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What could be the cause of mild prostatitis?

Q: I am a 35 years old male. About 2.5 months back, I had a bout of haemospermia (which was after I had some itching in the inner folds of the thighs between the abdomen and thighs). The urologist did a TRUS, semen culture, urine test and microscopy. The TRUS revealed inflamed seminal vesicles, bulky prostate and a small cyst. The semen culture and urine were normal. The doctor said that it was some infection and he prescribed Doxycycline 100mg twice daily and Flotral for 4 weeks. After taking the medication, haemospermia was resolved. But around 2 weeks back I was feeling a dull pain in the groin area (testicles) and sometimes short jabbing like feeling. The doctor told me to take Doxycycline for 10 days. The dull pain has subsided but hasn't gone fully. He feels that I have some form of mild prostatitis. What could be the cause for this? The doctor is not bothered about the bulky prostrate, he told me that it is benign. I don't have any other issues like frequency of urine, burning or discharge. Should I go in for second opinion. What do you say?

A:Haemospermia is mostly benign and may result from the diseases of the prostate and seminal vesicles. In youngsters like you, the causes are mostly inflammatory like prostatis and seminal vesiculitis. On many occasions the cause may be discernible and the disease may have to be labelled idiopathic. In elderly men, PSA is usually done to exclude prostatic carcinoma. Anxiety is invariably associated, as in your case. Reassurance that the disease is benign is part of the treatment and your treating physician seems to be doing it well. Acutely inflamed prostate may look bulky on ultrasound, but this would settle down, as the inflammation subsides.

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