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Urology/ED or CPPS?


QUESTION: Greetings,
I'm a 23 year old.

I went to urologist a while ago because I felt discomfort in the prostate area and somewhat painful urination, the doctor told me I may have CPPS (chronic pelvic pain syndrome), I searched it and I'm concerned that my case is more complicated than that.

The symptoms I have now and I've had for a while now are as follows;
- Loss of morning erection, weak erection in general but the erection could get pretty solid if the hand was involved, it may still from 1 up to 5 minutes.
- Pain in the base of the penis, sometimes I get stings inside the penis and near the base if I split my legs.
- When I defecate, a colorless fluid comes out of penis, not sure if it's semen.
- I've noticed that sometimes I do have a weak urine flow but other times I don't and there's slight pain when I urinate. I had a urine test a while ago and there was mucus in it.

Are those the symptomps of CPPS, or do I have ED? or is my problem more complicated than that? I'm going to a urologist this week but I need to clear my head from this. Thank you in advance.


ANSWER: Adele:

Your symptoms are suggestive of prostatitis.  CPPS is one type of prostatitis.  Not enough information was given to differentiate which type of prostatitis this might be.  The fluid that comes out with a bowel movement is probably just normal prostatic fluid.  The ED may or may not be related.

Checking with a urologist is the right approach.  For now, try sitting in a really hot tub for 10 minutes twice a day and avoid any caffeine or hot, spicy food.

---------- FOLLOW-UP ----------

QUESTION: Thank you for your response.

I was told by the urologist I went to a while ago that the presence of mucus in the urine sample indicates that the prostate is congested, and I had pain in the lower back and sides for a while. What tests should I do to know what type I may have of prostatitis? Also, how do I know if the ED is related to prostatitis and are there tests for ED? My appointment is on Friday.

The mucus may or may not indicate prostatic congestion.  Testing for prostatitis is beyond the scope of this forum.  Suffice it to say that it usually takes a urologist to make the determination which is typically done by a digital rectal exam and review of the symptoms.  In some cases, a 2 glass or 4 glass urine test can be done where the urine is carefully examined before and after a prostatic massage.  This is not often needed as it does not change the treatment.


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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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