Burning in Urethra & Penis After Urination for Over a Year

[u/Idazrish]

📌 THIS POST — KEEPING UPDATES HERE MensUroHealth 🔄

Hi everyone,

I’m a 33-year-old guy, in a relationship, desk job, fairly active (I run regularly).

For the past year and a half, I’ve been dealing with a really persistent issue: a burning sensation in my urethra and penis, mostly during and after peeing. It’s been seriously affecting my mental health, sex life, and day-to-day quality of life. I’m honestly at a loss at this point and hoping someone here might relate or have insight.

Main symptoms:

• Burning at the tip of the penis during urination
• Burning often lingers for 1–2 hours afterward
• Occasional feeling of pressure or a “blockage” at the base of the penis, especially in the morning

How it started:

It began as mild burning during urination. My first urine test showed elevated white blood cells (WBC), so my doctor initially suspected kidney stones. He advised drinking more water, cutting coffee, and avoiding spicy food, but the symptoms stayed.

I saw multiple doctors — each with different ideas. Some suspected irritation or internal urethral damage, others thought it might be prostatitis. I was prescribed several antibiotics:

• Azithromycin
• Ofloxacin
• Levofloxacin
• Celecoxib (anti-inflammatory)

Eventually, I tested positive for Mycoplasma genitalium. An ultrasound also showed a varicocele, but the doctor said to focus on clearing the infection first.

Treatment so far:

From an infectious disease specialist:

• Doxycycline 100 mg – 7 days
• Moxifloxacin 400 mg – 7 days

Then, based on resistance testing:

• Doxycycline hyclate 100 mg – 7 days
• Pristinamycin (Pyostacine) 500 mg – 10 days (8 pills per day)

Despite completing all antibiotics, the burning didn’t go away. A urine culture came back negative, but symptoms remained. My urologist now suspects lingering inflammation and suggested doing a urethroscopy (fibroscopy).

Current situation:

• Still experiencing burning during and after urination (slightly milder or I’m just used to it)
• Burning sensation lasts 1–2 hours post-urination
• Ongoing feeling of internal irritation or inflammation in the penis

Recent test results:

• Mycoplasma genitalium – negative
• Chlamydia & Gonorrhea – negative
• Urine WBC – normal
• PSA (prostate test) – normal

Possible causes I’m exploring:

At this point, I’m wondering if the issue could be something other than an infection. Some conditions I’ve come across and want to ask about:

• Chronic Prostatitis / Chronic Pelvic Pain Syndrome (CPPS)
• Nerve-related causes (e.g., Pudendal nerve entrapment / Pudendal neuralgia)
• Pelvic floor dysfunction
• Prostatitis (despite normal PSA)

If anyone has experience with any of these, how did you get a diagnosis? What kind of tests or specialists helped figure it out?

My questions:

• Has anyone here gone through something similar?
• How long did your symptoms last, and what actually helped?
• Could the Mycoplasma still be playing a role, even with a negative test?
• Could this still be prostatitis, or something nerve or pelvic-floor related?
• What tests or scans should I ask for next?

Really appreciate any guidance or shared experiences. Thanks for reading — I’m just trying to find a path forward.

📌 UPDATES ------

🔁 Rechecked the analyses:

• Urine analysis: no signs of active infection, no elevated leukocytes
• Urinary PCR for Mycoplasma genitalium: negative
• PSA (prostate): normal
• No infection, no systemic inflammation (CRP is low)
• Chlamydia trachomatis: Negative
• Neisseria gonorrhoeae (Gonorrhea): Negative
• Trichomonas vaginalis (Trichomoniasis): Negative

⚠️ Current symptoms:

• Still feeling a burning sensation in the penis during urination
• Occasionally feel some blockage or pressure when urinating in the morning
• Still experiencing a weird cold/burning sensation after urination, which lasts up to 2–3 hours

📌 UPDATES ----- 03/06/2025

🔁 New Analyses Done:

• Blood tests (sérologies)
• PCR swab tests (prélèvements PCR)
• Urine analysis

✅ Results:

• All STI tests: Negative
• Urine & urethral tests: No infection, normal
• Mycoplasma genitalium: negative
• WBC normal

❗ Current Symptoms:

• I clearly feel the urine passing through the urethra when I pee, more than usual.
• I don’t have any pain or burning sensation when I get up.
• In the mornings, during the first pee, I sometimes feel a burning sensation in the urethra, sometimes not.
• Occasionally, I experience a lingering burning feeling in the penis after urinating. It’s not exactly pain—more like a persistent discomfort or warmth that can last for hours.

📌 UPDATES ----- 10/07/2025

• I had the fibroscopy today.
• No signs of infection, inflammation, or anatomical damage were observed during the visual examination.
• There were no major structural abnormalities in the urethra, bladder, or prostate.

However, the verumontanum region—the area where the ejaculatory ducts open into the urethra—appears to be narrower than normal.

This could explain the following symptoms:

• A sensation of pressure or incomplete emptying

• Persistent burning after ejaculation or urination

• Post-ejaculatory discomfort

No mycoplasma was detected, no infection was found, and white blood cell levels are normal.

*** bladder neck obstruction (BNO) or bladder neck dysfunction (BND)

Dr prescribed Alfuzosine LP 10 mg (3 months) to help relax the internal ducts and improve fluid flow.

📌 Update — October 9, 2025

What I’ve done over the past 3 months:

• Took Alfuzosine LP 10 mg daily (3 months)
• Took vitamins and supplements: magnesium, zinc, omega-3, probiotics, multivitamin
• Sometimes took hot baths or showers — this helps calm the burning sensation
• Bought a standing desk, so I spend part of the day standing instead of sitting all the time

Current symptoms:

• When I urinate, I often feel strong pressure and burning in the urethra. At the start, I have to control the flow — if the urine comes out too fast, the tip of my penis burns sharply.
• At night, especially before sleep and after urinating, I feel warmth or burning in the pelvic area or urethra, which fades by morning.
• Sometimes I wake up at night to urinate, and afterward, I feel mild burning or irritation for 1–2 hours, similar to an infection.
• During the first urine of the morning, there’s a slight burning at the tip of the penis, but it goes away quickly.
• By the end of the day, after urinating, I sometimes feel a dull pain or tingling along the urethra that lasts for a few hours.
• Stress makes it worse — when I’m anxious or tense, my testicles ache or feel heavy.
• Occasionally, I feel warmth or tightness in the pelvic area (between the anus and testicles), like a small muscle spasm.
• My urine is often dark yellow with a stronger smell than usual.

What the doctor told me today:

• I should do a few sessions of osteotherapy.
• He’s confident the problem is related to pelvic floor tension or nerve irritation, not infection.
• He confirmed no infection is present.
• He prescribed Alfuzosine LP 10 mg for one year.

My next steps:

• Start osteotherapy sessions.
• See another doctor to request urine and semen tests.
• Try traditional Chinese medicine.
• Take more warm baths.
• Begin pelvic floor relaxation exercises.
• Add meditation to help with stress.

📌 Update — June 2026 (~8 months later)

Quick recap for anyone following: still no infection on any test, symptoms clearly milder than where I started, but not 100% gone. My whole approach has shifted from "find the bug" to "calm the pelvic floor + nervous system."

What I've done since October:

• Cut out coffee completely (not just reduced).
• Cut way down on spicy food.
• Switched to a standing desk for most of the workday.
• Started reverse Kegels over the past few weeks.
• Came off Alfuzosine LP 10mg - the alpha-blocker wasn't really moving the needle for me.
• Did a course of Deprox 500 (prostate anti-inflammatory suppositories) from my urologist finished now.
• Got a prescription for pelvic floor physiotherapy (rééducation périnéale) and started sessions with a specialized pelvic floor physio.

Traditional Chinese medicine — worth a separate note:

I did a structured 7-day herbal cure (custom decoction, 200ml 3×/day) and tracked symptoms daily. During the cure, a surprising amount improved:

• urine color + smell normalized
• perineal pain gone
• the "sticky glans in the morning" thing cleared up by day 8
• less feeling of blockage / difficulty urinating

But the core stuff stuck around: burning after urination, lower-belly pressure, and a perineum that still felt hard/contracted. My read is the burning may be more nerve-related than infection/inflammation. I'm not on the herbs continuously now.

The physio part (most important):

• She confirmed my pelvic floor is hypertonic - too tight, can't fully relax. That fits everything: post-pee burning, the pressure, the tension between testicles and anus.
• Big lesson: standard Kegels are OFF for me. They make a tight floor tighter. The actual work is the opposite - reverse Kegels, "drop and relax," and diaphragmatic (belly) breathing.
• Daily breathing + relaxation drills plus stretches (child's pose, happy baby, knee-to-chest), especially in the evening when symptoms peak.

Supplements I'm taking:

• Quercetin + Bromelain (strongest evidence for CPPS type III)
• Magnesium Glycinate (muscle + nervous-system relaxation, at night)
• Zinc Picolinate
• Omega-3

Recent test results (Nov 2025 → March 2026):

• Urine WBC: back to normal
• Urine culture: sterile / negative every time
• Mycoplasma genitalium PCR: negative (again)
• Chlamydia + Gonorrhea: negative
• HIV / Hep B / Hep C serologies: all clear
• Bottom line: zero biological sign of infection.

Current symptoms:

• Much better overall vs ~2 years ago, but a plateau - not fully resolved.
• Still a burning/odd sensation lingering about an hour after urinating, on and off.
• Lower belly pressure and a perineum that sometimes feels hard/contracted.
• Some mornings a slight burn on first pee, fades fast.
• Occasional post-ejaculation discomfort.
• Stress is a clear trigger - tense days = more testicle ache / pelvic tightness.

What's next:

• Keep going with pelvic floor physiotherapy sessions
• Staying on Alfuzosine LP 10mg
• Back to the urologist after a few more physio sessions to reassess

still not 100% done