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Urology/Prostate Issues?


Hello Doctor,

I am 38 years old and have had a history of what I was diagnosed with as prostatitis. It seems that over the past 15 years, I would get a burning sensation in my urine and some white “pus like” sediment at the end of my urine stream (the urine was otherwise clear). At other times I would get cloudy urine constant throughout the stream. This “flare up” would occur approx. every 8-12 months and would go away on its own. About 2 years ago, it seemed to become an infection that wouldn’t go away. My urine test showed blood in it and I had lower back pain. I went to an Urologist and was put on Cipro for 4 weeks. I was also sent for an ultrasound that should I was completely emptying my bladder. I have been fine for 2 years until a few weeks ago when I went for a routine physical. My urine test results showed the presence of blood (Small A). My PSA results were 1.09 and all of my blood work was normal. A few days after my physical, I started having this pus like sediment at the end of my clear urine stream and once again getting discomfort while urinating. Could a prostate exam have triggered another flare up? I also had the urine sample taken after the prostate exam was done in the office. Could this have been the cause for the trace amount of blood? Do you think this is still all related to the prostatitis and I should start antibiotics again?

Thank you,



Anything in medicine is possible, but a routine rectal exam will not create a prostatitis unless it was lurking there before.  Prostatitis could be the cause of the blood in the urine or it could be something else.  I suggest you consult a urologist as you will probably need to go back on the antibiotics for awhile.


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Stephen W. Leslie, MD


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


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.

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

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.

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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