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Drop in BMI and Prostatitis

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To whom it may concern,

First, I hope that I am able to describe my symptoms well to you, despite the fact that I am not native in English.

I am a 46-year old man. My length is 1,82 meter and my weight is today around 93-94 kilograms. In fact, I have lost about 7-8 kilograms during the last month or so due to (heavy) training. My BMI has dropped from about 30 to slightly above 28.

To be more precise about my training, I have exercised about 4-5 days a week the last 2,5 months. Mostly, I have been swimming in the outdoor pool (1 hour, or even more) and running the treadmill (also 1 hour each time, but a few times as long as 1,75 hours). I trained a lot when I was younger, so I am used with exercising a lot, even if I have not done this for at least 5 years.

To help reduce my weight, I have eaten Alli (orlistat) at a regular basis the last 2,5 months. I have never smoked tobacco and I drink very rarely alcohol.

The fall 2008 (when I came to the U.S. for one year) I got symptoms that correspond quite well with prostatitis; pain in my testicles, my back, the pelvic floor, the groins, more frequent urination, etc. I saw a physician. I had these symptoms for a number of months. I do not exactly remember for how long period. The symptoms have returned thereafter, but it was quite a long time since last time (except this fall).

The fall 2011 I got mild pain in the lower part of my stomach. A urine stick showed presence of blood, but the blood was not visible for the eye and I felt no problems urinating. They looked at my bladder (if I recall correctly) with ultrasound, they did enteroscopy of my large intestine, I took a PSA-test (for the second time in my life), but everything was fine. No signs of sickness. After half a year, the soft pain slowly vanished. I never received a diagnosis.

This fall (when I came again to the U.S. for one year) the prostatitis symptoms have returned, even though I believe that they are milder than they were 5 years ago. It started with a mild pain in my lower back as the only symptom (i.e., a sort of tiredness in my back). I therefore believed that my pain was because of my training in combination with having a big belly. (At the moment, my back is fine.)

One thing that is different now, which also is the reason I write to you, is that I saw a few drops of urine with blood inside (light red) when I urinated directly after having running at the treadmill last Sunday. I could see that it was a little blood in the urine before it slowly ran down into the water. The amount of urine was very small; maybe 0,1-0,2 deciliter, but absolutely not more. I had drinking quite a lot of alcohol during Saturday evening (during Saturday early evening, I was exercising for 2 hours; cycling and ski-machine, 1 hour each) and I had not drinking so much water before I trained, which also explains that the 1 hour running at the treadmill was heavy for me. About 15 minutes prior to urinating, I felt some burning pain (even though the word pain is a bit strong) in my penis.

I also feel this soft pain in my penis now, even though the urine looks fine (transparent or light yellow) and have done so this week. Monday and Tuesday, I have urinated extremely little, even though I felt the need to pee. On Monday, I stopped taking Alli because I have learned that you can get blood in the urine of Alli, though it is a very rare symptom. My urine has occasionally been (quite) dark the last month or so. When I first saw dark urine, I also had the burning pain in my penis prior to urinating.

What is your general impression of my description? The thing is that I am worried that I have cancer. For example, that I have bladder cancer or prostate cancer. (I am often worried that I have cancer, even though cancer is not a typical disease in my family. In fact, I do not think that any of my close relatives have had cancer.) I am aware of the fact that your impression from my description of my symptoms not at all is a substitute for seeing a physician.

Kindly, M

Category: Urologist

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Category: Sexually Transmitted Diseases(STD)Specialist
 29 Doctors Online

Dear M,

Thank you for choosing DoctorSpring and thank you for the detailed and structured description of your problem.

There is a possibility that you might be having recurrence of prostatis. Patients with prostatis can have backache, burning in passing urine and also occassionally blood in urine.
The most significant event in your history is the heavy exercise. A lot patients may also have blood in the urine secondary to heavy exercise. However such patients shall not have other symptoms. The burning you may have experienced may be the result of dehydration.

Cancer of course is a concern when there is presence of blood in the urine. But you should remember there are a number of other common conditions that cause blood in the urine. I assume that you have been evaluated by a Urologist or MD with similar expertise. So for sure he should have ruled out cancer. In that case you should not worry about that.

For this current symptoms set you should certainly get investigated with at least ultrasound and urine examination.


Patient replied :

Dear Dr Rajiv Goel,

You wrote in the second last paragraph that "I assume that you have been evaluated by a Urologist or MD with similar expertise. So for sure he should have ruled out cancer. In that case you should not worry about that".

Do you here refer to the examinations during the fall 2011? If so, there were 3 different MDs (also specialists) who examined me and they all ruled out cancer.

Or did I misunderstand you?

Kindly, M


Yes, I was referring to the 2011 evaluation and tests. As I suggested an Ultrasound and Urine examination might be required now. This, combined with a good physical examination will rule out the possibilty of cancer. (the possibilty appears very rare in your case).

Hope this helps
Please feel free to ask followup questions.

Dr. Rajiv Goel
Category: Sexually Transmitted Diseases(STD)Specialist
MCh(urology) Medical Council of India
Fellow, Laparoscopic urology, Germany
Fellow, Urooncology and Robotic urology, Australia
Felloship - MCH, Urology/Genito-Urinary Surgery, AIIMS, 2004
Residency - MS, Master of Surgery, AIIMS, 2001
Medical School - MBBS, Bachelor of Medicine and Bachelor of Surgery, AIIMS, 1998
Dr. Rajiv Goel and 4 other Medical Specialists are ready to help you

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