Prostate Concerns: Symptoms, Diagnosis, and Treatment

Suspected prostate issues?

Hello Doctor, four weeks ago, after resolving a physiological response on my own, I experienced a noticeable soreness in the genital area.
The soreness disappeared the next day, but I began to feel a constant urge to urinate (though the amount was not significant).
Additionally, when I saw some more stimulating images, I felt a discomfort in my penis, and I wondered if this could be psychological.
After resting for two days, these symptoms improved significantly.
I also had a urine test, and my liver, gallbladder, and kidneys were normal, with no bacteria found, but there was a trace of protein in my urine.
The doctor mentioned it might be related to prostate secretions and ruled out inflammatory symptoms.

A week later, I sometimes felt a wet sensation in my anus, but these symptoms did not last long.
In the past two weeks, I occasionally experienced a feeling of fullness in my anus, which was not intense (my bowel movements have been smooth).
I researched many symptoms of prostatitis online, but after comparing them to my own experiences, they did not match closely.
The frequent urination only occurred initially; I have not had it in recent weeks, and my urine flow and speed are similar to when I did not have these symptoms.
During these issues, my morning erections were normal, and I did not feel discomfort during erections, so I am unsure if there is a problem with my prostate.
During these weeks of feeling unwell, I sometimes felt something moving in my genital area (though infrequently).
One day, after sneezing, I felt a sensation in my perineum as if it were moving, but these symptoms have disappeared in the past week.
I wonder if this could be a symptom of prostatitis.
Additionally, I am uncertain if there is a psychological factor involved.
Previously, after masturbation, I would feel soreness, so in recent attempts, I have not been able to achieve a full erection before ejaculation (I noticeably felt my heart racing and some discomfort in my body).
However, when I was not planning to masturbate and saw more erotic content, I could achieve an erection without issue.
My semen appeared yellowish and had some jelly-like consistency.
I believe this may be related to psychological factors because I can achieve full erections in the morning, and after waking, I can maintain it for about five minutes before it subsides.
Sometimes, after a nap, I can also achieve a full erection, so I think I can rule out organic erectile dysfunction.
Due to my naturally suspicious nature, I tend to overthink and worry about missing the optimal treatment window, which could lead to more complications.
After reading about various prostate issues, I fear not receiving timely treatment could result in lifelong sexual regrets.
Therefore, I kindly ask for your assistance in addressing my concerns.
Thank you!
Additional questions:
1.
If there are issues with the prostate, can they be detected through diagnostic tests?
2.
Is erectile dysfunction caused by prostatitis reversible? (In other words, can sexual function return after treating the inflammatory symptoms?)

R, 10~19 year old female. Ask Date: 2013/05/31

Dr. Xu Weikai reply Urology

Hello, prostatitis symptoms can vary.
A physician's examination is necessary to determine the condition.
In theory, prostatitis should not cause sexual dysfunction.
Prostate examinations include: urinalysis, prostatic secretions, prostate ultrasound, digital rectal examination, and blood tests, among others.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only be used as a reference; it is essential to seek medical care at a healthcare facility if needed.
This message is from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan, who cares about your health.

Reply Date: 2013/05/31

More Info

Understanding prostate concerns, particularly chronic prostatitis and its associated symptoms, can be quite complex. Your detailed account of symptoms and experiences provides valuable context for discussing potential diagnoses and treatment options.

Symptoms and Diagnosis
From your description, it seems you have experienced a range of symptoms, including discomfort in the genital area, frequent urges to urinate with little output, and sensations of fullness or pressure in the rectal area. These symptoms can be indicative of several conditions, including chronic prostatitis, pelvic floor dysfunction, or even psychological factors contributing to your physical sensations.

1. Prostatitis: Chronic prostatitis can manifest as pelvic pain, urinary urgency, and discomfort during or after ejaculation. The fact that you have had a history of prostatitis and are experiencing similar symptoms again raises the possibility of a recurrence. However, the absence of bacterial infection in your urine tests is significant. Chronic prostatitis can be non-bacterial, which means that inflammation may be present without an identifiable infection.

2. Psychological Factors: Your mention of feeling discomfort when exposed to sexual stimuli and the anxiety surrounding your symptoms suggests that psychological factors may also play a role. Anxiety can exacerbate physical symptoms, leading to a cycle of discomfort and worry. This is particularly relevant given your history of anxiety and the stress associated with your symptoms.

3. Pelvic Floor Dysfunction: The sensations you describe, such as feeling something moving in the pelvic area or experiencing discomfort after sneezing, may be related to pelvic floor muscle tension or dysfunction. This can lead to a range of symptoms, including pain, discomfort, and urinary issues.

Treatment Options
1. Medication: Since your urine tests did not indicate a bacterial infection, antibiotics may not be the most effective treatment. However, medications such as alpha-blockers can help relax the muscles around the bladder and prostate, potentially alleviating urinary symptoms. Additionally, anti-inflammatory medications may help reduce discomfort.

2. Physical Therapy: Pelvic floor physical therapy can be beneficial for addressing muscle tension and dysfunction. A trained therapist can help you learn exercises to relax and strengthen pelvic floor muscles, which may alleviate some of your symptoms.

3. Psychological Support: Given the potential psychological component of your symptoms, speaking with a mental health professional may be helpful. Cognitive-behavioral therapy (CBT) can assist in managing anxiety and developing coping strategies for dealing with physical discomfort.

4. Lifestyle Modifications: Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and stress management techniques, can positively impact your overall well-being and may help alleviate some symptoms.

Additional Considerations
1. Diagnostic Tests: If symptoms persist, further diagnostic tests may be warranted. These could include imaging studies (like an MRI or ultrasound) to assess the prostate and surrounding structures, or a prostate-specific antigen (PSA) test to rule out other conditions.

2. Reversibility of Symptoms: Many cases of prostatitis, especially non-bacterial types, can improve with appropriate treatment. Addressing inflammation and any underlying pelvic floor issues can lead to significant improvements in symptoms and sexual function.

Conclusion
Your concerns about missing a critical treatment window are understandable, but it is essential to approach this situation with a comprehensive plan that includes both medical and psychological support. Regular follow-ups with a urologist and possibly a pelvic floor specialist can help ensure that you receive appropriate care tailored to your specific needs. Remember that many individuals experience similar symptoms, and with the right approach, significant improvements are often achievable.

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