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Chlamydia followed by Prostatitis

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
1 Responses
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Avatar universal
The most likely explanation is that your prostate issues are caused by an issue other than chlamydia. If the chlamydia was still present, then you do still expect to test positive in a urine test. It does seem that some men do experience prostate issues for some time after chlamydia is gone but I am not always convinced this is just the chlamydia.

Persist with your treatment. Chlamydia can cause issues but this is rare, the most likely outcome is that the body clears the bacteria without longer term damage or impacts.
Helpful - 0
Hey.  Your symptoms sound exactly like mine.  Im hoping youre not experiencing them still but would you happen to let me know how youre feeling lately and/or what happening w your bout?  Im in my 3month stage of experiencing the same issues w no sign of relief yet.  And went through all my bouts of medication.  Hope you get this and if so, please let me know.  Thank you!

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