Q: I am 42 years old. I am suffering from mild to medium burning sensation while passing urine. The burning sensation is localised at the tip of the penis. I don't have fever or abdominal uneasiness. The burning sensation increases when I sit or lie down for long durations or before passing stool. The urine volume is normal. Ultrasound and uroflowmetry reports are normal. I underwent routine urine test, which says that the pus cells vary from 1-2 to 2-3 in 3 tests. Subsequent urine culture shows scanty growth of E. coli (less than 100,000/ per ml of urine). I was initially treated with Norfloxacin 200 mg twice daily for 10 days, but the symptoms persist. After a drug sensitivity test, it was found that I am resistant to most of the drugs except, mildly sensitive to ofloxacin and highly sensitive to Nitrofurantoin. Then 200 mg of ofloxacin was prescribed twice a day. After 5 days of taking this medicine, I found no relief. I have a history of urinary tract infection and have already suffered E. coli infection 4 times over a span of 10 years. This time it has relapsed after 6 years. On previous occasions, taking the drug completely eradicated the problem. I have not suffered any weight loss and by blood reports including kidney function & liver test are normal. What is the future course of action? The doctor says that this is not serious and the symptoms will go away with time.

A:Your symptom complex and duration of disease suggests that you may be suffering from chronic prostatitis. It fits in clinically with chronicity, past UTIs, urinary symptoms, which are waxing and waning and absence of any specific urinary findings. Usual recommendation is ofloxacin or trimethoprim for a period of 10 to 12 weeks. The other possibilities, which need to be excluded, are a juxtavesical stone, chronic urinary tract infections like genitourinary tuberculosis and carcinoma in-situ. All of these may have similar presentation. Your urologist would go into details of everything and suggest you the best course of action.