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Frequently urinating and have a movable soft mass in front pelvic groin region. Taking Bactrim for prostatitis. Need advise

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General & Family Physician
Practicing since : 2005
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I have frequency to urinate, as well as urgency. I am going every twenty minutes sometimes. It is not weak or blocked. I am up several times each night, however I go way more frequent when I am awake. I have a movable soft mass in my front pelvic groin region. The mass is very flat and maybe the size of a quarter. Its not painful but i know its there. I have been touching it and fear I have irritated it though. However it obviously had some feeling or sensation that lead me to find it. I had been taking Bactrim for prostititus for just over a month. However, the current urination problems just recently started. I have had several urine cultures or tests and nothing was remarkable. I did have some discomfort in my left back down close to my tail bone. It worsened when extending my left leg. I assumed it was something from doing squats. Two weeks ago I had no narrowed stool for several days. However that cleared up and is back to normal. I am on the East Coast and out of the Kaiser network, so I do not have Insurance. Is there something i should do, or should I see another urologist. The urologist i saw who diagnosed the Prostititus is in SC where I was trying to relax for a few weeks. I am now in Pa. Overseeing my grandfathers hospice.

Thank you
Posted Sun, 17 Nov 2013 in Urinary and Bladder Problems
Answered by Dr. Prasad 1 hour later
Brief Answer:
You will need evaluation...

Detailed Answer:

Increased frequency and urgency is not normal. Though prostatitis may or may not be related, since you are already on antibiotics for over a month and the new symptoms started now, I would definitely consider ordering more tests to diagnose the problem. In this line, the first few test that I would consider as essential are:
1. Ultrasound abdomen which is done with full bladder and post void (after urination)
2. Blood sugar
3. Complete hemogram
4. Reviewing prostate state (prostatitis) - per rectal examination, examination of semen and prostate secretions after prostate massage.

I am sure the above listed test will give us clues to solve your problem. Theoretically the increased frequency and urgency can be related to urinary infection (masked by bactrim use), enlarged and obstruction prostate, systemic infection and blood sugar.

I understand you do not have insurance. Since the tests are going to be crucial, you can try visiting urgent clinic / low cost clinics (where doctor accept discounted fees) and plan those tests.

As far as soft mass in the front groin region is concerned, it may either be a hernia or a lipoma. Lipoma moves side ways while hernia moves in and out (reducible). Both these are unrelated to your latest urine problem and can be dealt independently.

Back issues may be due to musculoskeletal causes - exercise induced. If the pain doesn't heal in few weeks, you will need X-rays and scans of back and pelvis.

Hope this information suffices. Let me know if you need clarifications.

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