Just the tip?
April 3, 2013 9:28 PM   Subscribe

*It* hurts at the end. I already seen two different doctors (GPs) twice each, but don't feel like I am getting answer I need. I'm looking for suggestions for what I should ask/tell my doctor in a couple days. YANMD, etc. Details follow.

The last few months have been incredibly stressful and I've been dealing with bouts of anxiety. I was feeling pretty tired and nauseous, then 2.5 weeks ago after skiing for a day, there was pain at the end of my penis (the tip and about a centimeter down the urethra) on the bus ride home. I went to the doctor and he said it sounded like a bladder infection. After a week of antibiotics, the fatigue and nausea were gone, and the pain had diminished. However, on the second visit, when the doctor looked at my urinalysis and urine culture, he said there was no sign of infection and had no idea why I was hurting, but that it would last for several weeks and I should come back if there was more pain.
I immediately went to a second doctor for another opinion and told him the story. He thought it might be a prostate problem and gave me some meds for that. A couple days later the pain got intense again and I went back to the Dr. 2, but he just told me I was too stressed out and sent me away.
That was a week ago. I have a followup appointment in a couple days. Yesterday the pain came back strongly, though not as strong as before so I would like to think I am getting better gradually. But, I would still like a better answer than, "I don't know, just relax." So, is there anything I can ask my doctor or say that might help speed along my recovery?

Some other details:
Most of the time there's a little pain, but it's negligible, sometimes none at all
There have been three instances where the pain was pretty intense, each about 5-6 days apart and it lasts a few hours
The intense moments are after sitting all day (on the bus, afternoon at work)
Standing and walking helps a bit
There's no discoloration, swelling, sores, etc.
The pain doesn't seem to be triggered by anything in particular (urination doesn't seem to matter) it just appears, usually in the afternoon (almost at the same time)
Yes, I practice safe sex but understand there are always risks

Again, it's getting better (it seems) but slowly. If there's something I can tell Dr. 2 that won't make him think I am a hypochondriac and maybe get me on the right medication, it would be appreciated. Thank you.
posted by princeoftheair to Health & Fitness (12 answers total) 2 users marked this as a favorite

Did you get tested for STDs? If not, ask about that.
posted by treehorn+bunny at 9:50 PM on April 3, 2013

And by the way, your doctors should be ashamed for telling you to just relax. It's penis pain, for god's sake. It seems a little crazy but I think you need a third doc.
posted by treehorn+bunny at 9:54 PM on April 3, 2013 [1 favorite]

Can you make an appointment with a urologist instead?
posted by cecic at 10:33 PM on April 3, 2013 [5 favorites]

See more doctors until you get the help you need. Do not take no for an answer.

I was in the worst pain of my life last year and had doctors laughing at me. Since I suffer from anxiety and depression and have a stressful job, many insisted it was all in my head. One even tried to refer me to a hypnotist.

After searching for weeks, I found a doctor that took me seriously, and while he stressed that anxiety and stress problems amplify existing pain, he also ran tests and prescribed drugs. I had urine tests, blood tests, ultrasounds and CT Scans. I was told pain in the pelvic region is difficult to diagnose. I even participated in a university study (partnership between the psychology and urology departments).

Finally, after finding nothing out of the ordinary on any tests, the doctor reluctantly suggested "prostate inflammation of unknown origin" as a possible cause and put me on a couple of strong antibiotics (Cipro and something else) for about a month. The pain started to lessen after a few weeks of the antibiotics. Since then, I've been on Flomax and an SSRI (Lexapro) for anxiety and depression. I have not had another flareup but feel some discomfort when I go off of them.
posted by globotomy at 10:34 PM on April 3, 2013

I am not a doctor or even in the medical field, but I would look into the possibility of a herniated or bulging disc in your spine. Skiing often does not seem like a high impact sport, but there is a lot of twisting and sometimes with odd angles on the spine. The fact that the pain came after skiing and the intense pain seems to come after sitting for long times seems to make this plausible. I had a similar instance a while back, but in my case the pain would appear in a muscle in my leg, sometimes as a numbness or tingling, then as sharp pain after sitting or standing straight for a while. I was told they can usually pinpoint the area based on the location of the pain. A quick googling of "bulging disc penis pain" seems to show the L4/L5 discs are likely. Do you have any other signs or numbness or pain in your legs? If it turns to be a spinal issue, a few weeks of an inflammatory and muscle relaxer may allow the disc to heal on its own.
posted by Yorrick at 10:35 PM on April 3, 2013 [4 favorites]

globotomy, that sounds a lot like what my docs have been saying, and your situation seems very similar to mine. I'm not going to jump to the conclusion we are having the same experience, but it gives me a lot to think about. When you finally got the help, were you seeing a general practitioner or a specialist? How did you finally convince the doctor to help you? Or did he just take you at your word?

Also, yes, I'll get tested for STDs just in case.
posted by princeoftheair at 10:47 PM on April 3, 2013

Spinal, maybe also that sciatic thingamabobber that all them nerves pass through on the way to the spine (Not a doctor here, not even close to one, grain of salt etc.) I just searched 'sciatic nerve penis pain' on a hunch since you mentioned sitting down preceding some of the worse episodes. Apparently the nerves getting pinched in there is a thing that can happen to some people. It might be worth inquiring about.
(I sometimes also get some pain after doing some difficult business, and had thought it might either be just the pressure from that or maybe my toilet seat being all cheap and pinchy. Guess I'll be seeing a urologist at some point myself.)
posted by mcrandello at 11:13 PM on April 3, 2013

I am not a doctor but have had similar pain in the past. Did they do a digital rectal exam and find you actually have an enlarged prostate? If not, that would be a good place to re-start. If you are having any trouble with your urine flow, starting urination, and emptying your bladder, those could also be symptoms of an enlarged prostate. I don't know that an enlarged prostate itself would cause penis tip pain, but I presume if the cause of the enlarged prostate is an infection, then it would make sense that inflammation could cause radiating pain.
posted by Dansaman at 1:18 AM on April 4, 2013

Just to elaborate on the prior answer, pain at the tip of the penis like you describe is more suggestive of urethritis than prostatitis. STDs are a common cause of urethritis.

Prostatitis can cause urethral pain but since your prostate is located at the base of your penis the pain would more typically be of the prostate itself and a rectal exam would reveal a tender prostate. I think if you look at the other symptoms of prostatitis (inflammation of the prostate as globotomy puts it), you don't mention having them. Anyway, you can ask your next doctor about it.

One other thing to consider could be irritation from condoms I.e. Latex or spermicide.
posted by treehorn+bunny at 5:36 AM on April 4, 2013

Some other details:

Sounds a bit like my experience with kidney stones to me. Are you also feeling occasional discomfort/pain in your lower back (not necessarily at the same time at the penis pain)?
posted by 0 at 10:47 AM on April 4, 2013

Seconding possible kidney stones, if you're sometimes getting lower back pain.
posted by Wild_Eep at 2:39 PM on April 4, 2013

If someone finds this down the line, I just want to give an update. A few people have told me that they went through more or less the same experience, and the cause in each case was stress or anxiety and what cured it was time and dealing with stress rather than a specific medication for the pain.

I went to Dr.2 and got rather belligerent when he said again that it was stress-induced. He responded by explaining that he had seen this before in a lot of people who have incredibly stressful jobs/lives and that's why he reached the conclusion he had. When I pressed him on other possible causes, he asked that I continue the medication a little longer and if I still didn't feel better or wanted another opinion, he would make an appointment with a specialist for me.

Just knowing that the cause was stress has improved my condition a lot. I'm making an effort to relax, talking to a therapist, and doing things to relieve tension as much as possible, and it appears to be helping a lot. I want to thank everyone who posted, and if anyone has a similar condition in the future, maybe this will be of some help.
posted by princeoftheair at 4:21 PM on April 6, 2013

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