Q. I am a 27 years old man having continuous burning sensation in the urinary passage while passing urine since I got a sexually transmitted infection (STI) 19 months back. Sixteen months ago I had a urine culture done and the report came positive with a bacteria called Klebsiella 105 for which I took Niftran for 29 days. I repeated the culture after that and the report came negative but the problem continued, so I took Claribid 250 mg for a month. After stopping the medication, the pain started again in the lower right back, abdomen, in prostate region and then in the tip of penis. I also suffered from the problem of urgent urination but the flow is slow and it was dark orange in colour. I took Urispas for some time but the problem continued and after ejaculations the condition became worse. So the doctor gave me Alfoo10 mg for 2 months with Percin 650 after getting cystoscopy; but all in vain. Now I am experiencing pain in the prostate too and the doctor tried a digital prostate massage but the prostate was swollen and sensitive to touch. He is unable to trace what kind of infection has occurred inside the prostate. What should I do? Please advise.
Infection is certainly the most common cause of the burning while passing urine. Urine tests can usually diagnose acute infections. Sexually transmitted diseases are another common cause of such symptoms and need to be ruled out with appropriate tests (tests for gonorrhea, chlamydia and Herpes). The most common cause of chronic discomfort while passing urine, along with perineal, scrotal and low back pain, is an inflammation of the prostate gland, so called prostatitis. Increase in discomfort following intercourse as in your case also indicated to such a possibility. Too frequent or too infrequent ejaculation, sexual arousal without ejaculation, aggressive bike or horse riding, and excessive spicy foods, alcohol, and caffeine in the diet can aggravate prostatitis. Even sitting for long periods may aggravate the condition. If infections and prostatitis is reasonably ruled out, further evaluation with a CT and an endoscopic examination may be considered to evaluate for anatomical abnormalities (like urethral strictures, stones or polyps) by your Urologist to reach appropriate diagnosis.