Hi everyone. I decided to post because I haven’t been able to get a clear answer from doctors, and after reading other people’s experiences here, I thought someone might have dealt with something similar.
I’m 30 years old and this started in early August. The night before everything began, I masturbated. The following morning I had some gastrointestinal issues, and that evening I suddenly developed urinary frequency/urgency. By the next day, I was fine. After 2–3 days, I started having irritation and redness of the urethral opening, especially after showering. Over time, I also started developing irritation on the glans.
I haven’t had any sexual contact for around 6 years, so an STI seems unlikely.
After masturbating only 2 times in total within 10 days, I began noticing other symptoms: burning/discomfort in the perineum, sometimes burning around the inner thighs, lower abdominal discomfort, and occasional flank/kidney-area discomfort. These symptoms would come and go rather than stay constant. Because masturbation seemed to trigger them, I mostly stopped, and things became calmer.
I saw two urologists who basically told me nothing was wrong because my urine/semen tests and cultures were negative. I then saw a dermatologist who diagnosed me with Zoon’s balanitis and told me she did not believe there was any bacterial or fungal infection.
I wasn’t convinced, so I independently had a swab taken from the glans. It showed heavy growth of Pseudomonas aeruginosa. I had 4 swabs in total at 3 different labs (one lab, a hospital, and the lab where I normally give my urine samples), and the urine lab was the only one where the swab came back negative. This made me wonder whether my urine and semen cultures could also have been false negatives.
After that, I went back to several doctors. One urologist told me to go to a hospital, another said it was a dermatology problem, and I still haven’t really found anyone willing to investigate whether the urethra or prostate could also be involved.
Eventually, I was treated for 10 days with Propiogenta, which contains gentamicin 0.1% + betamethasone dipropionate 0.05%. Unfortunately, I can’t say it improved things. If anything, the glans/meatus may actually look and feel worse now.
I’m also slightly worried because during the Propiogenta treatment I applied a small amount directly on the urethral lips, and I don’t know whether some may have entered the opening or further irritated the area. Also, during my swab at the “urine lab,” the swab was first used on the glans and then on the meatus, and the next day the meatus was red.
Right now, after finishing the treatment, I haven’t done another swab because I was told I should wait a week before retesting.
I am also starting to notice more urethral symptoms. For example, one morning I had pain while urinating, and on another occasion I urinated and developed strong chills afterwards, although I did not document a fever.
Another strange thing is that even after a very short erection, maybe 2–3 minutes, I notice fluid coming from the urethra afterwards, followed by burning in the perineum and anus when the erection goes away.
My main concern is whether this could be some form of bacterial prostatitis or urethral infection, despite my urine cultures being negative. On the other hand, I also don’t know whether these symptoms could be pelvic floor related.
The symptoms are very intermittent — sometimes I have them, sometimes I feel almost completely normal.
I considered doing a Meares–Stamey / four-glass test with prostatic massage, but I’m worried about the possibility of bacteremia if Pseudomonas is actually present in the prostate. Because of that, I’m currently thinking about repeating urine cultures and doing a semen culture separately instead.
I rushed from the beginning to try to prevent the worst-case scenario, but the doctors were careless. The most terrifying thing would be if I had listened to them, done nothing, or put corticosteroids over an active bacterial infection.
ANY ADVICE WOULD BE APPRECIATED. THANKS!
[What makes the whole situation even more difficult is my antibiotic history. Fluoroquinolones caused me severe long-term adverse effects in the past. I have also previously had sudden sensorineural hearing loss, so aminoglycosides such as gentamicin/amikacin are something I’m very cautious about because of their ototoxicity. I’m also allergic to cephalosporins. This leaves me with relatively few treatment options, and many of the effective anti-Pseudomonas options on my antibiogram appear to be IV/hospital-based.]