Unresolved Urethral Discomfort: Seeking Answers and Diagnosis - Urology

More Info

---

Dear Patient,
Thank you for reaching out with your concerns regarding unresolved urethral discomfort. I understand that this has been a challenging situation for you, and I will do my best to provide clarity on your questions.

1. Testing for STIs: It’s good to hear that you have tested negative for HIV and syphilis multiple times. When it comes to testing for sexually transmitted infections (STIs) such as gonorrhea and chlamydia, nucleic acid amplification tests (NAATs) are indeed highly sensitive and specific. However, there are a few reasons why your initial tests may not have yielded results. First, the timing of the test is crucial; while you mentioned that you were tested around 12 days post-exposure, some infections may not be detectable until a few weeks after exposure. Additionally, if you were asymptomatic at the time of testing, the likelihood of detecting an infection may decrease. If you have persistent symptoms, it may be worthwhile to repeat the tests or consider additional tests for other STIs that may not have been included in your initial screening. Blood tests can also check for other infections, including herpes simplex virus (HSV) and hepatitis, which may not be routinely included in standard STI panels.

2. Chronic Prostatitis Symptoms and Diagnosis: Chronic prostatitis can manifest with a variety of symptoms, including pelvic pain, discomfort during urination, painful ejaculation, and sometimes flu-like symptoms. The diagnosis can be challenging, as symptoms can overlap with other conditions. To confirm chronic prostatitis, a healthcare provider may perform a digital rectal exam (DRE) to assess the prostate and may also recommend tests such as a urinalysis, prostate-specific antigen (PSA) test, or even a prostate massage to analyze prostatic secretions for signs of infection or inflammation. Treatment duration can vary widely depending on the underlying cause, but it often involves antibiotics if a bacterial infection is suspected, along with anti-inflammatory medications and lifestyle changes.

3. Urethral Symptoms: The progression of your symptoms from itching to significant pain in the urethra is concerning and may suggest an underlying condition that requires further evaluation. While urethritis (inflammation of the urethra) is a common cause of such symptoms, other conditions such as prostatitis, interstitial cystitis, or even pelvic floor dysfunction could also be contributing factors. It’s important to have a thorough evaluation by a urologist, who may recommend imaging studies or cystoscopy (a procedure to look inside the bladder and urethra) to rule out structural abnormalities or other underlying issues.

In summary, I recommend following up with your urologist to discuss your ongoing symptoms and the possibility of further testing. It’s crucial to communicate all your symptoms clearly, as this will help guide the diagnostic process. If you have not already, consider asking about a referral to a specialist in chronic pelvic pain or a urologist with experience in treating chronic prostatitis and related conditions.

I hope this information helps you navigate your situation, and I wish you the best in finding relief and answers.

Sincerely,
Doctor Q&A Teams