Link Between Candida Infection and Chronic Prostatitis: What You Need to Know - Urology

What is the relationship between Candida albicans and chronic prostatitis in terms of antibiotics?

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1.
At the beginning of September, three days after having sexual intercourse with my wife, I experienced pain at the urethral opening during urination, redness and itching of the glans, and white scaling around the outer edge.
I went to a local hospital where Dr.
A suggested it might be balanitis and prescribed Four Benefits cream for the glans, Blessing capsules, and antibiotics and painkillers for seven days.
The next day, my wife also had symptoms of vaginitis and went to see a gynecologist, where she was diagnosed with a Candida infection and prescribed suppositories and medication.
After completing our respective treatments, we both recovered.
2.
In mid-November, I experienced pain at the base of the penis after urination, so I returned to the local hospital.
Dr.
B reviewed my blood and urine test results from September, which primarily checked for sexually transmitted infections and showed normal results.
Dr.
B prescribed enteric-coated doxycycline capsules (an antibiotic) for seven days.
During the seven days of medication, I felt that the pain at the base of the penis worsened, and I also developed intermittent mild pain in the testicles and pain during ejaculation.
3.
At the end of November, due to the increase in symptoms after completing the medication, I went to the local hospital and switched to Dr.
C.
The doctor suggested it might be chronic prostatitis.
Dr.
C examined the glans and testicles, which appeared normal, and prescribed Silodosin and painkillers for five days, along with tests for PSA, IgE, and CRP.
After five days of Silodosin, the pain symptoms improved, but after five days, I started experiencing pain at the base of the penis after urination, intermittent mild testicular pain (sometimes on the left, sometimes on the right), and pain at the base of the penis after ejaculation.
I returned to Dr.
C, who conducted a uroflowmetry test (which was normal) and noted that the previous PSA, IgE, and CRP results were also normal.
Dr.
C then prescribed Silodosin and painkillers for another 14 days.
While taking the painkillers for 14 days, the pain symptoms improved, but after finishing the 14 days, I still had mild pain at the base of the penis after urination, intermittent mild testicular pain, and pain at the base of the penis after ejaculation.
I also noticed discomfort when sitting if pressure was applied to the testicles.
I purchased a multivitamin with zinc and took it for three days, which reduced the pain at the base of the penis, intermittent testicular pain, and pain after ejaculation.
4.
Although the aforementioned symptoms have decreased, I have not fully recovered.
In mid-December, I switched to Dr.
D at a large teaching hospital.
Dr.
D also examined the glans and testicles and I described my previous medical history.
Currently, my symptoms include mild pain at the base of the penis after urination, intermittent testicular pain (sometimes on the left, sometimes on the right), and pain at the base of the penis after ejaculation.
I also mentioned that I had a hernia several years ago and underwent bilateral groin repair surgery (the discomfort in the testicles feels similar to the pulling sensation I had during the hernia).
The doctor indicated that this should not be related to the hernia surgery and is more likely a chronic condition.
Blood and urine tests were conducted, but I have not returned for results yet.
The doctor prescribed Hiberix enteric-coated tablets and anti-inflammatory painkillers for ten days.
After taking the medication for three days, I felt no improvement; in fact, the pain slightly worsened, and my testicles became more sensitive, causing discomfort when sitting.
Additionally, I experienced a new stinging sensation in the penis.
I was originally scheduled for a follow-up in five days, but I plan to return earlier.
Based on my medical history, I conclude that aside from the improvement from the antibiotics and painkillers for balanitis in early September (which could also be due to the topical cream), the pain has worsened with different antibiotics prescribed by different doctors in mid-November and recently in mid-December.
However, the Silodosin prescribed by Dr.
C was effective, although prolonged use caused lower back pain.
I would like to ask Dr.
D whether I might have chronic prostatitis that is non-bacterial, or if it is possible that the Candida infection diagnosed in September has led to chronic prostatitis, causing the pain to worsen with antibiotic treatment.
I have read that certain antibiotics may promote Candida overgrowth.
Based on the above description, would you recommend antifungal treatment or suggest other diagnostic or treatment options? Thank you.

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Mi Tang, 30~39 year old female. Ask Date: 2023/12/28