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Shahid Karim
Shahid Karim, Board Certified MD
Category: Medical
Satisfied Customers: 1033
Experience:  MBChB
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I’m being treated for chronic bacterial prostatitis

Customer Question

Hi. I’m being treated for chronic bacterial prostatitis currently. I’d like to ask some questions to a doctor who specialises in this area.
JA: Have you seen a doctor about this yet? What medications are you taking?
Customer: yes I have seen a urologist. I’ve just finished a course of amoxicillin
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: Previous Cystoscopy
Submitted: 14 days ago.
Category: Medical
Expert:  Shahid Karim replied 14 days ago.

Hi, thanks for getting in touch. Could you tell me a little more about what you'd like to discuss? Thanks

Customer: replied 14 days ago.
Had UTI six months ago. Subsequent cystoscopy showed urethritis, therefore urologist said urethra was likely source of original infection. Sexual health screen negative, GP gave me empirical antibiotics for urethritis. Then, developed testicular and suprapubic pain, referred to urologist who diagnosed prostatitis and prescribed antibiotics. However, after so long, urethral opening is still red and swollen. And when I look inside, I can see the tube is also in same condition. Is this related to my prostate? How come it’s still present?
Expert:  Shahid Karim replied 14 days ago.

Thanks for the information there, that's very helpful. So it sounds like you've potentially had non gonococcal urethritis which can often be difficult to clear and take quite some time. Having the secondary prostate infection certainly wouldn't have helped. Usually it's a case of giving it more time after both infections have cleared. Have you had an ultrasound scan done at all?

Customer: replied 14 days ago.
I have CT ur organ which was normal. Also testicular ultrasound was normal.
Customer: replied 14 days ago.
Sorry, CT urogram
Expert:  Shahid Karim replied 14 days ago.

I see, thank you. I do wonder whether you need targeted antibiotics for non gonococcal urethritis, there is a hierarchy of antibiotics that we use if recurrent infection is possible. Here's a link for some more information. I would speak to your urologist or GP about starting further antibiotics as well as carrying out a full STI screen again in case anything was missed.

link:

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12***-***-****-4

Customer: replied 14 days ago.
Thanks. But recurrent STD infection unlikely, no sexual activity for over six months, since first treated for uti
Customer: replied 14 days ago.
sexual health deemed me low risk for STD
Expert:  Shahid Karim replied 14 days ago.

I agree, you're probably right, but on the off chance something has been missed I always believe in going back and doing a fresh round of tests particularly if we're about to put you back onto antibiotics.

Customer: replied 14 days ago.
Ok I will look into repeat screening
Expert:  Shahid Karim replied 14 days ago.

Fantastic, I hope that helped and you get to the bottom of it asap. Do come back if you've questions in the future and all the very best.

Customer: replied 14 days ago.
Hold on please
Customer: replied 14 days ago.
I have wondered if the redness around the urethral opening could be residual inflammation or even A dermatological problem. The redness is well demarcated and in close proximity to the urethral opening, redness more obvious after passing water.
Expert:  Shahid Karim replied 14 days ago.

That's certainly possible but it is a little odd to only have the dermatological problem there. I do however think it would be beneficial to ask to see a specialist in 'infectious diseases' as they really are the masters of tracking and pinning down rarer causes of issues like this and they will always perform a very comprehensive screening for you.

Customer: replied 14 days ago.
Ok I will bear this in mind regarding infectious disease specialist. I thought about dermatology because I used to use a lot of soap to clean this area in particular, and have even thought that maybe excessive hygiene might have led to the urethritis in the first place.
Customer: replied 14 days ago.
having tried so many treatments already, I am wondering if applying a steroid cream around the meatus might be worth considering?
Expert:  Shahid Karim replied 14 days ago.

I see, well that's certainly a possibility, why not stop using that and just use water for a while and do your level best not to touch or manipulate the urethral tip and see whether this helps?

Customer: replied 14 days ago.
I am wondering if applying a steroid cream around the meatus might be worth considering?
Customer: replied 14 days ago.
For instance, 1% hydrocortisone cream
Expert:  Shahid Karim replied 14 days ago.

It could be worth a try but I really would try the non-soap, non-touching it technique for a week first then consider what you've just described

Customer: replied 14 days ago.
Ok, thanks. I just want to ask, if I wish to ask follow up questions regarding same topic with you for continuity, how do I do that?
Expert:  Shahid Karim replied 14 days ago.

I believe when you post the question you can ask for me directly, most people just put 'FOR DR KARIM ONLY' in the question and then others know to leave it but you can also choose when you post the question. You're very welcome in deed, glad I could help if a little. Come back if you do have further questions and all the best again.

Customer: replied 14 days ago.
Ok bye for now, thanks
Expert:  Shahid Karim replied 14 days ago.

Take care, all the best :)