I was diagnosed with Chlamydia in early June 2015. Upon the first sign of discharge I went to a doctor who gave me a 1000g of Azithromycin and a shot of Rocephin. Two weeks later the physician did a swab test which still showed positive for Chlamydia. A 10 day course of Doxycycline then cleared the Chlamydia. I also had a 9 panel STD test (including Trichomoniasis) done at 3 months, 5 months, and 8 months and all results came back negative.
Starting in mid-August 2015 (3 months post incident), I started having intermittent discomfort when the tip/head of my penis rubbed against my underwear. I started wearing athletic shorts, and wore them lower, and that helped a bit. Until in early November the pain become consistent and continued to increase. At its worst in December I had to keep toilet paper wrapped around the penis to prevent anything from rubbing against it. I decided to go to a urologist (UR1) who said it was abacterial prostatitis and/or peripheral neuropathy. To treat it, he gave me a two week prescription of Alfuzosin (alpha blocker to help promote blood flow to the prostate) and a one week MethylPred pack (steroid). After finishing the meds in early January the pain was still getting worse. I read up some on peripheral neuropathy, and tried massaging the tip of the penis a few times a day and also applying Capzasin a couple times. I am not sure if it was the effect of the medicine kicking in late or the home treatment, but by early February I was feeling much better. Note - UR1 also had me give a semen sample, which came back negative for bacteria, but they did not test for Chlamydia.
Afraid the pain might come back, I went to another urologist (UR2) who I had heard about from a physician. UR2 heard my symptoms, said that someone my age does not develop peripheral neuropathy. He performed a DRE and said the prostate felt 'soft and boggy' which is a sign of infection, and prescribed me 500mg Cipro two times a day for one month. I am on day 17 and have an appointment with the doctor when I am done with the medication. On my last visit, UR2 said that if the one month of Cipro does not clear the infection, then we will need to do a three month course of some of other antibiotics. And if that does not work, we will have to do IV and will need to pull-in an infectious disease specialist.
Over the last couple days I have felt the prostate area/base of penis area moderately twitch and spasm. I have no pain while urinating but in a resting state I feel pain, sensitivity and weakness in the inside of my urethra towards the base. Also in resting state my penis is about 30% more elongated than before. I also do still continue to get moderate discomfort when the tip of my penis rubs against loose underwear or clothing. A few times a week there is a shooting pain in my inguinal area, mostly on the left and occasionally on the right. And maybe once a week I feel a shooting pain down into my testicles.
What should my next steps be:
1) Prostatitis is a known complication following Chlamydia. How do I find a physician who has experience treating Prostatitis caused by Chlamydia?
2) What kind of test can I insist on to make sure we know what we are treating? Blindly throwing antibiotics at something without knowing what it is seems like a bad idea. Is it possible to test semen discharge for Chlamydia, or would that have to be done with a 3 or 4 glass study?
Here are some concerns I have:
1) It is said that infection of the prostate cannot be transmitted, but what if it is caused by Chlamydia? Isn't a portion of the ejaculation discharge from the prostate, which means it could contain the Chlamydia, right? Could I thus infect my partner?
2) The infection went from my urethra to my prostate. It could very well go to my testicles and make me infertile, right?
3) There are a few cases where the infection of the prostate spread into the blood and causes Sepsis, which has a very high morbidity rate.
Apologies for the really long message. I really appreciate any insight you might be able to share. Thank you very much.
-An otherwise healthy 28 year old