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Suffering From Prostatitis After Having Unprotected Sex. Having Pain In Right Testicle. Took Zithromax And Cipro. Need Advise?

Posted on Mon, 23 Sep 2013

Question: Hey I have been dealing with prostatitis off and on for a few years , each reoccurrence would only develop after unprotected sex or orally , I would constantly get checked for stds and always negative , my doctor would give me cipro each time and after a couple of weeks it would clear up completely. A few months ago I had another occurrence through oral sex but this time I was feeling pain in my right testicle which never happened before , I was givin 1 dose of Zithromax and cipro for a few weeks, after i took the Zithromax all the pain in the right testicle went completely away , ok a few months later I received oral again and the same exact thing happened but this time I did a zithropac of 5 days and it didn't work I have also been on ampicillin and doxyclycline and augmentin but these haven't worked either it has been 3 months of this ongoing burst of sharp pain with inflammation in my testicle I've had std blood work , urine analysis , ultrasounds and swab test taken everything was still negative . I am scared that I might have developed a chronic form of epididymitis ? Or I haven't been taking the right antibiotics to clear this up ? Should I try the 1 dose Zithro again ? Or am I stuck with this chronic condition this time around ? Can this still go away like it has in the past ? Please help Ty

Answered by Dr. Manuel C See IV (2 hours later)

Brief Answer:
Dont take Zithro, get culture of prostate & urine

Detailed Answer:
You may be already sufferring from chronic prostatitis which could be bacterial or no-bacterial in nature. I would suggest getting urine and prostate massage fluid cultures to determine organism and what antibiotics it is susceptible to. You may be harboring resistant bacteria due to previous intake of antibiotics. NSAIDS (diclofenac, etoricoxib) may also help in the swelling and the pain while waiting for culture results. best of luck.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (4 hours later)

Ok but when i took the zithro 1 dose last time it took away the pain and i was fine for a couple of months afterwards until the recurrence from the oral sex . Just wandering why I shouldn't take the Zithro ?? do you think this is chronic epididymitis or do you think with right treatment I could get rid of this nagging pain again ? P.s I never had any noticeable swelling , my symptoms were a nagging pain in right testicle a lil smell and slight burn with urine, and inflammation in both testicles that burned .

Answered by Dr. Manuel C See IV (1 hour later)

Brief Answer:
Taking zithro again will develop resistance.

Detailed Answer:
Taking zithro again may lead to development of antibiotic resistance. Yes i believe everything will be back to normal once your infection is properly and adequately treated. I would strongly suggest doing the cultures to properly eradicate the bacteria. You may have chronic epidiymitis that is not fully resolved but just becomes dormant in times when you take antibiotics. You may also need prolonged antibiotics (one month).

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (11 hours later)

How do I go about getting the cultures and prostate massage ? Doesn't that have to be recommended by my urologist ? I would like to know if I should avoid sexual contact with my gf while waiting for this to clear ? Would it matter if I have sex unprotected with my gf during this process ?

Answered by Dr. Manuel C See IV (7 hours later)

Brief Answer:
Yes hold off contact while under treatment.

Detailed Answer:
Yes I would suggest to hold off sexual contact with your girlfriend while being worked up and treated. I would also suggest she gets a urinalysis to see if she has bacteria in her urine. does she has vaginal discharge? (whitish or greenish) Best of luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (3 hours later)

No she's never had anything like that . Dr my main question is will this pain in my testicle go away with the right treatment cause I have read many of articles that if you have pain in the epididymitis for longer than 3 months than it can't cured is this true ?

Answered by Dr. Manuel C See IV (2 hours later)

Brief Answer:
Yes pain will go away with proper treatment.

Detailed Answer:
Pain in the left testis will go away with proper care and treatments. Even with chronic epididymitis (more than 3 months) it can go away with proper treatment. That is the importance of cultures to identify the organism and the proper medicine that is needed for therapy. Thank you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (13 hours later)

My doctor made me get a semen analysis by ejaculating in a vile , is this the same as the prostate massage culture ? Because he said it was Hey Doc I have another question for you . Is their injection antibiotics that can go directly to your prostate if the oral antibiotics don't work or reach the prostate ??

Answered by Dr. Manuel C See IV (2 hours later)

Brief Answer:
Yes but it is not standard treatment.

Detailed Answer:
Yes I have been doctors inject directly to the prostate through the rectum but it is not standard treatment and results are anecdotal at best. Some class of Oral antibiotics can penetrate the prostate like fluoroquinolones. Prostate injections also has its complications like systemic infection (bacteria in the rectum goes into the bloodstream, difficulty in urination due to inflammation of the prostate etc.) I would not recommend direct prostatic injections. Best of Luck.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (19 hours later)

Hey Doc I gave a sample of my semen to my urologist to get tested is this the same as prostatic massage culture because he said it was ?? I have been on cipro for 10 days now and I believe my symptoms are slightly improving , if my test all come back negative and the cipro doesn't penetrate and cure this what antibiotic would you suggest if the infection has become resistant to the cipro ??

Answered by Dr. Manuel C See IV (5 hours later)

Brief Answer:
Ciprofloxacin has good prostate penetration.

Detailed Answer:
Good Day!

No semen and prostatic massage fluid are two different things. It is very important to have prostatic massage to milk the prostate and get the fluid to be cultured. I am glad to hear that your symptoms are getting better. Best of Luck.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (17 hours later)

Hey Doc I have been taken cipro off and on for the same bacterial prostatitis issue for 3 years now and every couple of weeks it usually clears everything but this time around I feel like it isn't working the same is it possible I may have become resistant to it ? And if I have what flouroquine antibiotic would penetrate my prostate the best to rid this infection the best ?? All of my test came back negative. I don't think my urologist has a clue ! What other antibiotic do you think I could try to cure this throbbing in my testicle and inflammation in the scrotum ? Please help

Answered by Dr. Manuel C See IV (9 hours later)

Brief Answer:
I would Get a prostatic maSsage and culture first.

Detailed Answer:
Good Day! I would suggest getting a prostatic fluid massage and culture before starting antibiotics, you may be resistant to ciprofloxacin already. Other medications is levofloxacin, ampicillin-sulbactam or cefuroxime. But you need to get prescription from your doctor to get a hold of these medicines. You may need to see another Urologist and discuss about chronic prostatitis and a 4 glass test. He would know what you are talking about if you mention a "Stamey-Meares 4 glass test". That will get urine, and prostatic fluid cultures to determine if you have a bacterial prostatitis or non-bacterial prostatis. Treatment would vary alot depending on the result of the above-mentioned test. You may need to take anti-inflammatories like tylenol or paracetamol to get rid of the pain and swelling. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (1 hour later)

Ok I will try another urologist ... Even if the 4 glass test come back negative which probably will cause i have been on antibiotics so long ... I am 100% sure this is bacterial, everytime I have had unprotected sex or oral sex these symptoms would occur right after. There isn't any other explanation. My doctor will listen to me about a antibiotic of choice which antibiotic will I be the least resistant to after taking cipro for so long ? I'm tired of these doctors not having a clue of what it could be from these negative test's ! I need a strong antibiotic that will penetrate this bacteria with out resistance.

Answered by Dr. Manuel C See IV (26 minutes later)

Brief Answer:
There is no antibiotics without resistance.

Detailed Answer:
I know it is very frustrating to be in your situation but there is no antibiotic without resistance. That is the reason for the cultures. Stronger antibiotics would be levofloxacin, Cefixime or carbapenems but that is intravenous only. Get the 4 glass test im sure it would provide answers to your problem. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (40 hours later)

Hey Doc I have been on cipro for about 2 weeks straight now 500 mg twice a day my symptoms seem to stay the same how long do you think it would take for the symptoms to get better because I think I have about ten days left. if this doesn't go away is it safe to say ill definitely need a different antibiotic ?

Answered by Dr. Manuel C See IV (49 minutes later)

Brief Answer:
Ciprofloxacin should have worked by now.

Detailed Answer:
You might be harboring bacteria that is resistant to ciprofloxacin thats why your symptoms has not yet gotten better. 14 days of antibiotic should have resolved your symptoms already. If it doesn't go away then it is safe that you need to take another antibiotic. The culture will tell us what antibiotic to use next. Best Wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (56 minutes later)

Ok thanks so much I'm sorry I have to keep asking all these questions the reason I am is because I want to know the most about this so I can n explain this to my urologist because I feel like he doesn't know. Lets say there isn't any bacteria found which I don't think it will be found. Trust me I know this bacterial though . if I were to try another antibiotic like levoflaxicin would this be resistant also since it is a flouroquine antibiotic like cipro ? Are cipro and levoflaxicin pretty much the same antibiotic ??

Answered by Dr. Manuel C See IV (6 minutes later)

Brief Answer:
Both antibiotics are not the same.

Detailed Answer:
Levofloxacin and ciprofloxacin both belong to the same class of antibiotics but they are not the same. Levofloxacin would be considered stronger than ciprofloxacin and has anti-bacterial activity to more organisms than ciprofloxacin. But I think it is safer to try a different class of antibiotics to be sure. If nothing grows in the 4 glass test then you will be considered as having abacterial prostatitis. They have the symptoms as bacterial prostatitis but treatment is defferent. It's like having asthma on the prostate that excacerbates regularly. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (23 hours later)

Hey Doc I wanted to ask you how come the last time I had this inflammation and pain in my testicle after oral sex when I took the Zithromax it cleared all of the pain ? But after this last episode after oral sex the Zithromax it
didn't clear the pain or inflammation ? Is that common ?

Answered by Dr. Manuel C See IV (15 minutes later)

Brief Answer:
Yes fairly common to develop resistance.

Detailed Answer:
It is common for bacterial strains to develop resistance when we take antibiotics over and over again. That is the reason why zithromax is not working for you anymore. Resistance develops when the bacteria is exposed to antibiotics repeatedly.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (15 minutes later)

Ok well I never took levoflaxicin if I take that can I still be resistant to it ? Does it mean that those antibiotics I have taken before that I can't use them anymore ?

Answered by Dr. Manuel C See IV (17 minutes later)

Brief Answer:
You may try levofloxacin.

Detailed Answer:
Yes previous antibiotic intake will develop resistance if the bacteria is not eradicated from that treatment. This is the reason why there are alot of resistance development in short term antibiotic use.

Levofloxacin might still work but hard to say without the benefit of a culture result. Its really a hit and miss.

Best Wishes and Good day.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (49 minutes later)

What is abacterial prostatitis ? Can this be cured with the right treatment ? And what treatment would you use for abacterial prostatitis ?

Answered by Dr. Manuel C See IV (3 hours later)

Brief Answer:
Abacterial prostatitis can be treated.

Detailed Answer:
Abacterial prostatitis or chronic prostatitis is inflammation or swelling of the prostate without evidence of bacteria or that is not caused by bacteria or any organism. It's like rheumatoid arthritis for the bones and joints but the swelling is in the prostate. Theories behind its cause could be: 1) Antibodies from previous bacterial infection 2)Auto-immune disease (like asthma or allergies), 3) Nerve Impingement, 4) irritation from the urine. There is still no proven cause of this disease.

Yes chronic prostatitis can be treated and controlled. Treatment includes pain relievers, prostate massage, hot sitz bath, prostate relaxation medicines (alpha blockers etc.). Avoidance of spicy food and chocolates may help in some patients. It will be a personalized treatment since the doctor needs to see constantly monitor your condition and adjust treatment as necessary.

Best Wishes to your health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (1 hour later)

Ok well in my case lets say I developed this chronic abacterial prostatitis from previous infection of the prostate by bacteria . are you saying that there isn't any antibiotic treatment for this to eradicate the original bacteria / or the bacteria that caused this that is unknown ? How could this be non bacterial if this was caused right after oral sex ? and this has never developed out of nowhere randomly ? What are the main symptoms of this non bacterial prostatitis ? When I had my last ultrasound of my testicals they said their was an epididymal cyst could this be the pain I am having in my right testicle ?

Answered by Dr. Manuel C See IV (6 minutes later)

Brief Answer:
Cyst will not cause the pain.

Detailed Answer:
Yes not antibiotic anymore but different treatment for abacterial prostatitis like what I mentioned earlier. Hard to say what caused it and why it is associated with oral sex. Maybe a reaction from saliva or increase in pressure that in the ducts from the penis to the prostate but that is speculative.

Non bacterial prostatitis has the same signs and symptoms of prostatitis. Perineal pain or discomfort sometimes difficulty in urination, pain in the scrotum or inguinal area. Culture result would determine if it is non bacterial or bacterial.

Epididymal cyst does not cause any symptoms and does not cause pain.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (57 minutes later)

Does the pain and symptoms of non bacteria prostatis ever go away for some people without treatment ?

Answered by Dr. Manuel C See IV (20 minutes later)

Brief Answer:
Yes it comes and goes.

Detailed Answer:
Good Day!

Yes it waxes and wanes , sometimes the symptoms are there and sometimes it is gone.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar