YANMD - Urinary Tract Infection?
March 13, 2014 7:29 AM   Subscribe

Hi - late 40s male here - YANMD - here are my symptoms:

No pain while urinating, but sensation afterwards that sometimes goes away in a little while, sometimes sticks around. Sort of a pins and needles/scratchy feeling, a bit hard to describe. First assumption was Urinary Tract Infection or Prostatitis - was put on Cipro for a few weeks by urologist, but symptoms did not go away completely. Then, had CT scan of kidneys, which apparently look fine. Then, had cystoscopy (hope to never have one of those again), and, again, everything looks fine. Symptoms are inconsistent from day to day, but never seem to go away completely. Any ideas?
posted by wittgenstein to Health & Fitness (11 answers total)
Did you get a full std screening?
posted by Dip Flash at 7:48 AM on March 13, 2014

Response by poster: Should have mentioned - it's not STD.
posted by wittgenstein at 8:25 AM on March 13, 2014

Did you change soaps or shampoos recently? Start taking baths instead of showers? Swimming or using a hot tub? If so, maybe you're irritating your urethra.
posted by carmicha at 8:43 AM on March 13, 2014

Interstitial cystitis is an affliction that's only diagnosable by process of elimination and which mimics some symptoms of UTIs. It's not terribly common, and even less common in men, but a possibility.

You ask if this is a UTI, but in my experience, every trip to the urologist comes with a urine test, and in particular when any antibiotics are being dispensed; a test would answer the question of whether what you have is a UTI. Did your urologist really not run a test before prescribing Cipro? If so, was it a culture? And have you been tested since then?

Does the inconsistency in symptoms seem to have any connection to what you eat or drink?
posted by heatvision at 9:08 AM on March 13, 2014

Try a pelvic floor physical therapist. Pelvic floor issues can be misdiagnosed as prostatitis and cause the symptoms you're experiencing.
posted by telegraph at 9:17 AM on March 13, 2014

Get a culture. Your particular bacteria (if you do have a UTI) may be Cipro resistant. I would really have thought they would have already done this, so maybe see if you can get a copy of the culture results?
posted by nat at 10:24 AM on March 13, 2014

Hm, I've never heard of interstitial cystitis in a man. I very much doubt that you could get through multiple appointments with a urologist and a cystoscopy without also getting multiple urinalyses and urine cultures.

You might find this page on prostatodynia interesting. But have you asked your urologist what they think the differential diagnosis is? Because if they are really throwing up their hands at this point and saying they can't help you, I think you need a new urologist.
posted by treehorn+bunny at 10:41 AM on March 13, 2014

Response by poster: Thanks for the responses. Saw Urologist today. In case this helps someone in the future, here's his diagnosis: persistent Prostatitis Type III, which is not uncommon in high strung people (guilty). Recommended treatment is low dose of Valium, which is supposed to calm both prostate and pelvic floor muscles ( thanks to the several Mefites who mentioned this). There is an alternate drug option if this doesn't work, so I'm trying it for a month. Best news: another cystoscopy is unlikely, so I can stop freaking out about that.

Other interesting tidbit: only a small percentage of Prostatitis cases are bacterial, but many of them respond to antibiotics anyway, so that is why that is a common first solution to the problem.
posted by wittgenstein at 12:14 PM on March 13, 2014

Sounds like the new catch-all term, LUTS.
posted by gramcracker at 3:30 PM on March 13, 2014

Check out this story.
posted by PickeringPete at 4:53 PM on March 13, 2014

Glad you got your diagnosis; it was what I guessed it might be since I get it myself - annoyingly often and for annoyingly long periods. I, too, went through the full battery of tests, and a scan revealed that I have prostate stones. I had no idea such things even existed, but apparently they're fairly common, especially in middle-aged and older men, and they can be an aggravating factor in prostatitis.
posted by Decani at 6:40 AM on March 14, 2014

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