opening, and occasional sharp pain.
Doctor, is it possible that this is urethritis again, or could it be that psychological factors are exacerbating the symptoms of prostatitis? Should I get tested for HPV, syphilis, and herpes? Thank you, Doctor.

kk, 20~29 year old female. Ask Date: 2016/10/22

Dr. Li Xinyi reply Urology

It sounds okay, but there is no guarantee of results.
If you are truly anxious, it is advisable to see a urologist for an examination and discuss your concerns with the physician.

Reply Date: 2016/10/22

More Info

It sounds like you are experiencing a complex set of symptoms that can be quite distressing. Based on your description, it is important to differentiate between prostatitis and urethritis, as both conditions can present with overlapping symptoms, but they have different underlying causes and treatment approaches.

Understanding Prostatitis and Urethritis
Prostatitis refers to inflammation of the prostate gland, which can be caused by bacterial infections or other non-bacterial factors. Symptoms of prostatitis often include pelvic pain, discomfort during urination, frequent urination, and pain in the lower back or perineum. In your case, the history of chronic non-bacterial prostatitis suggests that your symptoms may be related to this condition, especially since you mentioned ongoing pain in the pubic area and occasional urinary frequency.

On the other hand, urethritis is an inflammation of the urethra, typically caused by infections, including sexually transmitted infections (STIs). Symptoms of urethritis include burning sensation during urination, itching or irritation at the urethral opening, and increased urinary frequency. Given your recent experience with the massage and subsequent discomfort, it is plausible that you could be experiencing urethritis, particularly if the symptoms started shortly after that incident.

Possible Causes of Your Symptoms
1. Urethritis: The discomfort you are feeling in the urethra, along with the itching and occasional sharp pain, could indicate urethritis. This could be due to a sexually transmitted infection, especially considering the recent exposure. It is advisable to get tested for STIs, including gonorrhea, chlamydia, syphilis, and herpes, to rule out any infections.

2. Psychological Factors: Stress and anxiety can exacerbate symptoms of prostatitis. If you are feeling anxious about your health or the recent incident, it could lead to heightened awareness of bodily sensations, which may feel like an increase in symptoms. This is sometimes referred to as psychosomatic pain, where psychological factors manifest as physical symptoms.

3. Chronic Prostatitis: Since you have a history of chronic prostatitis, it is possible that the recent discomfort is a flare-up of this condition. Chronic prostatitis can be influenced by various factors, including stress, diet, and lifestyle.

Recommendations for Next Steps
1. Medical Evaluation: It is crucial to consult a healthcare provider for a thorough evaluation. They may recommend a urinalysis and urine culture to check for infections, as well as STI testing based on your recent exposure.

2. Prostate Examination: Depending on your symptoms, your doctor may suggest a digital rectal exam (DRE) to assess the prostate and determine if there is any tenderness or enlargement.

3. Psychological Support: If you suspect that anxiety is playing a role in your symptoms, consider speaking with a mental health professional. They can provide strategies to manage anxiety and stress, which may help alleviate some of your physical symptoms.

4. Lifestyle Modifications: In the meantime, consider avoiding irritants such as caffeine, alcohol, and spicy foods, which can exacerbate urinary symptoms. Staying hydrated and practicing good hygiene can also be beneficial.

5. Follow-Up: Keep track of your symptoms and any changes you notice. Follow up with your healthcare provider to discuss your symptoms and any test results.

In summary, while your symptoms could be indicative of urethritis, they may also be related to chronic prostatitis or psychological factors. A comprehensive evaluation by a healthcare professional is essential to determine the underlying cause and appropriate treatment. Take care of your health, and don't hesitate to seek medical advice.

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