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Hi Dr

I am 26 years old. About 4 months ago I was in Budapest for my bachelor party. On the last day of the 3 day trip, I visited a massage parlour and unfortunately the masseuse ended performing brief oral sex on me. This was my first ever sexual contact.  I immediately regretted it and the next day I started feeling a discomfort feeling in my penis, slight burning at the penis tip, pain near testicles and perineum, lower back ache developed a couple of weeks later. I also feel more tired than usual.

Concerned, I visited a sexual health clinic 2 days after contact where they prescribed azitromycin for precaution. They asked me to come back after 10 days for urine test to test for std's. Results were negative.

Still feeling pain I visted another std clinic for repeat tests. Blood and urine tests were negative. In fact I've been to 3 seperate clinics and the urine, swab and blood tests have all been negative. I also took a 7 day course of doxycycline 3 weeks after contact with no impact.

I then consulted a urologist (2 months ago). He suspected prostatitis and conducted a urine analysis and culture. He prescribed cipro for 3 weeks, again I didn't feel an impact. During my follow up appointment he said that the urine test showed no bacteria, however some red and white blood cells were noted, which he suggested as inflammation and said I had inflammatory prostatitis/utheritis 

I asked him to perform a prostate massage and conduct another urine test to confirm no bacteria. The results infant showed presence of e-coli. I was devastated by hearing this. He prescribed augmentin for 4 weeks, I'm currently in my 3rd week and don't feel much improvement.

My question is what else can I do to get rid of this infection as this is getting me so down. Also what are the chances of me having an std like mycoplasma, urea plasma, chlamydia in my prostate or other pathogens such as viruses or fungus? Sometime after contact I did get these red blotches on my penis head, which the dr treated as a thrush and prescribed canestan which helped clear the blotches.

I have read websites whereby these pathogens have been found in prostate by urologists in countries like china and philippines where they claim to have better ways to search for these pathogens and treat accordingly.

I'm just concerned that I have a deep rooted std or another pathogen in my prostate, which isn't being picked up. 

My symptoms are not excruciating but are persistent and impact my quality of life. I'm concerned that this will get worse. I can't explain whether this bug came from by bowels or from the woman, considering the incubation period of e-coli is 3 days and my symptoms started within 24 hours.

Answer
Bas:

You may need additional therapies such as quercetin, ongoing specific antibiotics, alpha blockers, hot sitz baths, 5 ARI meds, elmiron, caffeine avoidance, NSAIDS, etc.  These additional therapies each work some of the time for most people.  So far, your therapy has been limited. You may need to find a practitioner who is willing to use adjunctive treatment for you.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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