Prostate/UTI what is it?

Patient

Q: I started with problem urinating - poor stream and heavy straining to get sometimes a dribble out. Felt like urine was also stuck inside penis causing irritation. STD/blood/urine tests all negative, so doc tried cipro for 7days. This made no difference so cipro+doxycycline and oxybutinin for 14 days. This provided much more relief felt was getting somwhere. However last 3 days this has all came back with a vengeance - back to square 1. Had ultrasounds and nothing showing. Also getting some pains from side to side of testes. Ruining my life :( nhs says wait 6 weeks for ursoscopy of bladder etc.

Symptoms:  Irritable uretha, sore abdomen,dizzy, tired
Doctor

A:   Hello. Welcome to Ask The Doctor.
Thanks for trusting us for your health issues.

If we go according to your symptoms, following are the possibilities:
1. Urinary Tract infection.
2. Stones somewhere in the Renal Tract probably in ureter.
Prostate is very unlikely as you are young. However prostatitis is a possibility.
Moreover, your ultrasound is also normal so prostate hyperplasia is also has been ruled out. In fact, Prostatitis also gets evident on Ultrasound.
Urinary Tract infection (UTI) usually gets in urine examination but may not get evident if antibiotics are taken before the sample. In your case I would like to treat you with an antibiotic like Nitrofurantoin as most bacteria's are resistant to Ciprofloxacin now a days.
Let's keep UTI also aside.
My first diagnosis for you is Stones in your Renal Tract. Moreover, the radiating Pain to tests indicates that it might be in ureter. 10% of the stones are not visible on Ultrasound.
So I would advise you to get a NCCT Kidney and Bladder done. It will rule out the presence of any stones.
Cystoscopy being invasive procedure should be kept as last resort.
Also, get a repeat Urine Culture done.
Share my opinion with your doctor.
Stay Healthy.

Comments / Follow Ups

Patient: thanks doctor, i had ultrasound of kidneys done and bladder they came back negative. I had 3 urine cultures and all negative.
Would doxycycline ive been taking not kill everything? im really in unbereable irritation. whats most likel cause of it
Doctor: As i told you 10% of stones are not visible on Ultrasound. You need to get NCCT Kidney and bladder done first of all.
Antibiotics will help only if the cause is UTI.
Good Luck.

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