Sexually Transmitted Diseases/Complications

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Question
Dear Doc.

I had intercourse with a chinese girl, she was 24 years old. It was supposed to be a safe sex but the condom ruptured, though i realized it very soon. Anyway it was in early june this year. I started to feel blockage near the tip of my penis the very same night. I went to doc. The next day he gave me some antibiotics and asked me to visit after two weeks. Because of the communication problem i could.not find the same doc. The different doc. Stained a slide with penal fluid and found WBC. He said it is prostatits and gave me some chinese medicjne again. Anyway this kept happening. I asked a friend in oakistan to see a doc and let me talk to him as chinese do not understand english, most of them. The doc. From my country asked me to keep taking ciprofloxacin...which i did for two weeks then i could not find ciro here, so i switched to levofloxacin, jn addition to that my friend sent me some injevtions named fortum, i also had those injections. I took the medicine 500mg twice a day for almost a month. Then i went back home. By then my itching was reduced and blockage at the.tip.persisted. i did a lot of tests in pakistan like urine culture, seman culture,urethral swab cultur. I did them twixce to be sure. And Urine RE. All of them.were fine. Did ultrasound from.three different experts of prostate with a gap of one month with medication it was fine. But the blockage and irritation in my rectum still persisted. Doctors told me that am fine. I have no problems....when i came back to china i felt that the blockage is kind of moving upwards inside and that i can.not feel the urge to urinate. My frequency reduced many times. I wont feel the urge to urinate as often. But i had this slightly heavy lower belly. Now i feel difficulty in.urination and do not feel the urge to urinate when am sitting or lying on a bed. Did my pristate ultrasound turns out to be normal. Did hpv 6 and 11 and clymedia and Gnnoria tests again twice all are clear not i have RBC in my urine and infrequent urine. Discomfort in rectum has reduced many times but stil is there. I am using some medicine for rectum i guess those are a but helpful. IT us wirth elling to inform.you that in the beginnig like.jn the firt mont if the incident.i had an.accident in gym and i broke something.in.my lower belly i had a sharp.pain but lasted for a few moments...when i went to pakistan.it turned out that i have got varicocele in my left and hydrocele in my right testical. I still have buring penis. Not all the time though especially before urinating and after urination for a while but i do feel thaa the blockage has moved upwards and i feel slight pain in lowerbelly at times. Please help me with an answere that is realistic. Doctors do not take me seriously now they think that i am a feak. And i assure you that i am not a freak. There is another thing when i have pressure in my lowerbelly my left testical is deshaoes but it comes back to normal as soon as pressure is released. Its not hernia have checked for it. Looking forward for your answer thant what is really up with me? The Doctors in Pakistan were all against the view that i have prostatitis but as soon as i landed on chinese land they are calling it prostatitis. i need your opinion as already have asked the same question from another expert.

even if it is prostatits, is it curable?
when would i get better and how?
can i smoke E-Cig.
I am so messed up and I fear prostatitis more than death.

Thank you very very much in anticipation.

Answer
Hello Rizwan,
You fear prostatitis more than death?!! REALLY? You need a therapist to manage your anxiety.  You didn't tell me your age or your past medical or sexual history.  Prostatitis is not uncommon in men aged from their late 20s to early 40s.  Lots of antibiotics are used, including ciprofloxacin or levofloxacin, but bactrim probably works just as well.  However it helps to ejaculate (via masturbation or sex with a partner) at least daily, because this increases blood supply to the prostate, and hopefully the antibiotic is being delivered by that increased blood flow! Prostate infections may cause urinary retention symptoms including difficulty urinating, but so can benign prostatic hypertrophy (BPH), which usually occurs in men older than their mid-forties or fifties.

This requires an examination by a specialist. The varicocele and hydrocele are both separate issues that would not cause prostate symptoms such as urinary retection.

You also mentioned, "I started to feel blockage near the tip of my penis the very same night" which would not be due to your earlier sexual encounter. However if you have an obstruction in the urethra, the urethra might have become irritated. You later stated, "But the blockage and irritation in my rectum still persisted."  RECTUM? Your anxiety seems to be so overwhelming that you are even unable to clearly recount the story accurately.  

The sharp pain you had prior to noticing a varicocele or hydrocele are NOT related to your prostate.

Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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