• 5 months ago

    Urethra/meatus inflammation/irritation lasting for 2-3 weeks after sexual activity

    Thank you, anyone who reads this and decides to help. I am at my wit's end. Apologies for the novel.

    For the last 18 months, I have been suffering from chronic bouts of inflammation/irritation around my meatus/urethra hole, including random pains and sensitive areas that come and go near the frenulum and down the shaft a bit. Each time this happens, it is within 24 hours of sexual activity and ejaculation - either with my female partner or by myself.

    When flared, walking is challenging due to the penis rubbing on clothing, causing irritation. The pain is dull, but rarely lets me forget it is there. It is sometimes a little achy after urination, and I am noticing much more urine dribbling (incontinence) while flared - 4-5 drops every time I pee. Also noticed a semen discharge 2-3 hours after I masturbated last.

    A flare generally lasts between 2-3 weeks either with medicine (Cipro with or without fluconazole) or without (no meds, left it alone).

    My doctors are pretty stumped: Primary Care referred me to urology, Urologist says it is because I am too rough (i'm not) and need to use more lubrication (using as much or more than I have my whole life), Dermatologist said contact dermatitis and to use hypoallergenic laundry soaps, bath washes, and hydrocortisone. Washed all underwear in hypo-laundry soap 3 times. Have not put any soap on glans in over a week. If dermatitis, should have seen improvement, right?

    Currently seeing an Osteopath for a different angle (gave me a better cream that didn't help, looking for a better Urologist), Pelvic Floor Physical Therapy (chronic prostatitis for 10 years, non bacterial), and going to visit a psychiatrist to see if it may be in my head (end of the month).

    Was in the local ER a week ago for what they diagnosed as epidydimitis - swelling feeling, pain, and raised testicle on one side. Gave me 10 days of doxy. Feeling better but not perfect yet.

    Been tested:
    Chlamydia, Gonorrhea, Syphilis, Hep C, Trich, HIV
    No warts or lesions suggesting HPV/Herpes
    Urine tests show no blood, leukocytes, PH between 6-7
    Multiple DRE for prostate - normal
    Cystoscopy in Nov. found nothing except a small soft stricture in proximal urethra (16 FR).
    Ultrasound of testicles found a small hydrocele in each, but nothing else
    CT of pelvic region found nothing

    Meds tried: Cipro more than once, fluconazole more than once, Doxy twice, moxifloxacin (in case of mycoplasma genitalium), azithromycin, Nystatin oral (in case of candida/yeast), Uribel, hydrocortizone 2.5% cream, eucrisa gel, miconazole cream. I would love to take a NSAID, but I can't - gastric sleeve.

    It seems to happen randomly - I went almost 3 months between flares, and I have also had 1 week between them. Never happened with any other partner or masturbation prior to my first flare, but it is also happening when I masturbate.

    My current flare has been for almost 6 weeks, but the difference is I had sex and masturbated twice during the flare (scientific method) to see if 1) it would hurt (it didn't, but made me more sore for the next couple days), 2) show signs of something in my partner (I know that's horrible, but she understood and wasn't worried given all the negative tests I had - she has no symptoms), and 3) prolong the flare, which it has.

    Some ideas bounced around:

    Somehow I am damaging the meatus/urethra and it just needs to heal
    Using too little lubrication (I really don't think so)
    Some infection that hasn't been tested for yet: ureaplasma, H pylori, CMV, EBV, etc.
    Nerve damage (I don't have many of the classic signs for pudendal nerve issues though)
    Something in my semen is setting it off, like PGE2
    A very recurrent yeast infection (I cut out sugar and eat