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I really need an opinion. I've been to many, many Drs. about this. About three years ago, I got an ache in my penis and perennium after some prolonged sex. It went away after a week.  About a month later, I redeveloped the pain, which lasted for a year. Doctors were all over the place: early peyronies, prostatitis, pinched nerve, etc. I never developed a curvature or anything besides pain. It went away after a year. Then, about a week ago, it came back. Now I'm obsessing again.

Is it another bout of peyronies? I've heard that it can go away without curvature and then come back and cause deformity years later. Or is it my prostate? My urinalyses are always normal. Flomax and Cipro do nothing.

My symptoms are a variety of pains, usually dull aches, in the shaft, under the internal shaft behind the testes, and at the very base in the perennium. Also, I get that full, golf ball in my perennium feeling when I sit. Could PD cause this or is that only the prostate?

The pain is present flaccid and erect, both before and after ejaculation. But post ejaculation can be painful in the lower penis, behind the testes. It can also be a little more irritating with an erection.

I'd like someone to sort through these symptoms and help me reason why it could be one or the other. Am I getting continual bouts of Peyronies, or of prostatitis?

Thanks.

Answer
James:

Obviously I can't solve your complicated problem from here when all of your other physicians have failed to do so.  Peyronie's can wax and wane but that is relatively uncommon.  Prostatitis can certainly be present even with normal urinalyses.  Your symptoms suggest prostatitis, but depending on the nature, location and severity it would not be impossible for Peyronie's to do this but far less likely.  My guess from your description would be prostatitis.  Now check with your physicians to see what they think.

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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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