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Why do I have persistent irritation in the urethra?

Q: I am a 30 years old man having irritation in the urethra and surrounding areas till the anus and sensation and irritation on the tip of the penis for the last five months. The symptoms continue for weeks and then disappear for 2-3 days or sometimes for weeks but they reappear. Urination is very normal and never had any kind of problem but sometimes I feel some irritation when I try to urinate with force. Sometimes the urge to urinate is a lot but the urine is normal. I have consulted many doctors and they said it is infection but I have got no relief in symptoms. I underwent urine tests and everything was normal, prostate x-ray was also normal and nothing was found in the ultrasound for prostate and lower abdomen too. I took antibiotics - Azythromycin, Ofloxacin, Ciprofloxacin, Norfloxacin but they gave no relief. This irritation is persistent in the left side in the urethra just after hydrocoele and sometimes I feel irritation on the outer side of the entire surrounding of the anus too. I take too much green chillies in my food. I am unable to understand what has happened to me. Please advise.

A:You have irritative urinary symptoms, which may have a varying aetiology. You have probably been treated with a label of prostatitis, the most common diagnosis with such presentation. Chronic prostatitis, however, is a diagnosis after other possible aetiologies have been excluded. You need to be evaluated by a urologist for other underlying problems which may be a stone, a stricture (narrowing in the urinary passage), an inflammatory condition of the bladder or prostatitis (infection of the prostate glands). An ultrasound, uroflowmetry, a retrograde urethrogram and probably an endoscopic examination of the lower urinary tract are some of the tests, which may provide an answer and a subsequent pathway to effective treatment.

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