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Chronic Urethra Irritation, docs clueless, please help
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An_242063 posted:
Male in 30's.

Symptoms:
dull, usually mild, but near-constant stinging sensation felt in urethra or penis tip
often is worse before and/or after urinating, but sometimes seemingly not related to urination
occasional random twinges of pain or discomfort in the urethra
polyuria
very mild dysuria
no visual signs, except slight puffiness of meatus just after urination
generalized pruritus, mostly trunk and neck
these symptoms have lasted for 5 months - they were worst shortly after onset, tapered, but have seemingly reached a "plateau" where it doesn't seem to be getting any better overall - it just waxes and wanes

Workup thus far:
gon & chlam tested shortly after onset, both neg.
Cipro 14 day course given shortly after onset, little or no change to symptoms.
full STD panel (including gon & chlam again) 45 days after onset, all neg.
standard blood panel, including blood sugar, liver and kidney function, all normal (GP says "excellent").
Bladder-kidney ultrasound reveals nothing.
Cystoscopy reveals nothing in bladder, "possibly a little irritation" in urethra, doxycycline 7 day course given afterwards, no change to symptoms.
Several urinalyses were performed at urologist, some with attempted culture of bacteria, none ever detected bacteria or WBC. Those performed shortly after onset indicated microhematuria which persisted for a couple of months, while the recent ones ones have not had hematuria. Urine pH has been "on the acidic side" (pH of 5).
Azithromycin 5-day course given for an unrelated issue - this produces temporary relief of urethral issues.
Two digital rectal exams, one shortly after onset, the other months later, both revealed nothing
Urologist has noted that the urethra is very sensitive to contact, based on the fact that the cystoscopy caused excrutiating pain in urethra despite numbing gel. Also, manual examinations of the urethra by urologist have been more painful than he would have expected.
No discharge, odor, or lesions were ever observed.

So the only actual clinical findings were:
microhematuria which is now gone
urethra sensitive to contact
urethra "may have had a little irritation" (uro's words)

So I'm at my wit's end. My uro is a nice guy but it seems that he is out of ideas and is now toying with garbage diagnoses such as interstitial cystitis. Any suggestions would be greatly appreciated. I'm thinking that it must be some sub-clinical infection or resistant strain of bacteria, and considering trying d-mannose or a different antibiotic.
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counterso responded:
You do not have interstitial cystitis. You have a chronic irritation that is either caused by an allergy or a parasite. It does NOT sound anything like an infection.

You can follow a standard allergy elimination protocol (fabrics, cleansers, foods). And you can get checked for parasites, especially if you have eaten shellfish (like fried clam strips or something) near the beginning of these symptoms, that would make me even more suspicious of parasite over allergy.
 
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An_242063 replied to counterso's response:
Thanks for the insight! I will be seeing an allergist soon and will ask about the possibility of parasites. I never suspected this, because I did not have any significant gastrointestinal issues, but I'm sure it is still possible. I did inexplicably lose some weight shortly after the time of onset, but I've since gained it back. I did eat crab before it started, but never suspected that it could cause something so persistent.
 
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counterso replied to An_242063's response:
There are different kinds of parasites, not all of them have an effect on your digestive system. Shellfish are notorious for different kinds of nematodes that irritate the soft parts of your body (like armpits, elbow crease, groin), pretty much anywhere tender making them feel slightly burned or itchy. This can include the tip of your penis, webbing of your fingers, lots of places. I don't know that you have this. It's just a suggestion to check since other common solutions to your symptoms have not had an effect and not many people think of it on their own.

Allergies are more common, whether to a detergent, fabric softener, soap, fabric, lotion, food, etc. Even a mild nut allergy can cause irritation of the skin in the same places mentioned above.

It's only a urology issue because your penis is involved, but the cause of your symptoms may not be urologic at all.
 
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rollmantiz responded:
I have had the same symptoms for a whole year and I have taken every antibiotic there is but still there's no help in sight. I have seen four urologists they all did their best and don't know what to do anymore. All tests have come out negative. Any help out there will be highly welcome.
 
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counterso replied to rollmantiz's response:
rollmantiz, have you seen an allergist? You also need to do some repair of your immune system after all those antibiotics. Take a comprehensive probiotic for no less than a month.
 
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Mixer responded:
I had this about 3-4 years ago....and it finally went away. About a week ago, it returned. The same thing. It feels like an infection in my entire body but causes an almost constant irritation in my bladder and around/inside my anus. There is a warmth inside that who area. Ice helps a bit. In additon, I feel an irritation in my eyes this time. It is almost like there is an infection roaming my entire body. All tests were negative for anything, when I first had it. No antibiotics helped at all. After about 3 months, it became less worse, and them finally I noticed that it was gone...for about a year, I was fine. Someone mentioned an abbreviation for what I had and said there was nothing you could really do...unfortunately, I lost that bookmarked page, so I forget the name. It was not one of the regular assumptions about this. It is very frustrating as it makes you very cranky with the constant irritation.
 
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counterso replied to Mixer's response:
It still sounds like an acute allergic reaction.
 
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JesusIsLord28 replied to counterso's response:
Hello, my name is Chris & I'm a healthy 29yr. old male dealing with what I believe is a Bladder Infection. So this all started off like four months ago. I was peeing a lot, burning when I peed, no discharge, lower back pain, lower abdomen pain & also a itch inside the penis. My family doctor did a urine sample on me & he said the sample came back with a bit of an infection, so he gave me a antibiotic but I can't remember the name, & said to take it for five days. Well, I did that & it was still lingering around, went back & this time he gave me Cipro & said to take it 2X's a day for 14 days. Well I did that & went back for a third visit, same thing, did another urine sample & said their seemed to be a little stubborn infection still their & game me four pills of Zithromax & that worked for like five days then it came back. My doctor was worried about Kidney & Bladder stones, so he sent me to a referral to get a CT Scan, also checked me below for anything else. Well a few weeks ago, I went to get my CT Scan on my kidneys & bladder, i came back clear but said I had a mild case of Diverticulitis (WOW). Well I went to to the Urologist Wed, he checked my testicles & penis, also did another urine sample & said the culture did not grow anything. I told him I had been drinking water & taking cranberry extract pills as well. The Urologist said he said it is probably just a stubborn case of Bladder issues that will probably have to heal over time, but I'm getting sick & tired of this issue & want my regular life back, if anybody has any answers, please send me a message or leave comments here. I need help. I have been told it is Candida which can cause itching in the penis. I need help please. I have been tested for everything under the sun... Now I have mouth ulcers, Is this just stress from freaking out, please I need help!
 
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counterso replied to JesusIsLord28's response:
Nice hijacking of the topic here Chris.
Candida cannot be treated with an antibiotic. It is a fungus, and has to do with a lowered immune response (which could be an after-effect of the strong antibiotics), and poor diet (too much sugar and red meat, not enough water and fiber).

There are two critical steps in treating a urinary tract infection. The first one is a urinalysis to determine you actually have an infection, and then a sensitivity test of the bacteria found in the urine sent for analysis to determine which antibiotic will be effective. It sounds like some idiot didn't do the second step, otherwise your first antibiotic treatment should have been successful since they would have known in advance which antibiotic to prescribe.

Diverticulitis is very serious, but not a urology issue. It may however have influenced your candida problem.

Since you had some very powerful antibiotics that killed all the good flora in your gut, you need to be taking a good probiotic for at least a month to restore that intestinal flora. Restoring your good flora will dramatically help to control the candida.

Cranberry can only prevent e.coli bacteria from adhering to the bladder lining. It cannot treat an infection that has already occurred. Most UTIs are e.coli based, but some are not, and that's what's important about your urinalysis and learning what treatment will be effective.

Your family doctor is completely incapable of dealing with genito-urinary issues. A GP gets about as much training in that area as you do in rocket science. Fortunately you went to see a urologist later.

It's not clear from your note what symptoms are persisting, and why your urologist would be dismissive. It's your job to prompt him to solve the problem or provide concrete answers.

The mouth ulcers are again from the weakened immune system from the horrible antibiotics you took. You need medical treatment to control the candida right now until you can restore your own immune system. It may be a prescription mouthwash as well as an anti-fungal medicine. Sorry that one thing lead to another.
 
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JesusIsLord28 replied to counterso's response:
My symptoms consist of urethra itch from time to time, lower adominal pain but have been checked for stds & am clear so what can I do all natural to get rid of this annoying itch.
 
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counterso replied to JesusIsLord28's response:
This could be dietary, weight-related (pressure on a nerve), an allergy, anxiety-related, or something else. Unfortunately there's really not enough information to assess.

What do you mean "natural?" Natural means something completely different to a lot of people.
 
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entro responded:
please help.

i have the same problem and have all the same treatments as describes to revel nothing about from a kidney stone which i have great pleasure pushing out yesterday. not nice, ive just got to Australia from the UK a month ago and trying to work with this is unbearable! it only started when i landed. the hospital refused to see me after the four time i was in a and e because they thought i was a hypochondriac and what makes it worse im paying for all my treatment on a backpacker budget. please help thank you
 
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entro replied to entro's response:
and i was taking about the the problem An_242063 at the .
An_242063 did you every find a cure??


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