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Have itchiness in anus and scrotum, stool test normal. History of prostatitis, done sigmoidoscopy. Should I have other tests done?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions

I will begin with a quick background of my medical history. About 6 months ago I saw a urologist for issues, which was later determined to be chronic non-bacterial prostatitis. The urologist originally prescribed me cipro for a month long course before he knew what I had. I later had one of those procedures where they view the penis and he determined I had the prostatitis. Around the time of my cipro treatment, I developed an itchiness in my anus. The urologist originally recommended anti-fungal creams, which I tried, but they did nothing to help the itch. He sent me to a gastroentonologist. They performed a sigmoidoscopy, at which time they notified me everything looked good. They had me try citrucel fiber pills and special probiotics. Neither of these have helped the anal itch. They said maybe I should try seeing a dermatologist next. In the past week or so, my scrotum has also started to itch a bit, although there also is nothing visibly wrong with my scrotum.

Both doctors have not seen anything visible on my butt. I have had my stools tested, all the results were negative. My question is, could the doctors be missing anything? Should I have other tests performed? Could it be an std, skin infection, lice, etc?? What doctor should I try to see?

Posted Tue, 22 May 2012 in Constipation
Answered by Dr. Ketan Vagholkar 6 hours later

Thanks for the query.

From your history it appears that you are not suffering from any disease warranting surgical intervention at present.

I have a few questions for you:

1. Non bacterial prostatitis was diagnosed on the basis of which report?
2. Was a urine culture of the specimen obtained after proststic massage done to confirm the diagnosis?
3. Have the stools been evaluated specifically for ova and parasitic cysts? These are a common cause for pruritus ani (worm infestation).

Antibiotic therapy was started empirically. I would suggest the addition of doxycycline as well for the proststic problem as this covers a broader spectrum of organisms. Cipro at times can cause pruritus.

If physical examination by the doctors was negative then you need not worry. I would then suggest the following measures:

1. Avoid the usage of any cream in the anal and scrotal region. This can cause more harm than good.
2. Use antifungal medicated soap for bathing daily. Wash the areas twice a day.
3. Dust the region with a good antifungal or antiseptic powder. Keep the area as dry as possible.
4. Use cotton undergarments. Ensure that they are washed with a antiseptic soap.
5. Keep the area well aerated by using clean and somewhat loose garments which will prevent excessive swelling.

I hope this treatment gives you complete relief. Should you have any further concerns, I will be glad to help you.

With Regards
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