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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20389
Experience:  Specializing in general urology and reconstructive urology.
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I'm having groing, lower back and perianal discomfort/pain

Customer Question

I'm having groing, lower back and perianal discomfort/pain.
Submitted: 2 years ago.
Category: Urology
Expert:  Dr. Y. replied 2 years ago.
Hello and thanks for trusting me to help you today. I look forward to working with you.
How long has this been going on?
Customer: replied 2 years ago.

I'm a man and 10 months ago I received unprotected oral from a sex worker.

After that I had months of stress and anxiety and I had a full set of STD tests 1 months after and then 4 months after. All negative

6 months, I had some urethral irritation in my penis but I was checking and opening it a fair bit, both sets of STD tests came back negative and the clinic said low risk and that there next steps was counseling for guilt as they wouldn't test again.

Last week I was again feeling irritation in my penis so visited my GP who did a quick Urine test and said there was Protein and Blood in my urine and prescribed Trimethoprim200mg twice a day for 7 days for a uti and sent the sample for further tests.

I then went to std clinic, they conducted a urethral swab and said white bloods cells exist and diagnosed non specific urithritus prescribed Doxycycline twice a day for 7 days. Further Urine tests Then results from the urine test come back clear for Gonohrea and Chlamydia so it remains NGU.

Howvere I'm also sure there's something going on with my prostate as I can feel a sensation deep inside.

After 5 days of doxycycline penis irritation was better but that prostate sensation contiuned

I'm healthy, bmi 28, BP normal,

But have ongoing lower back (can be quite sore) and groin pain but can't localise it, ALos Perianal area but deep inside feels tight/sore

And what are the chances of prostitis after 3 negative testss for Chamlidyia GOnohrea but a NSU/NGU diagnosis.

What could be causing this after 2 course of antibiotics?

I had abour of diverticulitis last year for 4 - 6 weeks and was under a Gastroentoligis tand changed lifestyle since then. (diet and exercise) BMI was 37

Expert:  Dr. Y. replied 2 years ago.
This is very unlikely to be an STD at this point.
It could be your diverticulitis causing your pain instead. I would recommend that you see here gastroenterologist again for an examination see if you need to be treated for diverticulitis. If they think this is prostatitis instead, they may need to send a semen culture to identify the bacteria so they place you on an appropriate antibiotic based on the culture.
Dr. Y. and other Urology Specialists are ready to help you
Customer: replied 2 years ago.

What are the possible bacteria if it was prostitis?

I take it the diverticulitis couldn't have anything to do with the NSU/NGU diagnosis?

Expert:  Dr. Y. replied 2 years ago.
There are so many possible bacteria that I cannot list them all. It could be anything from E. coli to Klebsiella to staphylococcus.
No, diverticulitis would not have anything to do with those STD diagnoses.
Customer: replied 2 years ago.

Thanks Dr.

Really feel like its prostate related very tight feeling deep in pelvis.

So my next action should be to see my GP and discuss a potential prostate exam and semen culture?

Expert:  Dr. Y. replied 2 years ago.
If you can see a urologist first this would be ideal. But if you can only see your primary doctor first then that would be the best course of action.
Customer: replied 2 years ago.

I have to get referred to a urologist by the GP, i have a private policy I can use.

Thanks again

Expert:  Dr. Y. replied 2 years ago.
You're welcome
Customer: replied 2 years ago.

Hi Doctor

I visited my family doctor today, discribed symthoms as above, he conducted a pelvic exam, seemed to focus on the colon aspects and diverticulitis from last year, prescribed a course of anti spasmodics.

I continue to have pelvic pain radiating but in order of area of pain 1. Just above anus severe ache, 2, base of penis 3. Above pubic bone. But anal area by far strongest.

Have post urination irritation of the urethra. Not producing much urine but I think that's something to do with subconsciously keeping liquid intake low.

As per previous question. 3. Sets of std checks urime, blooded, rectal throat swabs all clear\negative over 6 months. Nsu diagnosed at last test. partner tested and treated although nothing found.

After urination there is irritation.

Do you think I should press for a urologists referral rather than antispasmodics

And do you have any thoughts on any possibilities of potential diagnosis?

Expert:  Dr. Y. replied 2 years ago.
This is either diverticulitis or prostatitis. I would definitely recommend a urology referral.
Customer: replied 2 years ago.

Last time I had diverticulitis I felt severly unwell. Fevers and weeks with alternating constipation and diahrea

This feels like something else. Don't have fevers constipation etc. Pain raidiating around pelvis mainly above anus, glands in groin feel sore. Urethral discomfort after urination.

Is there any chance the negative std testing could be false negs? How accurate are they? I'm in the UK.

The anal area is throbbing feals like its been squeezed In someone's fist.

Also had a broad

Expert:  Dr. Y. replied 2 years ago.
It's unlikely that STD testing would be falsely negative, but anything is possible.
Your symptoms seem to be consistent with prostatitis.