what could this be?

[bosnianworrier]

For the last 4 years I have pain in both testicles. Its there mostly if I touch it or poke it but the pain is very very severe. Also often I have burning pain in my penis during and after I urinate. There is some strange foul smell in my urine. I am going to see a new urologist soon. The 1 I say 2 years ago said it is normal without even checking me. I did urine and blood work a number of times and it always came back normal. I also have sexual dysfunctions and anxiety disorder. Age 28.

[Vanessa Lacuesta]

Hi,

I understand this may be very frustrating for you.

However, it is posssible to get normal and insignificant urinalysis and culture results in the presence of an underlying prostate problem. I suggest you discuss with your physician the probability that this is chronic prostatitis, prostatodynia or urethral syndrome.

Chronic prostatitis may present with a negative urine culture but may present with bacterial growth in the prostatic secretion culture. Prostatodynia may present with discomfort in the groin area but the culture results may not show anything. Urethral syndrome may present with pain and burning in urination as well as increase in urinary frequency.However,the urine culture in urethral syndrome may not necessarily show anything.

Do discuss this with your physician.I believe you are being managed well.This should offer some form of relief.

[bosnianworrier]

There is some sensation of urinary retention during urination. But no too bad though. I also suspect underlying infection, but where? My last rectal exam showed no prostate problems but the pain and smell is there. I also had abdominal ultrasound and it showed mild fatty liver but I doubt it has anything to do with my problem.

Sometimes I have anal discomfort after #2. It is all very complicated and my worst fear is that doctors will find nothing.

[Vanessa Lacuesta]

Hi,

You may inform your family doctor about the tests . A urinalysis may be easily  done. It is best to have the urine culture done prior to antibiotic use and have the results followed up to guide treatment.Your urologist may be able to request for the urine  and prostate secretion cultures.

Your symptom of testicular pain, burning pain and foul smelling urine suggest an underlying infection.

Is there any sensation of urinary retention during urination?

Prostatitis is a condition which is relatively not easy to treat. One differential for you is chronic prostatitis.Chronic prostatitis may require further evaluation as this may involve nearby structures like the testicles.

[bosnianworrier]

Sexual Dysfunctions started about two years ago. Can't have ercetion and when use viagra, there is no feelings. I was taking celexa at the time and now switched to effexor but no imptovement

I did 2 testicular ultrasounds and 1st one showed imflammation and second one (2 years later) showed nothing wrong.

I am not sexually active plus I'm married and our marriage is sexless.

I was tested for HIV and other diesase that they test with urine sample (not sure for the name) and it was all negative.

I did cardiac testing and was good.

I think there is something wrong with one of the following

1) bladder/prostate (urology related)
2) Neurological  (did a brain ct 2 years ago)
3) Anxiety

Please define what is repeat urinalysis. Should I wait for to see urologist for a urine culture with prostate secretion culture or should I ask my FD right away.

PS. I was diagnosed with prostatitis or prostate ifllammation 2 years ago by rectal exam and was on antibiotics but it didnt relieve my symptoms.

[Vanessa Lacuesta]

Hi,

You have posted that you have sexual dysfunctions and anxiety disorder. Would you be able to elaborate more when you say sexual dysfunction?

I suggest that you get a second opinion with regards to this. You may need a repeat urinalysis, a urine culture with prostate secretion culture done.Also, a testicular ultrasound will be able to determine any involvement of the testicles and epididymitis and other structures in the scrotum.

Severe pain in the groin area in the absence of any significant urinalysis or urine culture results may suggest that you be further evaluated.

As this is relevant to your case,allow me to ask some sensitive questions.So please bear with me:

May I ask if you are sexually active?

Have you been tested for STD's?

[bosnianworrier]

forgot to mention. More often that not I get numbness in my penile area especially during sex or masturbation.