Could Your Symptoms Indicate Chronic Prostatitis? Urological Issues

Suspected chronic prostatitis?

Around early September last year, I experienced a sharp pain at the urethral opening after masturbating while holding in urine for a temporary thrill.
I did ejaculate, but the pain was unprecedented.
In the following days, the sharp pain persisted, accompanied by urgency, burning during urination, and occasional dribbling after urination.
I visited a urology clinic, but my urinalysis results were normal, and a bladder ultrasound showed 0 cc.
During the physical examination, the doctor noted that I have a cyst at the urethral opening on the glans, leading to a diagnosis of urethritis possibly caused by the cyst.
I was prescribed doxycycline and a topical ointment, which provided temporary relief.
However, the burning and sharp pain during urination returned intermittently.
I later consulted a different urologist at a larger hospital, who also attributed my symptoms to the urethral cyst and prescribed the topical ointment again.
When my symptoms worsened, applying the ointment helped alleviate the discomfort, but the symptoms would return after a few days without treatment.
Distressed by the ongoing issues, I researched my symptoms online and suspect that I might have chronic prostatitis.
I would like to ask the doctor if these symptoms could indicate chronic prostatitis.

Ban, 10~19 year old female. Ask Date: 2022/02/20

Dr. Li Xinyi reply Urology

Based on your description, it seems you have prostatitis.
When you see your doctor, you should inform them about the incident of holding your urine and the DIY situation, as this will help them make an accurate diagnosis for treatment.
However, sometimes prostatitis can be a difficult chronic condition to manage.
This is a lesson learned; in the future, do not misuse your body, as it can lead to problems that are not always easy to treat.

Reply Date: 2022/02/20

More Info

Chronic prostatitis, particularly chronic pelvic pain syndrome (CPPS), is a complex condition that can manifest with a variety of symptoms, including pain in the pelvic region, urinary difficulties, and sexual dysfunction. Based on the symptoms you've described, it is indeed possible that you may be experiencing chronic prostatitis or a related condition.

Understanding Your Symptoms
1. Pain and Discomfort: The sharp pain you felt during ejaculation, followed by persistent burning sensations during urination, is indicative of a potential inflammatory process in the prostate or surrounding tissues. Chronic prostatitis can lead to ongoing discomfort, which may not always be accompanied by clear signs of infection in urine tests.

2. Urinary Symptoms: The urgency and burning sensation during urination, along with the feeling of incomplete emptying (i.e., leaking a few drops after urination), are common complaints among those with chronic prostatitis. These symptoms can significantly impact quality of life, leading to anxiety and distress.

3. Previous Treatments: Your experience with doxycycline and topical treatments suggests that while there may have been temporary relief, the underlying issue has not been fully addressed. Chronic prostatitis often requires a multifaceted approach to treatment, as it may not respond well to antibiotics alone, especially if there is no bacterial infection present.

Diagnosis and Considerations
1. Diagnosis: Chronic prostatitis is typically diagnosed based on clinical symptoms and the exclusion of other conditions. Since your urine tests and imaging have returned normal results, it may be beneficial to consider further evaluations, such as a prostate-specific antigen (PSA) test, or even a prostate massage to analyze prostatic secretions, if deemed appropriate by your physician.

2. Non-Bacterial Prostatitis: Many cases of chronic prostatitis are classified as non-bacterial, meaning that they do not respond to antibiotics. This type often requires different treatment strategies, including pain management, lifestyle modifications, and possibly physical therapy.

3. Psychosomatic Factors: Given your history of anxiety and the circumstances surrounding the onset of your symptoms, it is also important to consider the psychological aspects of chronic pelvic pain. Stress and anxiety can exacerbate physical symptoms, creating a cycle that can be difficult to break.

Treatment Options
1. Pain Management: Since you have experienced limited relief from topical treatments, it may be worth discussing other pain management strategies with your healthcare provider. Options may include oral pain relievers, muscle relaxants, or even nerve blocks in some cases.

2. Physical Therapy: Pelvic floor physical therapy can be beneficial for many patients with chronic prostatitis. A trained therapist can help address muscle tension and dysfunction in the pelvic region, which may alleviate some of your symptoms.

3. Lifestyle Modifications: Implementing changes such as avoiding irritants (caffeine, alcohol, spicy foods), practicing stress-reduction techniques (yoga, meditation), and maintaining a healthy diet can also contribute to symptom relief.

4. Regular Follow-Up: Given the chronic nature of your symptoms, regular follow-up with a urologist is essential. They can monitor your condition, adjust treatment plans, and provide support as needed.

Conclusion
Your symptoms do align with those commonly associated with chronic prostatitis, but a definitive diagnosis should be made by a healthcare professional familiar with your medical history and current condition. It is crucial to continue seeking medical advice and exploring various treatment options to find a regimen that works for you. Chronic conditions can be challenging, but with the right approach, it is possible to manage symptoms effectively and improve your quality of life.

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