Urethral Inflammation: Symptoms, Causes, and Treatment

It's inflamed!

Hello Dr.
Pan! I experience urethritis every few months, with symptoms including a white, clear discharge from the urethral opening, urine splitting, and a slight burning sensation.
The last occurrence was in February, where I received treatment at a clinic.
My urinalysis showed a white blood cell count of 25, and I took a lot of ineffective medications that caused my face to swell up like a pig's head.
Later, the doctor recommended a self-paid medication, which brought my white blood cell count down to around 3.
The treatment lasted for two months.
The doctor mentioned it could be a sexually transmitted infection, but aside from my wife, I haven't been with anyone else.
A few days ago, the symptoms recurred, so I quickly took my wife for a urinalysis (bacterial culture), and the results showed no bacterial infection for either of us (but my WBC was 8-10, while my wife's epithelial cells were 12 and WBC was 1-2).

Additionally, I had mumps with orchitis when I was 20 years old, and I underwent a varicocele surgery at a military hospital on an offshore island.
Since then, my left testicle has been very sensitive; any touch causes pain in the left lower abdomen, with a pulling sensation.
At 30, I had a vasectomy, and the clinic insisted on general anesthesia.
After the surgery, my scrotum swelled like a Fuji apple and was painful for a month.
I always suspected that I was treated like a guinea pig at that hospital, as others had local anesthesia and experienced no pain afterward.
Why did I have to go through that? As a man, I often worry about my lower body pain.
Ah! Who knows my troubles? Dr.
Pan, do you understand?

Xin huang huang, 30~39 year old female. Ask Date: 2004/05/10

Dr. Pan Zhenqin reply Urology

If you have not had any other sexual contact and have a history of these conditions, inflammation of the seminal vesicles or prostate must be considered.
It is recommended that you maintain adequate hydration, ideally consuming more than 2500 ml of fluids daily.
Additionally, it is beneficial to include foods such as tomato juice, pumpkin, and almonds in your diet.
You may also take warm sitz baths while showering, soaking the perineal area for about 10-15 minutes each time.
At the same time, avoid spicy and acidic foods, especially alcohol.
You can visit the outpatient clinic for further evaluation.
My clinic hours are Tuesday and Friday mornings, as well as Friday evenings.
Wishing you health and happiness from Tainan Hospital, Department of Health!

Reply Date: 2004/05/10

More Info

Dear Patient,
Thank you for sharing your concerns regarding your recurrent urethral inflammation and the associated symptoms. It sounds like you have been through a challenging experience, and I appreciate your patience as we navigate this complex issue together.

Urethral inflammation, often referred to as urethritis, can be caused by various factors, including infections (bacterial, viral, or fungal), irritants (such as soaps or lotions), or even trauma. In your case, the presence of white blood cells (WBC) in your urine suggests an inflammatory response, which could be due to an infection or another underlying issue. The symptoms you describe, such as the burning sensation during urination and the discharge, are common indicators of urethritis.

Given that your recent urine cultures returned negative for bacterial infections, it raises the possibility of non-infectious causes of urethritis. This could include conditions such as chemical irritation, sexually transmitted infections (STIs) that may not have been detected, or even autoimmune conditions. It's also worth considering that your history of mumps orchitis (testicular inflammation due to mumps virus) and previous surgeries may have contributed to your current symptoms, potentially leading to chronic inflammation or sensitivity in the area.

The treatment for urethritis typically involves addressing the underlying cause. Since your recent tests did not indicate a bacterial infection, it may be beneficial to explore other potential causes. Here are some recommendations:
1. Follow-Up Testing: Since your symptoms have recurred, consider asking your healthcare provider for further testing, including tests for STIs that may not have been included in your previous evaluations. Additionally, a urethral swab may provide more specific information.

2. Medication Review: If you experienced significant side effects from previous medications, it’s essential to discuss alternative treatment options with your doctor. There are various classes of medications that can help manage inflammation and discomfort without causing adverse reactions.

3. Lifestyle Modifications: Maintaining good hydration can help dilute urine and reduce irritation. Additionally, avoiding potential irritants such as scented soaps, lotions, or hygiene products may alleviate symptoms.
4. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help manage discomfort. However, consult your doctor before starting any new medication.

5. Physical Therapy: In some cases, pelvic floor physical therapy can be beneficial for managing chronic pelvic pain or discomfort. A specialized therapist can provide exercises and techniques to help alleviate symptoms.

6. Consultation with a Specialist: If symptoms persist despite treatment, consider seeking a referral to a urologist or a specialist in male pelvic health. They can provide a more comprehensive evaluation and explore other potential diagnoses, such as interstitial cystitis or chronic prostatitis.

7. Mental Health Support: Chronic pain and recurrent health issues can take a toll on mental well-being. If you find yourself feeling overwhelmed or anxious about your condition, consider speaking with a mental health professional who can provide support and coping strategies.

In conclusion, while urethral inflammation can be distressing, there are various avenues to explore for effective management. It’s crucial to maintain open communication with your healthcare provider and advocate for further testing and treatment options that align with your needs. Your health and comfort are paramount, and I encourage you to seek the support you deserve.

Wishing you relief and improved health,
Doctor Q&A Teams

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