Discomfort in the Urethra
Hello, I’m a 45-year-old male reporting no underlying health issues. For the past four months, I’ve been experiencing a burning sensation in my urethra. The discomfort intensifies during urination and occasionally radiates to an area near the glans, just beneath it. Additionally, I feel a burning sensation during ejaculation, which has completely diminished my sexual enjoyment, as I also experience pain during erections. This issue began following a bout of vigorous sexual activity a few days prior, where I believe I may have accidentally struck my penis in the "cowgirl" position. Although the pain didn’t manifest immediately, it started a day or two later. It's worth noting that there was a chance I had unprotected intercourse a few weeks before this started, but I underwent STI screenings that came back negative on two separate occasions. One of these tests even included a broader panel covering infections such as MGEN. Moreover, I had a UTI test performed, including a strip test and bacterial culture, which returned negative results. Another aspect worth mentioning is my ongoing issue with a foot fungus that I’ve tried treating in the past, as well as a history of oral thrush. Currently, I’m not taking antifungal medications since they adversely affect my stomach. An MRI of the lower abdomen yielded clear results, and a penis ultrasound conducted by a radiologist revealed some scar tissue near the tender area. He recommended an MRI, but my health insurance does not cover that. Medical practitioners initially suspected a urethral stricture due to my reduced urine flow. However, after undergoing a cystoscopy, no strictures were found, and my bladder appeared normal, despite some inflammation detected in the prostate. What might be causing this discomfort? The ultrasound findings did not initially point towards Peyronie’s disease as it wasn’t palpable through manual examination. Although some white spots were noted in the urethra, they did not seem significant enough to suggest lichen sclerosus. The urologist who performed the cystoscopy indicated this was likely not the case. Might it be a fungal infection or an unidentified bacterial issue? I was prescribed medication for prostatitis but have yet to begin the treatment. The MRI indicated that my prostate size is normal. Thank you for your input.
Answers (1)
8/14/2025, 1:10:58 PM
OpenHealth AI
I understand how distressing it must be to experience persistent discomfort in your urethra and related areas, especially with the impact it has on your sexual health and overall well-being. Given the details you've provided, it appears you've been through a thorough assessment already. Here are some insights into what might be contributing to your symptoms and steps you can take.
Main Points
- Your symptoms may be linked to pelvic floor tension, irritation, or inflammation in the urethra and prostate rather than a specific infection or anatomical issue.
- Initiating the prescribed prostatitis treatment could help manage inflammation.
- Self-care measures and lifestyle adjustments might alleviate discomfort.
Explanation
Despite negative STI screenings and UTI tests, recurrent symptoms can sometimes stem from non-infectious causes like pelvic floor dysfunction or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The scar tissue noted in the ultrasound and inflammation in the prostate could be contributing to your pain, particularly during urination and ejaculation.
The fact that you've had inflammation in the prostate could indicate that the discomfort is related to prostatitis, whether acute or chronic. While those initial images did not suggest Peyronie’s disease, scar tissue can lead to tension and discomfort, which might not always be identified through a standard examination.
Next Steps
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Initiate Prostatitis Treatment: Start the medication prescribed for prostatitis. This is crucial since it targets potential inflammation in the prostate and could alleviate some of your symptoms.
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Pelvic Floor Exercises: Consider incorporating pelvic floor relaxation exercises or physical therapy (if accessible). This helps reduce tension around the pelvic region, which may relieve discomfort during urination and intimacy.
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Hydration and Diet: Stay well-hydrated and consider avoiding irritants such as caffeine, alcohol, spicy foods, and acidic foods, which can exacerbate urinary issues.
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Symptom Diary: Maintain a record of your symptoms, noting any patterns related to activities, foods, or stressors. This could aid in identifying triggers and will be beneficial if further discussions with healthcare providers are needed.
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Follow-up Care: If your symptoms persist despite starting treatment, or if you notice any significant changes, it would be wise to follow up with a healthcare professional to discuss further options and possibly reevaluate the diagnosis.
Remember, addressing your discomfort may take some time, and it's important to communicate any ongoing issues with your healthcare provider. You’re taking the right step forward by seeking information and addressing this matter head-on. Please feel free to reach out if you have further questions or concerns.
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