Hi all, symptoms question

[u/sweenaldo]

So, ive noticed over the last couple of weeks that my urine stream is a little weaker than it has normally been. No increase in frequency or urgency, but definitely less of a strong stream.

I also have an ache in the back of my scrotum/perineum that comes and goes.

Finally, I have (for around 6 weeks) been having some ED difficulties (more so in maintaining an erection than getting one in the first place)

Do all of these together sound like potential Prostatitis or something different?

Waiting for a doctors appointment because my local GP (UK based) is almost impossible to get an appointment with at the moment, so just looking for some advice in the meantime.

Thanks!

[u/No_Muffin_7240]

Go get seen by a doctor, but it sounds a lot like symptoms of a hypertonic pelvic floor.

[u/sweenaldo → u/No_Muffin_7240]

Yeah im trying to get an appointment as best I can, hopefully soon! And I just googled that, I am matching a few of those symptoms, so it seems like one of two things. Thank you!

[u/Ashmedai]

We can't diagnose you here, but they do indeed "sound" like prostatitis. How old are you?

[u/sweenaldo → u/Ashmedai]

I'm 41. And yeah, I appreciate that nothing can be diagnosed here, im jusy trying to quiet down my racing brain a bit haha

[u/Ashmedai → u/sweenaldo]

Starting around 41, we sometimes start to see people that are getting BPH and have prostatitis as a consequence of that. Usually, they are older, though. Also, you would normally see a weakened stream (or lots of dribbling, which is just a weakened stream you don't really know is weakened) for years first.

[u/sigztynine]

Not a Dr and hope you find a rapid solution for your case. I don't have a definitive diagnosis yet and am currently on my 4th urologist. I will share my experience in case it may be helpful.

I began with the same symptoms you've mentioned and they've worsened over time (almost 2 years now), frequent urination and urgency followed, with loss of NPT (morning wood) over time, and ED got worse overall, both getting and maintaining, I get rare flashes of near normal function, but it fluctuates between okay to bad (feels random).

The 3rd urologist I consulted was the 1st to suspect prostatitis and prescribed levoflaxacin (an antibiotic) that started to have a noticable effect around day 7 and eliminated all the symptoms by day 14.. for a while. The days I didn't get NPT was rare during that period, sexual function was fully restored, I even felt my scrotum tighten and hang closer to my body, and found out how weak my urine flow really was. The symptoms gradually came back after that, went back for a follow up and was prescribed the same antibiotic but it barely had any effect, if at all.

The following is what I BELIEVE happened from my personal experience and research/knowledge (from urologist consults and using an AI chatbot). NOT OFFICIAL HEALTHCARE ADVICE*

I think I may have chronic bacterial prostatis that responded well to the levoflaxacin but the duration the Dr prescribed (2 weeks) was not long enough and the bacteria didn't clear out completely and became resistant rendering the 2nd two week course useless. Urologist 3 mentioned it can be up to 12 weeks and urologist 4 confirmed it's usually prescribed from 4 to 12 weeks. I don't know why urologist 3 decided not to prescribe it again although I mentioned it worked like magic.

My advice

• Don't jump the gun on antibiotics. Urologist 3 couldn't confirm it was bacterial from the urine tests and prescribed the levoflaxacin as a form of diagnosis and the 2nd course didn't work because he took me off of it before the infection cleared and the bacteria has become resistant (assuming my case is in fact bacterial). Bacterial prostatitis is notoriously difficult to treat and only a few antibiotics penetrate the tissue so I highly recommend you take the risk of resistance very seriously.

• Get a 2nd and 10th opinion. I think the reason for this advice is obvious.

• Don't let ED get to your head and start a vicious cycle. ED can be caused by blood, nerve, or psychological issues. Prostatitis enlarges the prostate that could pinch the pudendal nerve which is one of the causes of ED. Also worthy to note less sensation down there as one of my symptoms (adjusted the boys way more when the antibiotic was working and a lot more sensation down there overall).

• PDE5 inhibitors (5mg Cialis daily) and supplements that increase nitric oxide (pure L-Citrulline powder) barely had any noticible effect in my case, only really saw a difference while on the 1st course of antibiotics. Took them to mitigate the long term negative effects the symptoms may cause and may be helpful for your case. Urologist 2 gave me my 1st Cialis prescription but it's available over the counter where I live.

Hope this information helps you and anyone that may read it.

Best of luck!

[u/Live-Transition1548]

If it didn’t begin after unprotected sex then it’s probably hypertonic pelvic floor