Thank you for your query at DoctorSpring.com
It could be due to a local infection at the head of your penis, or due to some on-going UTI.
Do you have any other history besides this? Any burning micturition or pain while passing urine?
Is there any recent STD risk?
Any redness or whitish film like structure surrounding the glans?
Kindly answer these queries for me to be able to guide you better.
Patient replied :
Greetings - I attmpted to update my question on the site but I was given an error - here is a more complete question:
I have had pain at the tip of my penis off and on for several weeks. It happened originally in October and went away after about two weeks and a short dose of azithromycin. I had sex with someone that had herpes, we were very safe, Doc says herpes is not a concern and I tested negative for STDs and the disappearance of the symptoms with administration of azithromycin was a coincidence. I don't presently have any other symptoms besides microscopic hematuria, and I received a sonogram today (my kidney's are "beautiful" and my bladder clear). My blood showed no white blood cells, the Doc told me that meant no bacteria.
I tested negative for STDs again. The pain comes and goes over the course of days, when it's there it's constant and doesn't get worse with urination. It's more annoying than really painful. My thoughts about the possible causes are:
new detergent from the laundromat (I also have a mild, small rash on the back of one of my legs that looks similar to pictures on the internet of rashes caused by irritating chemicals)
vigorous rubbing (I have been seeing a new woman and while we haven't had intercourse there has been fairly vigorous rubbing, usually while clothed, sometimes not) - I'm not sure if this would explain the microscopic blood, I don't see any but perhaps I have a cut or tear inside?
prostatitis (I had bacterial prostatitis 3 years ago, I don't have pain in that region now)
bladder cancer? (this is the worst thing the internet has thrown at me)
An STD that wouldn't show up on a test or gives false negatives a lot? (I don't have other symptoms that are typical of STDs but I know some STDs exhibit atypical symptoms)
I am going to wash everything I own with hypoallergenic detergent and cease the vigorous rubbing for the time being but do these even seem like likely causes? I'm asking because my Dr. doesn't know what's up, I'll probably see a urologist next week, but in the meantime I'm feeling nervous.
late 30s male white 155 5'6" eastern USA
Thank you for the follow up.
Please do not worry bladder cancer firstly. Internet does list out a 100 different causes causing a lot of anxiety.
Your symptoms are suggestive of prostatitis. In some cases it won't show any bacteria, but the presence of microscopic hematuria points towards an infection causing prostatitis.
Prostatitis is a clinical diagnosis based on history and clinical examination.
You should start yourself on antibiotic such as ofloxacin or doxycycline and alpha blocker such as tamsulosin under the care of your doctor for 4 weeks and you shall improve. This is important because as I mentioned, not all organisms can be seen in urine. Hence to have a conclusive diagnosis prostate secretions need to be cultured and obtaining prostate secretions is tough and painful for the patient.
Also please do not use laundromat.
Especially use very mild detergent for your underwear especially.
I feel a course of Ofloxacin/ doxycycline will definitely help you.
There are no long term complications of prostatitis. However, it can recur by itself.
Patient replied :
Thank you for the quick answer. This would make the most sense to me, I've been confused mostly because the pain is at the tip of my penis which seems so far away from the prostate.
1. Is it contagious at all?
2. My understanding is that for a prostate infection a relativley low dose of antibiotics for a longer period is the best way to go. You don't think that 2 weeks of treatment would be enough?
3. I'm planning to treat it of course but if I didn't would it go away on its own or get worse?
4. What is the most likely way I was exposed? A trip to the sauna or gym? Oral sex? Something else?
thank you so much!
Thank you for the follow-up.
Yes in prostatitis referred pain can be felt at the tip of penis, with some groin muscle tightening. Sometimes the pain can be radiated down to lower limb also.
- You should continue Doxycycline for at least a month, chances of recurrence will be lesser. 2 week treatment will reduce the infection, and probably treat it but has not given satisfactory results.
- It doesn't go away on its own, so you need to treat it.
- It could be from unprotected intercourse or oral sex. However, sometimes gut bacteria ( E.Coli ) from your own body can lead to prostatitis.