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Had tuberculosis in urinary tract and seminal vessel. Pain in penis when urinating. Recurrence of TB?

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General & Family Physician
Practicing since : 1979
Answered : 624 Questions
Hellow doctor,
I had recurring URinerary tract infection and pus in seminal vessel for almost 18 months in the interval of 2-3 months in year 2008-09. I got done all the medical check ups but the reports were normal except many pus cells in urine which confirms infection. Then finally I consulted Dr. R C Kaza of MAMC and he diagnosed as tuberculosis in UTI and seminal vessel and advised me to take full course of TB. I have taken full 11 months course and do not have any UTI and infection in seminal vessel but now I am having continuous pain in and around genital organ and also while passing urine. Is it the repurrcation of TB had in the past or something else?? My urine reports are absolutely normal but volume of seman drastically low. I am really looking for genuine advice. Also pl. forward this query to best TB specilist. Appreciate your early reply. Thanks, AAAA
Posted Wed, 26 Sep 2012 in Urinary and Bladder Problems
Answered by Dr. Chandra Shekhar Sharma 5 hours later
Welcome to XXXXXXX
Please consult an Urologist or general Surgeon and get your Prostate palpated. If it is tender, you might be suffering with Prostatitis with pelvic pain syndrome. You get your prostate massaged by Urologist and if any secretion comes out, get culture and sensitivity (including culture for TB) tested. If there is no secretion, get your urine passed just after massage, tested for culture and sensitivity. If prostate is not tender, you might be suffering with non specific interstitial cystitis. Cystoscopy can reveal condition of urinary bladder. Please get sonography of your urinary bladder & Prostate, and blood sugar(F & PP) done.
Meanwhile, you can take Aceclofenac + Tizanidine tablet twice daily or Diclofenac with chlorzoxazone thrice daily with food and Psyllium husk(Isabgol) 3tsf with water before going to bed.
Thanks for trusting XXXXXXX and posting your query.
Hope you found my response to your query informative and helpful.
If you have further concerns in this regard, I would be happy to discuss those with you as well.
With good wishes,
Dr.Chandra Shekhar Sharma
Above answer was peer-reviewed by
Follow-up: Had tuberculosis in urinary tract and seminal vessel. Pain in penis when urinating. Recurrence of TB? 17 hours later
Thank you very much for your reply. I forget to mention few things in my earlier email. Before detecting TB in 2009, I went thru the folllowing test:

TRUS ultrasound for unerary bladder, prostate. It was normal.

PUS culture and routine, sensivity test was done for seminal fluid and fluid after palpeting the prostate by urologist. Reports were normal except some infection. Which

He delarered as prostitites. Urologist also said that my prostate was bit hard but it might be due to infection. Medication was given and temporarily OK but re

occurred after sometime and then I finally I consulted Dr. Kaza who suspected this as TB infection and taken medication. Is sonography and TRUS is same?? Pl. confirm.

I also went thru colored ultrasound at Lal path lab for utheria and the structure was observed. This structure was operated in 2010 by Dr. XXXXXXX Agrawal,  Urologist and after

that he declared every thing normal. I also did PSA and the report was normal as attached downwards. Blood sugar levels are normal. I have pain in the

urenanry bladder potion and the right and left hand side. Now I have the following questions:

1.      Dr. Kaza mintioned that after TB cured, it leaves some scars and my seminal tubes are blocked therefore no secration of seminal fluid and drastic

reduction in the seman quantity. Is this the side effect of TB and this pain could be because of that. PL. confirm??

2.      Is prostitites infection having recurrance nature and there is no permannent solution??

3.      If PSA normal, will there be a chance of Cyst in it and could be source of this pain??

4.      After reading the above history, which test is ideal to know the root cause of problem??

5.      Last but not least, could you suggest some geniune urologist who can find the root cause of my problem preferably in east delhi area but location is not

a restriction. I am really looking for geniune advice.

Looking forward to your reply.

Kind Regards,



















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Test Name








Please correlate with clinical conditions.

Reference Range:



Answered by Dr. Chandra Shekhar Sharma 2 hours later
Welcome again,
Sonography and TRUS is same. TRUS is sonography done through rectum.
(i) How TB infection was confirmed? Do you feel pain while ejaculating? If not, then there should be no problem with your ejaculatory duct. The decrease in the quantity of semen can be due to retrograde ejaculation.
(ii) It is difficult to cure chronic Prostatitis. Organism can develop resistance to antibiotic during treatment. Recurrence can occur because of incomplete cure.
(iii) Your PSA is within normal range. PSA is done to rule out cancer. Pain is due to inflammation, & cause of inflammation is generally infection. Sometimes it is non specific also. If routine cultures are sterile, then culture is done for TB. Cyst if present, should be detected through sonography.
(iv) Urine (routine) test, C & S if pus cell present, Sonography of urinary bladder & prostate, and culture & sensitivity(C & S) of expressed secretion of prostate are required.
(v) This you have find out yourself. You can get yourself checked up through Urology deptt. of AIIMS.
Have you started treatment advised to you for symptomatic relief?
Hope you found my response to your query informative and helpful.
With good wishes,
Dr.Chandra Shekhar Sharma
Above answer was peer-reviewed by
Follow-up: Had tuberculosis in urinary tract and seminal vessel. Pain in penis when urinating. Recurrence of TB? 42 hours later
Good question. My test reports for TB For seman and seminal fluid was negative and my urologist was given me repeated treatment for chronic prostitutes. Dr. Kaza had studied 2 years history of medication and verious tests and decided trials for TB for two weeks and there was significant reduction in pus cells and LFT was normal and my overall health also improved. He has mentioned to me this is the hidden type of Tb and can be ensured when the infections continued long time without finding the real root cause. He has already treated such patient in the past.
I am having pain during ejaculation and this pain persist after ejaculation for some time. I am also having pain while urination. I urge for frequent urination even when the bladder is not full. Again the prostate is normal in size.
Can you suggest me TB specilist to rule out the after effect of tb ?? What is your opinion ?
Will there be a chance of any chronic recurring infection in urine bladder? Can cystoscopy confirm this?
I have recently tested my urine routine and showing pus cell 2-4?? Should I really go again for TRUS?
Can you also suggest me some good urologist?? I can not visit AIIMS due to the time constraint.
looking forward to your advice.

Answered by Dr. Chandra Shekhar Sharma 1 hour later
Welcome again,
As you are suffering with pain during ejaculation and during micturition, some sort of infection is present should be present in your prostate and seminal vesicles. You can consult any general Surgeon or Urologist and it your prostate palpated and massaged. If there is pain on palpation or massage, prostatitis is present. After massage collect discharge if any, & give to path lab of good reputation for culture and sensitivity(C&S) including TB. If there is no discharge, you should collect urine passed just after massage and get it tested for C & S. You will be in a better position with reports of per rectal examination and C & S.
If you are suffering with evening rise of temperature and loosing weight, it can be again due to TB. After effects of cured TB are generally scarring only. Recurring infection of urinary bladder can occur due to chronic prostatitis. Tubercular infection of urinary bladder gives characteristic appearance to bladder wall which can be seen during cystoscopy. If reports are sterile, you can again try anti TB drugs for 2 weeks and decide according to response. You can consult Urologist at XXXXXXX Hospital, Noida. Though you are not suffering with constipation, but I have suggested you to take Isabgol. Meanwhile please try it and Tab. Aceclofenac with Tizanidine twice daily and Tab Supradyn one daily. For you, a Urologist will be more helpful then TB specialist.
Hope you found my response to your query informative and helpful.
If you have further concerns in this regard, I would be happy to discuss those with you as well.
With good wishes,
Dr.Chandra Shekhar Sharma
Above answer was peer-reviewed by
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