Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
175 Doctors are Online

Had unprotected sex continuously despite urine infection. Cytoscopy said tight meatus and urethral dilation. BPH or prostatitis?

User rating for this question
Very Good
Answered by

Urologist
Practicing since : 1998
Answered : 577 Questions
Question
Hi. I would like to ask about my condition. My situation goes back sometime september last year. At that time i had frequent sexual intercourse with woman. At that time i had an irritation when urinating, then i was suspecting that i might get STD so i went to the local doctor. and the local doctor gave me antibiotics. Then i continued to have sexual intercourse again because i did not really understand about the seriousness of this at all. I had sexual intercourse without condoms most of the time. So sometime in December i still had the irritation when urinating or sometime but not all the time to feel pain after ejaculation/when drink less water in the day. again so the doctor gave me antibiotics again, i felt pain when urinating. Then in December i checked for HIV tests and it is negative. Then this Year May. I went to Kuala Lumpur to see one of the urologist there. i still had his medical reports. He did a Cytoscopy and it demonstrated a tight meatus and had a urethral dilation. There is no urethral stricture. i can send the report if needed. There, i tested for VDRL,TPHA which shows the test that it is negative. So he gave me Zithromax 250MG taken in a day. total i took 4tabs+2 tabs , Avodart & Xatral for one month and ended in XXXXXXX He also suggested me to test for other STD, gonorrhea, Herpes, Chlamydia, FULL RFT, AND FBC, AND urine analysis. The doctor in Kuala Lumpur suggested that i had a LUTS due to BPH with some degree of inflammation or infection. At that time when i was taking the medicine sometimes i felt pain when urinating. And when the medicine is finished i felt pain again when urinating, but not so much just mildly especially when the urine first discharge and felt it at the TIP of the penis in the urethra and not in the middle. I can send over the video done by him when doing the Cytoscopy. And Recently, because i am getting more worried about my situation. I went to a local doctor in Jakarta Hospital. As i felt that sometime when i finished urinating, there seems to be a feeling that i still need to urine again, the bladder is not emptied properly. There i did a urine analysis, USG for bladder, kidney, liver, prostate, urowflowmetry test, and sperm culture. i did not do FULL RFT&FBC. I can send them too. There is no bacteria found in the urine analysis but the leucosit is amorf+ suggested that i had a crystal in the urine. now the sperm culture results showed that there is an infection, and the bacteria found is Staphylococcus Haemoliticus. There is no sign at all like mentioned for STD, its just that when i drink less water i felt pain when urinating worse compared to drink lots of water. but still there is a pain when urinating especially at the tip of the penis, and feel the need to urine again---SO now i am taking Xatral since last week, given the order by the Doctor in KL, but i stopped taking Avodart week ago. When i was diagnosed that my prostate is fine???? there is no enlargement when USG. The doctor in Jakarta gave me a prescription for me to take Antibiotics treatment Amox-Clavulanic for 3x1 6 weeks. and gave me an anti inflammatory when urinating 20 tabs for the next week or so. I am very confused as to which one is actually my condition and what what should i do now. What is actually my sickness? Is it BPH, or is it the prostatitis? what caused me to have the LUTS and not being able to empty the bladder. and the felt pain at the tip of the penis. What should i do after this treatment of 6 weeks of antibiotics if it does occur again? in the mean time what other diagnosis should i go for? Should i go for the prostate secretion to see where the location of the bacterial????? my email is YYYY@YYYY
Posted Sun, 29 Apr 2012 in Men's Health
 
 
Answered by Dr. Rajiv goel 19 hours later
Hi,

Thanks for the query.

You seem to have had recurrent Urinary tract infections secondary to unprotected casual sex and usually such infections take plenty of time to clear up.

With your current treatment, I shall strongly recommend yourself to be treated for chylamydia and mycoplasma infection also. You may discuss about this with your urologist and take the treatment under his/her care.

Based on your symptoms, you don't seem to have BPH or prostatitis. So stop worrying about either of the conditions.

However I am also worried about the meatal stenosis part. I am keen to see your latest uroflowmetry report and also know how good or bad your urinary stream is. If you have those reports, you may upload them using the facility provided on the right hand side. If you are unable to load the full reports, you may send them to my attention to YYYY@YYYY

Hope I have answered your query. Please accept my answer if you do not have any other queries.
I will be available to answer any other queries that you may have though.

Regards
Above answer was peer-reviewed by
 
Follow-up: Had unprotected sex continuously despite urine infection. Cytoscopy said tight meatus and urethral dilation. BPH or prostatitis? 25 days later
Hi Doctor XXXXXXX This is Ferdian. How are you. I have sent attachments reports to your email. Can you take a look at the reports. I am still on medication as mentioned before, taking Antibiotics treatment Amox-Clavulanic for 3x1 6 weeks(by doctor in Jakarta) and Xatral at night(seen onthe internet). Will report to you my full conditions and situations in details to you. I do not mind to pay more for the consultant fees as i really do need some one's expert advice. Thanks dr.
 
 
Answered by Dr. Rajiv goel 13 hours later
Hi,

Thanks for reverting.
I have not been able to see any reports as attachment. Kindly send them as attachment. You can email them at YYYY@YYYY . In the subject line, you can put, Attention to Dr. Rajiv Goel.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had unprotected sex continuously despite urine infection. Cytoscopy said tight meatus and urethral dilation. BPH or prostatitis? 27 hours later
Hi Dr,

I just sent all the reports i had so far. Just one Video File left. The video is an Optical Urethrotomy is done in XXXXXXX Eagles KL. which is taking sometime as the internet speed connection here is very slow. So will be sending you the video file. In the mean time, can look at the reports first.
 
 
Answered by Dr. Rajiv goel 5 hours later
Hello.

Thanks for follow up query and providing me your reports.

I have gone through all the reports of yours carefully.

I sincerely feel that you have been treated on the right lines by the doctor in Jakarta.

Your uroflowmetry looks good and nothing needs to be done for urethral stenosis part.

You should stop the medications after the completion of the present schedule. However, if the symptoms recur, then you may have to undergo expressed prostatic secretions culture. Beyond that nothing active needs to be done at this point of time.

I hope you find my recommendations helpful.

Wishing you good health.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had unprotected sex continuously despite urine infection. Cytoscopy said tight meatus and urethral dilation. BPH or prostatitis? 5 days later
Hello Doctor,

Thanks for the info. So does that mean I am not having BPH as to what the Doctor in KL told me? So i am currently having Chronic Bacterial Prostatitis - With the bacteria Staphylococcus Haemoliticus? There is still 15 days before the completion of my current medicine. Currently i am experiencing burning pain when urinating, but not as much as before i supposed this is due to the fact that i am taking antibiotics now. And still unable to empty the bladder properly after urinating but only little bit of liquid compared to before the urge to pee is reduced.(My current Condition). What if i am getting the burning pain after the completion of the medicine & still experiencing this?

WWW.WWWW.WW And what i want to ask is that, what is usually will happen. So that it will be known what kind of bacteria is growing inside? and how to cure/kill that bacteria? is that right? What kind of disease is usually known to patients who underwent expressed prostatic secretions test? prostatitis in general or other kind of diseases could be known? How much does the test cost normally there? in US, or UK?-expressed prostatic secretions test.

Can you tell me more about Staphylococcus Haemoliticus. Is that dangerous?because the doctor told me that i have this, chronic bacterial prostatitis. So i assumed that i currently have Chronic Bacterial Prostatitis? 100% accurate? As i am told that this prostatitis that caused the UTI will occur again and again and will take a long time to be cured. Is there any other way/method that can be done before i go for expressed prostatic secretions? Can i take any other kind of antibiotics that is stronger and that is not resistance to Staphylococcus Haemoliticus? to kill this bacteria. How about the recommendation from you??
[[shall strongly recommend yourself to be treated for chylamydia and mycoplasma infection also]] the doctor here in my local place does not understand mycoplasma . What is that doctor? and with this i assumed that i do not have gonorrhea, chylamydia, hermes, syphillis or any other stds. as my condition is felt burning pain when urinating, and unable to empty the bladder which is causing the UTI. Is that right? heheez
will wait for your reply.
Thanks.
 
 
Answered by Dr. Rajiv goel 12 hours later
Dear,

You certainly are not suffering from BPH.

You may be suffering from prostatitis. Prostatitis may be bacterial or non bacterial. Staphylococcus that you have grown in semen does not mean that it has come from prostate and I am not really bothered about it.
You have been treated with almost everything that is available on earth and hence no stronger antibiotic is required at this point of time and also you have been treated for mycoplasma and hence stop worrying about that.
A lot of patients shall keep on experiencing the symptoms for a fairly long period of time and may have to be treated for long period. However, I shall at this point of time advise only expressed prostatic secretions culture. It will serve two purpose. It shall possibly tell us about bacterial growth. Secondly, it is obtained by prostatic massage and prostatic massage by itself is curative for a big proportion of patients.
You dont need to travel to US or UK for it. It can be easily done in Indonesia too. See any urologist and get it done.

Hope I have answered your query. Please accept my answer if you do not have any further concerns.

Wishing you good health.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Had unprotected sex continuously despite urine infection. Cytoscopy said tight meatus and urethral dilation. BPH or prostatitis? 45 days later
Hi ..

Recently, i am continuing my antibiotics medicine for another 6 weeks. with Amox-Clavulanic the same medicine taken before for 6 weeks. i stopped taking the medicine for 3 weeks now but will continue taking it again. Just that my current condition is that, i always felt pain when i urine every mornings... not during the days and nights. and the urine is yellowish. and i was told by my local urologist that usually after 6 weeks of taking antibiotics as i have did it, normally the antibiotics will penetrate well into the prostate gland and usually that will be cured after 6 weeks. and why do i still felt pain after 6 weeks? could that be the bacteria is not in the prostate gland, maybe in the urethra? as i always felt pain in the mornings when i urine especially at the tip of the penis seems so there is an itchy and burning when i urine. IS the condition getting better? maybe the bacteria has now gone to the urethra or the upper part of the penis, and is not in the prostate gland anymore? heehe. please advise. i will take the antibiotics for another 6 weeks. and after that then i will gor for the EPS as the place i am currently living does not have the EPS test. have to travel to jakarta. thanks.
 
 
Answered by Dr. Rajiv goel 3 hours later
Dear,

Thanks for writing back.

You are being treated well. However, I will like you to treat you with Fluconazole . There is possibilty that you still have fungal infection and hence treatment with fluconazole.

Stop worrying about the urethral pain. I will also like you to be placed on T. Tamsulosin. It shall relax your prostate and allow better healing and also response to antibiotics.Kindly consult your doctor for exact dosage after a detailed examination.

Wish you good health.
Above answer was peer-reviewed by
 
Follow-up: Had unprotected sex continuously despite urine infection. Cytoscopy said tight meatus and urethral dilation. BPH or prostatitis? 10 hours later
Hi,
Thanks for the info. Does that mean i am getting better? what does the fungal function mean? what does it link to the bacterial grown before?

Tamsulosin XXXXXXX Generic Flomax.4 mg 100 Capsules -> is it this?
GENERIC NAME: fluconazole BRAND NAME: Diflucan -> is it this?PREPARATIONS: Tablets: 50, 100, 150, 200 mg?
Follow-up: Had unprotected sex continuously despite urine infection. Cytoscopy said tight meatus and urethral dilation. BPH or prostatitis? 22 minutes later
what is the dosage for the patients u handled before? and for how long is this treatment course? so i know how much quantity to be ordered.
 
 
Answered by Dr. Rajiv goel 1 hour later
Hi,
Thanks for getting back to us.
Long term use of antibiotics can lead to fungal infection of the urine and it is very difficult to pick up this infection. Patients with fungal infection shall have the same symptoms as you are experiencing. Hence I want you to start on anti fungal agents. I shall suggest that you take tablet fluconazole and tablet tamsulosin. Treatment with fluconazole lasts for 5 days (at intervals) and treatment with tamsulosin lasts for 4 weeks. These are prescription drugs and I shall be unable to prescribe the same for you since I am unable to examine you. I would suggest that you XXXXXXX your treating physician who can prescribe the same for you.
I hope you understand.
Regards
Above answer was peer-reviewed by
 
Follow-up: Had unprotected sex continuously despite urine infection. Cytoscopy said tight meatus and urethral dilation. BPH or prostatitis? 1 hour later
Hi,

Ok, thanks for the info.will talk to my doctor here about the prescription.
I want to ask, what do you mean by very difficult to pick up the infection? you are saying it is hard to cure? Does that mean that i will be partially cured after this treatment? so the fungal infection that caused me to have the burning feeling when i urine? if this is treated well, wont have the prostatitis anymore?
 
 
Answered by Dr. Rajiv goel 4 hours later
Dear,

I apologize for not being clear in my previous reply. Let me clarify now.

“Difficult to pick up” means difficult to be detected by tests. And hence all patients suspected of fungal infection are started on emperical therapy with antifungal agents.

You should soon start doing well. Stay reassured.

Hope it is clear now. Do accept the answer if you do not have any further queries to me.

Thanks again.

Wish you good and healthy recovery.

Regards
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Drug/Medication
Medical Topics

The user accepted the expert's answer

Ask an Internal Med Specialist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor