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Pain in urinary tract, testicular pain, anal itching. CT scan and urine test normal. Taking chlordiazepoxide, amitriptyline. Suffering from anxiety

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Pediatrician, Infectious Diseases
Practicing since : 2005
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i am male,42.2 years ago i suffered from dull pain in urinary tract and tightening of perinium muscles with anal itching.ct scan of pelvis,urine tests,usg reveled nothing.I was finally given chlordiazepoxide+amitriptyline(libotryp)and fluoxetine(flunil)for a few months which cured again i have similar symptoms.Testicular pain is felt on pressing.urine flow is ok.i am a habitual sufferer from anxiety and doctor says it is functional disorder due to anxiety.please advise
Posted Sun, 15 Apr 2012 in Men's Health
Answered by Dr. Hema Yadav 3 hours later
Thanks for posting your query.
Your symptoms are suggestive of psychosomatic pain.
As such, anxiety can produce varied symptoms in different individual.
Sometimes the symptoms present in the form of pain which can occur in any part of the body.
Also, the fact that your doctor has ruled out other etiologies like infection, inflammation injury etc and that there is notable relief with anti anxiety medications, make it the most likely possibility.
In such case, the best treatment apart from medications is psychotherapy or behavioral therapy by a good therapist or psychologist.
The medications prescribed are otherwise appropriate for the condition.
However, I would also like to confirm that prostatitis, particularly prostatodynia has been ruled out.
I would suggest that you see a urologist for the same. Appropriate tests need to be done to rule this condition out.
Once this is ruled out, the possibility of psychosomatic pain is confirmed is confirmed then treatment would be similar anti-anxiety medications and psychotherapy.
Meanwhile, you should try and distress with yoga, meditation and XXXXXXX breathing exercises. Also, a healthy diet, plenty of water and a regular exercise (atleast 30 min of brisk walk daily) will help.
I hope I have addressed your concerns. I shall be available for follow ups.
Above answer was peer-reviewed by
Follow-up: Pain in urinary tract, testicular pain, anal itching. CT scan and urine test normal. Taking chlordiazepoxide, amitriptyline. Suffering from anxiety 17 hours later
since i live in a small town with no urologist,can you advise what tests are to be done for prostitiis and prostatodynia?
i have had a routine urine test which was normal.should i go for culture and/or any other test.2 years back i had a ct scan of pelvis which was was seen by the top urologist in kolkata.
also,what is behavariol therapy?
as for XXXXXXX breathing exercises,i suffer from a deviated nasal septum,which makes it difficult to breathe deeply.
Answered by Dr. Hema Yadav 7 hours later

Thanks for posting your query.

Answer 1.

Testing for prostatitis involves looking for signs of inflammation or infection in the fluid secreted by the prostate gland and in the urine. The following tests are used.

•Microscopic analysis of expressed prostatic secretions (EPS)

The fluid produced by the prostate gland is examined for infection. This fluid is obtained by prostate massage, which is also done during a digital rectal examination. These expressed prostatic secretions (EPS) are collected on a glass slide and examined under a microscope for signs of infection, such as abnormally high levels of infection-fighting white blood cells.

•Urinalysis/urine culture

Prostatitis is most commonly diagnosed through a three-part urine test which collects urine from the urethra and the bladder, as well as urine containing fluids from the prostate. The procedure is slightly different as three separate samples are collected; first void urine, midstream urine and last residual urine after prostatic massage.

But these tests might require consultation with a urologist or a general surgeon.

If you can at least get urine culture done it would be preferred over just urine routine test.

Answer 2. Cognitive Behavioral therapy is a type of psychotherapy where the therapist talks to the patient and tries to treat his psychological problem.
It is a way of talking about:
How you think about yourself, the world and other people
How what you do affects your thoughts and feelings.

CBT can help you to change how you think ('Cognitive') and what you do ('Behavior'). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

It is one of the most effective treatments for conditions where anxiety or depression is the main problem.

It is the most effective psychological treatment for moderate and severe depression.

It is not related to XXXXXXX breathing exercises.

You can look out for more details on the site

Or consult any MD Psychiatrist in your vicinity.

Hope I have answered your query.

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