Dysuria, pelvic pain, other mild symptoms - prostatitis or something worse?

Patient

Q: Hello.

In mid April I noticed while urinating that the meatus of the penis appeared slightly swollen. Shortly after this time I noticed it burned slightly right at the tip after urinating. On some occasions it looks flat on one side, and slightly red.

I had a urine test done on two separate occasions, both came out clean. I was prescribed an antibiotic, and about three or four days after completing the course the pain went away. It eventually came back, lasted a few weeks to a month, then went away. Now it's back.

Over the past few weeks I have also noticed odd groin pain that was very sporadic, and typically occurred or was at its worst when I sat down. When I was standing or lying down the pain was virtually non existent. At times it also feels...well, weird. It lasts a few seconds on the skin and typically right about the base of the penis, then disappears. Other symptoms include the feeling of needing to urinate immediately after doing so, occasional dribbling, and, in the mornings on some occasions, dark colored, foul smelling urine.

For the past month I have also been experiencing jock itch. It wasn't going away, so a little under a week ago I got an oral anti fungal and some prescription strength cream. Since taking it, the pain in the groin and pelvic area is pretty much gone, though the swollen meatus and slight burning or stinging after voiding my bladder is still present.

I have had no lesions or sores, though on occasion I will get acne and ingrown hairs on my groin and buttocks. Those typically go away within a couple of days and do not hurt or break open, nor are they filled with fluid. I have had a doctor look at them on several occasions, and the diagnosis is always the same, folliculitis or acne. I never experienced swollen glands, flu-like symptoms, fever, or anything that typically occurs with an initial HSV infection. The last time I had sex was in late December 2010, and the girl it was with said she got tested for all STDs, including HSV, immediately afterward, and it all came back clean. In fact, every time I have broached the subject since then she gets mad at me. I have been tested for Chlamydia, Gonorrhea, and HIV, all came back clean.

So I guess to summarize

Symptoms: are infrequent mild groin pain and a weird feeling on the skin; dysuria with swollen meatus, frequent urination and need urinate; pain while sitting; occurs every other month or so for about a month at a time. Not severe, mostly annoying than anything.

My diagnosis based on the symptoms and reading about those with similar symptoms? Prostatitis.

Thoughts?

Doctor

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