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Urology (Expert Forum)
What Should I do Next?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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What Should I do Next?
by zencha, Nov 19, 2005 12:00AM
I am a 36 year old male, in good health, sexually active in a new
relationship and using condomns as protection.
On Oct 28th I noticed that I was having some "heaviness" in my left testicle and began to have a little burning at the head of my penius. I've had recurrent bots of prostatitis in the past, so much so that I have a standing perscription for cipro from my gp with my local pharmacy. Next morning I was traveling so I grabbed the perscription and began taking 500mg Cipro twice a day (10 days is my usually regimen).
By Wed November 2nd the issue hadn't really cleared up and after
consulting my gp I went to an urgent care. After a physical exam the Dr.noted that my left testicle was a little "higher" then the right and ordered an ultrasound. Ultrasound showed a slight varicocele on the left and a small cyst on the right. Both were incidential findings and did not seem cause for concern. Urine test was also clean. Was told to continue on Cipro and follow-up with GP when I returned home.
I continued taking the cipro 2*500mg until the 6th when I noticed a "wet"feeling at the end of my penius after urinating. Again, I have had this with prostatitis. I also found that if I "milked" the ureter I could produce a slight clear discharge (looked and felt like pre-ejaculate). Since I was getting ready for travel again I consulted with my gp and was sent to a local urgent care. Dr. there did a digital rectal exam and found the prostate unremarkable. He recommended doing a precautionary test for
gonorreha and chlamydia. At his request, I went off the CIPRO for 8 hours and then turned in a urine test. All tests can be negative including a four day urine culture. His conclusion was that it was possibly prostatitis or urethritis. Suggested changing antiobiotics, to doxycycline (2 twice a day)
for 10 days.
I have finished the perscription and all of the dominant symptoms are gone with the exception that I occassionally still have this "wet" feeling and in the morning in particualr will see a slight clear discharge. When it occurs it usually occurs after I have first voided in the morning, or within a short time afterwards. I have refrained from "milking" the penius when I feel this since I know that can cause irritation. I should also add that
during the last seven days if I become sexually aroused I seem to have an abundance of pre-ejaculate.
I am waiting to get my referral frm my HMO to a urologist in my town but am curious if I should be doing anything more aggressive? In specific, what might the likely cause of this slight clear discharge (which looks/feels like pre-ejaculate) be?
>
> Thanks
relationship and using condomns as protection.
On Oct 28th I noticed that I was having some "heaviness" in my left testicle and began to have a little burning at the head of my penius. I've had recurrent bots of prostatitis in the past, so much so that I have a standing perscription for cipro from my gp with my local pharmacy. Next morning I was traveling so I grabbed the perscription and began taking 500mg Cipro twice a day (10 days is my usually regimen).
By Wed November 2nd the issue hadn't really cleared up and after
consulting my gp I went to an urgent care. After a physical exam the Dr.noted that my left testicle was a little "higher" then the right and ordered an ultrasound. Ultrasound showed a slight varicocele on the left and a small cyst on the right. Both were incidential findings and did not seem cause for concern. Urine test was also clean. Was told to continue on Cipro and follow-up with GP when I returned home.
I continued taking the cipro 2*500mg until the 6th when I noticed a "wet"feeling at the end of my penius after urinating. Again, I have had this with prostatitis. I also found that if I "milked" the ureter I could produce a slight clear discharge (looked and felt like pre-ejaculate). Since I was getting ready for travel again I consulted with my gp and was sent to a local urgent care. Dr. there did a digital rectal exam and found the prostate unremarkable. He recommended doing a precautionary test for
gonorreha and chlamydia. At his request, I went off the CIPRO for 8 hours and then turned in a urine test. All tests can be negative including a four day urine culture. His conclusion was that it was possibly prostatitis or urethritis. Suggested changing antiobiotics, to doxycycline (2 twice a day)
for 10 days.
I have finished the perscription and all of the dominant symptoms are gone with the exception that I occassionally still have this "wet" feeling and in the morning in particualr will see a slight clear discharge. When it occurs it usually occurs after I have first voided in the morning, or within a short time afterwards. I have refrained from "milking" the penius when I feel this since I know that can cause irritation. I should also add that
during the last seven days if I become sexually aroused I seem to have an abundance of pre-ejaculate.
I am waiting to get my referral frm my HMO to a urologist in my town but am curious if I should be doing anything more aggressive? In specific, what might the likely cause of this slight clear discharge (which looks/feels like pre-ejaculate) be?
>
> Thanks
Doctor's Answer
by Kevin Pho, MD, Nov 21, 2005 12:00AM
, Nov 21, 2005 12:00AM
Testing and culturing the fluid should be considered. Urethritis, prostatitis can be caused by bacteria and STDs that may be resistant to the antibiotics you are taking.
You can consider a digital rectal exam to milk out any fluid from the prostate that can be analyzed and cultured.
More specialized testing, including a transrectal ultrasound as well as a cystoscopy, can be considered. The ultrasound can image the prostate looking for any abscesses that can lead to your symptoms.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
You can consider a digital rectal exam to milk out any fluid from the prostate that can be analyzed and cultured.
More specialized testing, including a transrectal ultrasound as well as a cystoscopy, can be considered. The ultrasound can image the prostate looking for any abscesses that can lead to your symptoms.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
Member Comments
by gre66ne, Feb 02, 2006 12:00AM
To: Prostate
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