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My doctor asked me to give a urine sample for bacterial infection after a prostate massage. Should I collect the initial urine (first part of the stream) or a midstream urine sample after the massage?

If you've had this test done or know the standard procedure, I'd appreciate your advice.

I understand this is a prostatitis sub, but given how the two are linked I figured I'd post here.

Any advice healing post urethritis inflammation?

I never tested positive to any bacteria, this all stemmed from an unprotected sexual encounter on may 16th, noticed first symptoms (discharge, pain, acute inflammation) on may 21st, the day my life changed for what feels like will be forever at this point.

Whilst the discharging and urinary frequency has stopped, my glans has distinct white patches/splotches and feint brown dots that seems like swolen glans that do not itch, the meatus is inflamed (dark glans colour/redness that fluctuates, fish/botox lip opening) but not bright red or as bad as it was first pre treatment (1g azith, 14 days 100mg doxy)

Even light/quick masturbation on the very few times I have tried, results in the redness temporarily flaring for an hour or two, and i feel tightness/pinching in the urethral tube right on climax with lingering pain for an hour or so after followed by worsened pelvic feelings and general discomfort/awareness, i could not imagine what actual sex would do to it and how i would even explain this to a partner without scaring them off, not that I'm in a rush to engage in sexual activity after this nightmare anyway but the point is, im still not okay and my function is far from normal..

If anyone in a similar position who eventually recovered can share their story, wisdom or any advice whatsoever and maybe give me some hope, it would be greatly appreciated.

Next Monday, I have an appointment with a sexual health clinic that saw me 3 weeks ago that told me "give it two weeks you'll be back to nornal, if not, call us" and am hoping i can form a good plan moving forward, it will also be 3 weeks since my last antibiotic test so im in a good testing window now and plan to test for everything they possibly can just to rule out residual infection, the person I had that fateful encounter with is also testing and is now supporting me through this which i greatly appreciate, she gets results tomorrow from her urine and swab tests, we're both pretty nervous however she is completely asymptomatic.

I have a complicated case of chronic prostatitis that started after sexual contact with a woman who had a sexually transmitted infection (STI). I had multiple standard cultures performed, but no bacteria were detected, even though I initially had urethral discharge and severe pain during urination. Later, my symptoms progressed to urinary frequency and pain in my lower abdomen and perineum.

I have received several courses of antibiotics: first 15 days of doxycycline (Vibramycin), then 20 days of levofloxacin, followed by another 15 days of doxycycline, 14 days of azithromycin (Zithromax), 14 days of cefixime for suspected gonorrhea, and I also received an injection of ceftriaxone.

More recently, Escherichia coli (E. coli) was detected on a urethral swab. I then saw an infectious disease specialist, who prescribed 6 weeks of trimethoprim-sulfamethoxazole (Bactrim) and 4 weeks of doxycycline.

What would you recommend I do? I still think a persistent Ureaplasma or Mycoplasma infection may be responsible and that it has caused chronic prostatitis. Has anyone experienced something similar or have any advice?

I also have balanitis. I'm not sure whether it is related to all of this.

Disclaimer (AI drafted): I've been inputting my various symptoms and experiences to Gemini and I asked it to summarize my experience to date in a digestible format for this Reddit post.

TL;DR: Had sudden, unbearable 9–10/10 left testicular pain 6 weeks ago. Emergency surgery (orchiopexy) performed; surgeon saw no active 360° twist but stitched testicle to scrotal wall anyway. Ultrasounds confirm testicle is healthy and fully healed, but I’m left with 1–2/10 pain aggravated by walking and tight clothing. Also had pre-existing shaft symptoms. Looking for thoughts/experiences regarding nerve irritation, CPPS, or pelvic floor involvement.

Pre-Event Symptoms (2 Months Prior)

• 37M, located in Europe.
• For ~2 months leading up to the main event, experienced an intermittent itchy or needle-like pain inside the penis shaft, particularly noticeable during erections.
• Avoided seeing a doctor at the time.
• A few days before the acute event, applied over-the-counter thrush/candida cream to the tip of the penis.

Acute Event & Surgery (6 Weeks Ago / Mid-June)

• Sudden, severe ache in left testicle while walking to the store. Escalated to unbearable 9–10/10 pain within 20 minutes (hardly able to speak/walk).
• Went to ER. ER doc suspected testicular torsion; administered strong painkillers and attempted manual detorsion.
• Emergency Orchiopexy: Under general anesthesia within 2 hours of pain onset.
• Surgical Findings: Surgeon reported no visible evidence of active torsion upon opening, but performed left testicular fixation (stitched testicle to scrotal wall) as a preventative measure.

Post-Op Course & Medical Workup

• Hospital Stay: Discomfort & brief severe pain spike overnight; discharged after 2 nights following a clean ultrasound.
• Infection Suspicion: Developing pain days later led doctor to suspect infection.
  • Urine culture: Negative
  • Semen culture: Negative
  • CT Scan: Negative (ruled out kidney stones)
• Antibiotics Taken:
  • Course 1: Amoxicillin (finished late June) -> temporary mild improvement.
  • Course 2: Doxycycline (1 week in early July) -> minimal change.
  • Course 3: Amoxicillin again (7 days) -> minimal change.
• Prostate Check: Doctor examined prostate recently, noted nothing major.

Current Status & Triggers

• Ultrasound Results: Multiple follow-up ultrasounds show the left testicle is healthy, structurally intact, and well-perfused.
• Current Pain Level: Settled at a low-grade, persistent 1–2/10 ache/tenderness (down from a 4–5/10 flare-up early July).
• Specific Triggers:
  • Walking: Repetitive movement triggers a cumulative dull ache.
  • Clothing: Any pressure from tight underwear seams or pants against the scrotum creates tenderness.
  • Ejaculation: appears to trigger pain in following hours but not sure if this is imaginary.

Questions for the Community:

1. Has anyone experienced persistent mechanical/nerve pain after testicular fixation (orchiopexy) even with clean ultrasounds?
2. Could the pre-existing shaft itching/needle sensation combined with the traumatic pain event point toward pelvic floor muscle guarding or nerve entrapment (CPPS / Genitofemoral / Ilioinguinal nerves)?
3. If you had similar symptoms post-surgery, did pelvic floor physical therapy or nerve-modulating treatments help?

I just started baby Pose exercise a day ago and I see my symptoms approving like less urgency after peeing and less frequency.

I also have little pain and burning in ureatha and left side penis pincing pain which have decreased alot.

Idk if anyone wants to give it a try.
I do it in the morning for two minutes and afternoon and before bed.

I almost feel normal and i hope this progress continues

Wanted to talk to anyone that has had PRP injections into the glans, meatus and shaft for glans and meatus damage, inflammation and pain.

Ive been prescribed 100mg of doxycycline twice a day for 2 weeks for what the dr says could be difficult to detect bacteria in the prostate since all labs come back negative. Did a ureaplasma test im still waiting results on but he said to take it anyways. Ive been reading some stories about people getting psychological (even psychosis) side effects from doxycycline. Whats been your experience at treating prostatitis/ non bacterial prostatitis with this antibiotic ? Should i wait for my appointment and ask the doctor for an alternative? Im a very anxious person when it comes to taking medication that pose these type of side effects

I'm 29 years old male , healthy no medications no other issue , no urinary issue or blood in urine

about a month maybe even a month and a half i noticed blood in semen , at 2 weeks mark it went away and then came back and still present .

if i dont ejaculate for a lot of days the blood gets heavier and more concentrated .

I did 2 semen culture checks and STD check .

STD came back as negative and Semen Cultures came with a rare bacteria called "Strep. dysgal./canis" .

This bacteria is from dogs and cats and I have a dog but no clue how it was transferred .

Ether way I started Antibiotics based on the resistance test they did in the semen culture but after 7 days nothing changed .

Urologist said that this strep bacteria is not the issue and antibiotics should have solved the issue even in less than 7 days ,

He gave me other type of antibiotics and said that he suspects Protstatitis as a main cause .

Further investigation will be done later if it persists but wanted to ask you guys if that’s reasonable and common for Prostatitis ?

Usually whenever I drink a lot of water . It causes burning urine mainly inside of glans . It burns and stinging . So today it happened . After it went away . If I get aurosed or erect muscle in penis pain .what's happening .iam panicked

Not anxiety, posture, etc. The only thing that seems to decide whether I have CPPS or not is how good the ejaculation was.

If I have a really strong, satisfying orgasm: CPPS completely disappears and stays gone.

If the orgasm is weak or unsatisfying: CPPS, agiation, hard flaccid, etc. all come back immediately and stay there 24/7 until I have a good one again.

Of course, once it comes back I start trying to force a good orgasm, which obviously makes it worse and usually leads to another lackluster one lmao

Anyone else?

Has anyone had PRP injections in their glans, meatus and shaft to heal damaged glans and meatus?

Some background, Late 30s M, Caucasian. I have been having dull orgasms where it's not painful but I feel a warming sensation when ejaculating, but no other symptoms. Not sure when this started but I feel like it was a boiling frog. I'm noticing it now. I've not been diagnosed but think I have PE as well, and have had a history of edging/stopping while having sex to last longer. I've also been very horny lately.

I've been doing the reverse keagles and other stretches, recently discovered massaging my perenium at the point of orgasm helps a lot to make it feel more normal.
Is this cpps or something else?

My urologist put me on antibiotics but it didn't help and I have a follow up next week where I believe next step is cialys and a prostate exam. Does anyone else only have this symptom out there? It's not painful ejaculation, but pleasure is very muted, the rest of sex pre orgasm still feels good. I think maybe I lost sensation in my pereneum for a while and am starting to get it back (maybe?), but I'm trying to figure out if anyone else out there is similar.

hello! not sure if this is the right subreddit because I don't know what this could be.

on July 9, i developed pain at the base of penis, slightly to the left, after masturbation. it hurt only when touched (during palpation). after about 3 days, the pain became much less noticeable, so I masturbated again on July 12 and 13.. after that i noticed another symptom that freaked me out: both times semen was too liquid, watery (there was some white cum clumps though) after those sessions the pain came back, so i haven't masturbate since.

on July 17, i saw a urologist, he examined my penis, testicles, prostate, nothing abnormal was found. I didn't even have the pain during the examination. later that day, after i had an erection and touched the area, the pain returned.

i also had a urinalysis: no signs of UT infection. an urologist recommended me to do a semen analyses to rule out an infection, which currently I am afraid to do, because I assume that pain will come back after an erection/masturbation.

(TL;DR) my symptoms are:

• pain at the base of penis, when pressing the area, which worsen after masturbation/erection
• extra effort to squeezy out the last drips of urine (is it urine dribbling?)
• watery semen, which worries me the most

any advice needed, any similar cases? does this sound more like a muscular/soft tissue injury, or could it be something like prostatitis or seminal vesicle inflammation? the thing that scares me the most is watery semen.. should i do a semen analyses anyway?

Hello everyone.

For me it all started 4 years ago after severe stress.

I got symptoms out of nowhere pain and irritation in pelvic floor and penis I also got hardflaccid. When it started it was 10/10 for about a month and a half. Anxiety and stress over symptoms made it that severe. After about a month and a half after I stoped caring about it it all went away. I was completly symptom free for a month. Then it came back but it was only 1/10 this time and wasnt constant.

First 2 years my symptoms were very minimal. Most of the time in first 2 years I was symptom free.

Now about a year and a half ago symptoms slowly got worse and I again suspect because of my fear and anxiety over them. I read tons of horror stories and worried about everything that was happening to me.

Every symptom every change frightened me and I spiraled in very dark toughts. All this made it worse.

Now about 9-10 months ago I started experiancing numbness in penis after a very normal sex. Nothing rough, no injury, absolutly nothing abnormal.

My penis just went numb after sex and I only noticed in the shower after. The water felt weird. Like my penis is covered with condom. Also temperature sensation is very very minimal.

Didnt think much of it as I tought its just maybe a flare up and will go away. Well it didnt. My sensation since then is minimal in my penis. In the shaft and in the glans. But I do still have normal sensation in inner foreskin area tight under glans where I was circumsised. I feel temperature and touch well there.

This is now starting to scare me. Im not sure what im dealing with as I never had an actual injury.

I had spine MRI and its clean.

I had Pelvis MRI and its clean

Blood work also clean

No diabetes

No vitamin deficency.

Prostate ultrasound - normal size normal results

Test for bacterias - negative multiple times so no infections ever

Ive been to pelvic floor PT last week and here is what she said.

She did internal work and it went like this.

General pelvic floor tension is not bad.

She said most muscles are 3/10 tension in resting tone and she said that is normal for males.

She did find very tight coccygeous muscle.

Prostate area was very painful. When she pressed around prostate a sharp pain was felt at my penis glans.

Sitbone area also painful.

Im pretty much lost at this point. Why did numbness aprear like this and I never had it before.

Hope someone can help me out.

Can I still recover sensation ?

I still feel temperature but very little.

I feel light touch but its muted.

I feel a bit of pressure but also muted.

Other symptoms:

Pain in perineum and pelvic floor ranging from 1-4. Trouble sitting.

The scar area under glans from circumsision is normal tho.

I can get erect and have sex. Orgasm actually still feel good. Usually I feel it in penis glans and shaft.

thanks for anyone who read this and I hope for all of you to recover from this. God bless you all

I’ve tried anti biotics , diet , PT nothing helps . Need some
Hope

Has anyone see a urologist in London that just didn’t tick boxes ?

I posted a different paper showing linkage between CPPS and mast cell / tryptase. I also said that since taking Zyrtec twice a day my CPPS is gone. It’s still gone. I only hope that this helps someone else.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10592376/

I've had symptoms of hematospermia for about 5 days and have no other symptoms (fever, pain). I went to the doctor and he did urine and blood tests. There's a very small amount of blood in my urine. There's no inflammation in my blood or urine and PSA is okay. How many days will it take to clear up and what will the doctor's next step be? Each new ejaculation produces bright red semen btw.

Im 46band have had symptoms for almost 3 years. Just diagnosed with MCAS. Im on dupixent, hydroxyzine and quercetin specifically for that and will be adding a few more soon. Probably Ketotifen.

Wondering if the inflammation from these hyper active mast cells is causing prostate inflammation? Its causing asthma and EOE and my symptoms started at the same time of a huge flair that led me to the er multiple times right after covid.

Ever since, my psa numbers have been a roller coaster up and down. Lowest was 3.2.. highest was 5.9. Im currently 4.8 but just started all these medications 2 weeks ago. Im also starting pelvic floor therapy and an intense exercise routine to strengthen my legs after leg surgery a few years ago that wasn't properly addressed.

If I do get better, I won't know if its the medication, exercise, or the pelvic floor stretches. Oh and I also might start taking lexapro for anxiety. Im basically doing everything possible to finally get better.

Im wondering though. Has anyone with confirmed MCAS noticed any difference after starting specific MCAS medications?

Hi I'm having a lower abdomen discomfort and some of the veins become prominent I had also taken some antibiotics but nothing happened

It's quite irritating for me

Link to the image: https://kommodo.ai/i/xwJ58MbPg5OSKeCyOUiR

Hi all! My Dad (61) was diagnosed with prostatitis about 12 weeks ago. He was on a long course of Cipro, but no changes besides his mental health (the gut brain connection is real and insane). We also have no idea if it was even bacterial or not in the first place. He is in so much pain he is having near panic attacks and the shakes constantly. The urgency is also a real problem. He is not himself at all. He has to lay down—he can’t really sit, even with cushions. Walking does help and he paces a lot. He’s a bucket of anxiety over this? completely spaced out. His hands shake, a symptom he’s had on and off for a year or so, but it’s become much more severe and constant. Not sure if it’s related or not. Either way, this is all really scaring me. He has always been an independent and stoic man, very reluctant to ask for help. When he asked for help, I knew it was bad. He has a procedure coming up to take a biopsy and clean out some “excessive tissue” they saw on the testing he’s already had. He’s been trying stretches, ditching caffeine, etc. He can only take OTC medication or non-addictive because he is 20+ years sober. What else can I do to help him? Thank you!

Since last week, maybe Wednesday, I noticed my urine stream/output wasn't as strong as it usually is. Like in the morning I’ll have two water bottles and then have to urinate like crazy for an hour or so since I chugged water lol. But I noticed it wasn’t coming out as strong still. Also noticed a little groin pain on The left, and my pelvis area would sometimes feel pressure. But I never had a fever or burning or anything like that, just difficulty urinating sometimes. But then sometimes it comes out fine and fast. Right now I don’t have a PCP, but I found one and set it up for July 31st, the earliest they could see me. Also set up a urologist Appointment for August 11th.

Anyway, I went to my local urgent care and they did a urinalysis and it was all good except for a trace amount of blood and the clinician there wasn’t too concerned about it but sent it out for a urine culture And put me on cephalexin. I called back Wednesday and got the results and they were all negative, no infection, and they even did some STD tests to be sure and they were negative (I’ve only had one sexual partner, my girlfriend, that we have a child together). So I suffer from bad anxiety and stress, and definitely am a hypochondriac. So I went to the ER yesterday, and told them my problem and that I went to urgent care. They ran tests, urine and blood and did a CT scan. My urine and blood tests were okay and fine and didn’t show infection or white blood cells, but the CT scan showed my prostate was enlarged/mildly inflamed, and so the NP told me she was gonna put me on antibiotics to deal with it. I was kinda just flabbergasted and was trying to ask questions, but I never saw that NP again after she left the room to go see if my blood work was done. A regular nurse came in and he discharged me and gave me a first dose of ciprofloxacin. I then looked up that antibiotic and see that it can cause all these issues like tendon ruptures and tendinitis and nervous system problems. I take 1mg of clonazepam in the morning, and I was told it would be fine to still take it with it. I was so annoying since I kept calling the ER back about my bloodwork and the antibiotic and they said that’s what I was deemed to be put on by the NP for my inflamed prostate. I picked up the medicine today and took my second pill, and am going to take the second for the day around 10pm tonight.

But basically I’m wondering if it’s even bacterial? They said they werent totally sure I believe when I asked and called, but my symptoms pointed to that. But then I keep thinking it might be CPPS, since I have a lot of anxiety and stress and maybe made my pelvis floor weak from it. So I’m just sitting here constantly googling stuff since I can’t be seen by a urologist until next month and can’t get in earlier to my new PCP. And calling the hospital saying this antibiotic scares me to take, they say it’s the best one for prostatitis and that once they discharge you they can’t really change anything. And not to get TMI, but I noticed when I was going to ejaculate last night I reached climax but only like a drop came out. When earlier in the day it came out fine. So I tried again this morning and I barely ejaculated again, so that has me all nervous now why that started happening, I’ve never had that.

So ive been dealing with daily urethral burning that increases after ejaculation, sometimes peeing and after bowel movements for a year. Ive seen many urologists who have told me a range of things. The last one said it could be prostatitis/cpps and prescribed daily 5mg cialis + a 2 week round of doxycycline antibiotics. So far semen culture, std, urine culture, uti tests have all comeback negative. Im still waiting on a ureaplasma test i did yesterday. Question is, has cialis worked for any of you with similar symptoms? Its frustrating because this started one day last july and has stayed with me for a year now without a cure. I also have pain in the left side of my testicle although not thr testicle itself, more like the veins beside it/on top of it. Im also scared to do thr antibiotics bc ive seen they cause insane sunburns even with little sum exposure (i work in the sun)

It seems to work pretty quickly for me which makes sense as it's just supppsed to relax your pelvic floor muscle.

Does it take it a few days of taking cialis for you guys?

Thanks

Hello guys I've been suffering somewhat from this and I will cut directly to the chase. To tell you what my symptoms are basically the feeling of unemptied bladder, lack of libido and related symptoms, and irritation in the bladder etc.

I never had massages before but 2 years ago when I went to holiday in a very touristic part I decided I should maybe get massage for the first time in my life. I never thought about cp/cpps at that time and how it'd relate. So I booked 30mins swedish massage + traditional Turkish hammam scrub and foam massage and this would take 20 mins so it's 50mins in total. Keep in mind if you are getting a massage like this in a hotel or reputable place it's usually a female staff that gives you the massage and not some fat hairy dude. Anyway, I first go to sauna for 5 minutes and then I lay down in the heated marble platform of the bath. First scrub and foam massage and then I went to get swedish massage and let me tell you after everything was done I had an immense feeling of warmth in my pelvic area it's like blood rushing to there and I felt so good in general in that day and every issue I had was gone for that day. After this experience I tried several other massages like thai and balinese massage or swedish massage without the hammam part but none gave me the exact feeling. The hammam part is what makes this work somehow for me because I've booked this exact swedish massage + scrub and foam massage later and got the similar good experience of warmth and pleasure in the pelvic area. It's something else somehow because I tried jaccuzis and hot tubs and just staying there doesn't provide the same effect. Anyway, I wanted to share this maybe if you get such an opportunity you should definetly try this. I get it from time to time and when I do my day goes very well.

I have a cystoscopy procedure tomorrow and would appreciate any advice you can offer. Thank you so much!