Family, Internal Medicine, General Medical Questions/Viruses

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QUESTION: What percent of viruses go away on their own versus require antibiotics or something else? I had normal sex with someone, developed penis pains and uneasiness when ejaculating, got whole battery of Std tests which came back negative. Primary doctor gave  me antibiotics for ten days. I started feeling better but it got worst again  after.. Went to see urologist who put scope in me and said he didn't see any cancer, polps, or anything of great concern.. He gave me antibiotic for a month which seemed to help a little but not as much as the first  one. He doesn't seem to know the issue and I met with his assistant last time a month ago and don't see anyone again until mid-april. He didn't seem to think I had enough symptoms for prostatitis so right now it has been nearly six months without an official diagnosis. I still feel indescribable dull pains between my prostate and end of penis and although my stool has remained pretty solid I feel like I have a diaper rash  most days.  It is uncomfortable to sit for long periods of time and particularly if I need to drive around a lot. If I had gotten some kind of virus what are the odds it will go away on its own? If I do still have a virus I wish I had some ballpark idea of what it is  so I can ask to be tested for it.  I have been reduced to going to see a psychic who says a virus was likely involved and that I should cut citrus out of my diet for a week. I wish the doctors I've seen could have given me as  much to run with. Speaking of which running is also  uncomfortable.

ANSWER: You are mixing up infections, viral/bacterial and possible prostatitis..... it is a complicated situation..... first issue, make sure there simply isn't an STD.... you did that.   Then the presumed situation is that you have a low level prostate infection.... not viral, (antibiotics are ineffective against viral infections).   We presume these may be bacterial, as antibiotics tend to help them, but hard to prove whether there is a true infection or simply inflammation of the prostate without a definite infection.    It sounds like prostatitis from the description.  

I don't know if citrus restriction does much of anything, and I don't think I would get my prostate care from a psychic.

We tend to treat with longer term antibiotics, doxycycline or cipro usually and see if it fades away.   Sometimes you need to avoid irritating the prostate, which means hold off on sex/ejaculation until it calms down.   

I would consider a longer course of antibiotics.

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QUESTION: The urology assistant didn't make longer term antibiotics seem like the  most likely option. It seems like they want to wait and see which concerns me because if I have acute prostatitis and it becomes chronic in the mean time I will not be happy. I know viruses are not effected by bacterial antibiotics which is why I am asking about most viruses going away on their own since I don't know if there being a virus is a consideration at this  time or whether I should  have all the sdi tests done again just to make sure.

Answer
If you had a round of sexually transmitted disease tests and with those symptoms, I would not repeat them.

Prostate infections are not caused by virus', so that is considered when thinking about treatment.

Some of these chronic prostatitis problems/symptoms fade away, often we repeat a longer course of antibiotics..... that is up to your and your doctors, depending on your symptoms.....

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Robert Borucki

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