Question: Hello Doctor, I am having intermittent pain in the pelvic region (groins, perineum, inner thigh, urethra (in penis), testicles, lower abdomen). Also, I have burning while urinating most of the times. The pain currently is not too much but some uncomfortable feeling. The pain is not always in all these areas but keeps moving around. I have been having this for over 1.5 years now. It started after i had protected sex (no breakage) with an acquaintance (not sure if its just coincidence or if this has any relevance to the problem). The condition started exactly on April 23rd 2012. I started having burning sensation while urinating. I met a Urologist nar my place and he asked me to undergo the below test and prescribed a Cefixime antibiotic for 3 days and asked me to take the below tests before the course.. -> Urine Routine & Culture - Normal (no pus cells or bacteria) In these 3 days, I started getting pain around my pelvic, urethra(penis) and testicles/groin. I met doctor after 3 days, doctor looked into the report and mentioned there is nothing wrong as per the reports. Anyway, he prescribed me with doxycycline for 7 days both morning and evening at the end of 7 days, I felt improvement but it was short-lived. I again started with all the symptoms in couple of days. I waited for a week and went to a different urologist for second opinion. After examining me, he mentioned I have non-bacterial Prostatitis and he ordered the following tests.. 1) Semen Routine and Culture - No Growth / Bacteria found 2) Urine flow analysis - Slight variation 3) Pelvic Ultrasound - Normal (except for a midline cyst in prostate and Few Simple Renal Cysts in both Left and Right Kidney, all organs including prostate were normal in size) He prescribed me with the following medicine. 1) Punox 600 mg - 1-0-0 (14 days) 2) Niftas 100 mg - 1-0-1 (for first 10 days and 0-0-1 for next 20 days) 3) Maxgalin 75mg - 0-0-1 (6 weeks) 4) Spasmo Proxyvon - SOS (when pain is severe). 5) Nafodil 50 mg (0-0-1/2) for 6 weeks. All my symptoms continued but the intensity was low. I was again prescribed the following medicine and i was told that what i have is chronic non-bacterial prostatitis and CPPS. I was also told that I might be getting these symptoms intermittently life long. 1) Cifran - OD (500mg) - once daily for 6 weeks 2) Roliten - OD 2mg - once daily for 6 weeks At the end of this medication I felt all my symptoms all gone. I took the following test to ensure i dont have any STDs... 1) HIV - I & II (did the test in 3 months, 6 months and after 1yr 3 months) - NORMAL 2) VDRL - Normal (3 months and 1yr 3months) 3) HBsAG - Normal (3 months and 1yr 3months) After few months again the problems started but the intensity was less, I was told by urologist to take ayurvedic treatement which i took for 3 months. it helped me but again now for the last 1 month, I have these problems. as mentioned in the beginning, its not too much but an uncomfortable pain with dysuria (occasionally). I know its a long email and history but i wanted to check with you if this could be because of chlamydia or gonorrhea? I never had any discharge from my penis. Even the previous doctors told me even if it was that it could have cured with the antibiotics i took. I would really appreciate your opinion as well. Thanks, XXXX

Dear Dr XXXXXXX Really appreciate your response. 1) So are you suggesting me to get a semen and urine culture done now and again in future? if so in what duration i need to do it? 2) Do i need to worry about the STD's like Chlamydia or Gonorrhoea and do i need to take any specific tests for the same via urine culture? 3) I was told that the midline cysts in prostate is not a concern but do i need to check that as well by repeated pelvic scan? 4) Finally, can i continue to have sex life and if masturbating or sexual encounter would aggravate it? Please advice. Regards, XXXX

Thanks doctor. I will do the semen and urine culture. With respect to urine culture. Do I need to get any STI specific culture? Appreciate your response and once again thank you for your advice. Regards, XXXX