Could Your Pain Indicate a Prostate Issue? Urological Symptoms - Urology

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Could it be a prostate issue???


Hello Doctor: I am very worried about my condition.
I have been experiencing significant pain in the anal and rectal area.
Normally, I do not feel anything special, but during ejaculation, the pain is extremely intense and lasts for about five minutes before it starts to ease.
I do not experience any particular pain or bleeding during bowel movements, and I do not have noticeable constipation; my bowel movements are generally smooth.
However, sometimes I feel like I haven't completely emptied my bowels.
I also experience pain during urination, specifically at the base of the penis and the glans.
Last March, I underwent a sigmoidoscopy, which was normal but showed mild internal hemorrhoids.
Recently, I had a CEA test, which also came back normal.
A peculiar experience I had was when I took tetracycline for two days due to a severe cold (I carefully checked the medication against the pharmacopoeia, and those medications did not make me feel drowsy).
Strangely, during those days, I did not experience any pain, but two days after stopping the medication, the pain gradually returned.
Could this be prostatitis? PS.
My private life is normal, with no unusual practices (such as anal intercourse or multiple sexual partners), and I have no sexually transmitted diseases, as I donate blood regularly.
Thank you, Doctor.

mentor, 20~29 year old female. Ask Date: 2004/05/02

Dr. Liu Jianting reply Urology


Haha! Experience makes one a good doctor.
Your condition is likely chronic prostatitis.
Please visit a urologist for an examination.
By the way, please take this article with you for the doctor’s reference!

Reply Date: 2004/05/02

More Info


Your symptoms certainly raise valid concerns regarding potential prostate issues or other urological conditions. Based on your description, it appears that you are experiencing significant pain in the anal and rectal area, particularly during ejaculation, along with pain during urination at the base of the penis and glans. The absence of pain during bowel movements and the normal results from your previous examinations, including the flexible sigmoidoscopy and CEA test, suggest that the issue may not be directly related to the rectum or colon.

Given your history of discomfort during ejaculation and urination, it is possible that you could be dealing with a form of prostatitis, which is an inflammation of the prostate gland. Prostatitis can manifest in various forms, including acute bacterial prostatitis, chronic bacterial prostatitis, and chronic pelvic pain syndrome (CPPS), which is often non-bacterial. The fact that you experienced relief from your symptoms while taking tetracycline suggests that there may be an underlying inflammatory process at play, even if a bacterial infection has not been definitively diagnosed.

Chronic pelvic pain syndrome is particularly challenging to diagnose and treat, as it can be caused by a variety of factors, including muscle tension, nerve irritation, or inflammation of the prostate without the presence of bacteria. Your experience of pain during ejaculation and urination, along with the sensation of incomplete voiding, aligns with symptoms commonly associated with CPPS.
It is important to consider lifestyle factors that may contribute to your symptoms. Stress, anxiety, and prolonged sitting can exacerbate pelvic pain. Additionally, dietary factors such as caffeine, alcohol, and spicy foods can irritate the bladder and prostate, potentially worsening your symptoms.
To address your concerns, I recommend the following steps:
1. Consult a Urologist: Since your symptoms are persistent and have not improved with previous treatments, it would be beneficial to consult a urologist who specializes in pelvic pain. They may recommend further diagnostic tests, such as a prostate-specific antigen (PSA) test, urine cultures, or imaging studies to assess the prostate and surrounding structures.

2. Pelvic Floor Physical Therapy: Many patients with chronic pelvic pain benefit from pelvic floor physical therapy, which can help alleviate muscle tension and improve pelvic floor function.

3. Pain Management: Discuss pain management options with your healthcare provider. This may include medications such as anti-inflammatory drugs, muscle relaxants, or even nerve blocks if appropriate.

4. Lifestyle Modifications: Consider making lifestyle changes that may help reduce your symptoms. This includes regular exercise, stress management techniques (such as yoga or meditation), and dietary adjustments to avoid irritants.

5. Follow-Up: Regular follow-up appointments with your healthcare provider are essential to monitor your symptoms and adjust your treatment plan as necessary.

In conclusion, while your symptoms may suggest a prostate issue, they could also be indicative of other underlying conditions. A thorough evaluation by a urologist, along with appropriate lifestyle modifications and potential physical therapy, may provide you with relief and improve your quality of life. Remember, it is crucial to communicate openly with your healthcare provider about your symptoms and any changes you experience.

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