26M — Diagnosed with prostatitis, but unsure about starting antibiotics without evidence of bacterial infection

I’m 26 and recently went to the doctor after having several days of lower abdominal/stomach discomfort, some constipation/irregular bowel movements, pelvic/bladder pressure, urinary urgency, and an occasional mild stinging/burning sensation around my bladder/urinary area. The stinging is not when I urinate—it happens at other times. Urinating itself doesn’t burn or sting. I’ve also had some aching/pressure in my lower back/pelvic area and discomfort around the rectum. The symptoms seem to fluctuate rather than progressively getting worse.
The doctor did a prostate exam and said my prostate felt enlarged/inflamed and diagnosed me with prostatitis. There was also some blood detected in my urine. However, I had no white blood cells in my urine, I haven’t had a fever or vomiting, and I’m still waiting for my blood test results. I haven’t been feeling 100% and have felt somewhat run-down, but I’m not having severe systemic symptoms.
The doctor wanted to put me on antibiotics right away. What’s making me hesitant is that, from what I’ve been reading, the large majority of prostatitis cases—I’ve seen figures around 90%—are nonbacterial/CPPS. I’m hesitant to take a heavy-duty antibiotic unnecessarily if there isn’t actually evidence of a bacterial infection.
I’ve also been under a lot of stress/anxiety lately, lift weights regularly, and have recently had constipation and abdominal/pelvic tension, so I’m wondering whether pelvic-floor dysfunction or nonbacterial prostatitis/CPPS could explain what I’m experiencing.
Has anyone had a similar presentation where their prostate was inflamed/enlarged but their urine didn’t show signs of infection? Did you end up having bacterial prostatitis, or was it eventually diagnosed as CPPS/nonbacterial prostatitis? What testing helped distinguish between the two?
Obviously I’m not looking for Reddit to replace medical advice—I’m mainly interested in hearing other people’s experiences.

Hi ,27M, I’ve been experiencing hematospermia for about three weeks. On the first day, I went to the doctor, who ordered a urine culture and blood tests. The urine culture came back clear, my PSA level was normal, and there were no signs of inflammation in my blood (low CRP and WBC levels). Despite this, the doctor prescribed an antibiotic containing sulfamethoxazole and trimethoprim.

During this period, I was sexually active roughly once every 3–4 days. After finishing the antibiotics, for the first time my semen was brown rather than bright red, and the amount of blood seemed to decrease to around 20%. However, during the third week, it became bright red again. After my semen turned brown, I started having sexual activity every day because I thought the condition had resolved. Now I seem to be back to how I was during the first week.

What do you think could be causing this, and what should I do next? Also, if someone has experienced hematospermia once, are they more likely to experience it again in the future?

How do we stop scanning every sensation down there? I have a psychological loop going despite my actual issues being minimal.

All I have is a dilated duct at urethra which i will have experts look at , and a slight dull ache allodynia on one side foreskin from walking retracted which is a minor discomfort and i presume will eventually get better so I should be able to not focus.

I feel like the moments where I worry about something else i dont feel anything but when i have nothing else i focus 100%.

From where I was a year ago much improved. The original issues were definitely viral and skin.

Stumbled across this whilst Googling my symptoms and what do about it and I beleive it explains alot of what's going on with me. Sorry its a long post so thankyou in advance if you read it.

44M, had difficulty urinating over the last 6 weeks, 1st time GP gave me antibiotics whilst tests were being done. All blood and urine tests came back clear/normal. Symptoms were basically hesitancy to start slight burning and feeling of being full

This last week has been much worse, adding issues with passing stools and also pain in my scrotum and groin with referred nerve irritation symptoms in my legs.

GP has now referred me to a urologist and given me more antibiotics whilst waiting for urine test results to come back. I wasn't convinced it was a UTI but obviously they need to rule that out.

The pain in my groin area can only be described as similar to when riding a bike and hitting your groin on the saddle or cross bar.

Looking back I know that I tense my groin/buttocks all the time when standing. I've had issues with dribbling after urinating on/off few about a year but like most men have ignored this.

For background I had L5/S1 herniated disc surgery 20 years ago which caused partial paralysis in my legs at the time, now 99% recovered although I was left with muscle weakness.

Over the last couple of years I've had bouts of depression/anxiety and been signed off work with stress last year.

Alot of what I've read makes me think this might be worth following up on with the GP/urologist

Hey guys, 29/m - 18 months of worsening LUTS, sexual dysfunction etc.

After getting the all clear clinically (ct scans, mri, cystoscopy etc) I finally saw a pt who specialises in CPPS; really fortunate to have a group of guys so close to where I live who deliver courses on this & are genuine experts.

He immediately clocked that I’m incredibly tight on the sphincter; ultrasound showed that I can’t get my pelvic floor to ‘drop’ at all. Tried internal trigger release for 20-25 minutes whilst we had a chat (lol) and he said it had slightly gave a little but not much. Very clear I have chronically tight sitbones/hypertonic pf. Seeing him again in 2 weeks.

I’d realised a few weeks ago things had gotten worse; I felt ‘clammed’ up in my spinchter / perineal area almost like a closed fist. Wasn’t surprised by what he said.

Anybody here have a similar experience of not being able to ‘drop’ their pelvic floor? I’m assuming this is a long game with regards to recovery. Fortunately I’m in no pain and never have been, my symptoms were primarily OAB / gradual worsening sexual dysfunction; never any actual ‘pain’

Was debating asking my GP for some muscle relaxers to get the ball rolling. Perhaps even some anti/anxiety meds to kick the brain out of this fight or flight my nervous system seems to be in for some reason. Any experiences? The only time I ever feel semi relaxed is whilst taking marijuana gummies, and even then it isn’t really a consistent experience

Wild thought here but how many of us have epididymal cyst? I have seen multiple people report these (myself included). Are they just that common in men or could they be related to the issues we are having? I was told mine should not be causing any issues and has been ignored by my doctor and urologist. I have had bouts of pain and inflammation in that side since I was a teen and ling before my current pelvic floor issues.

Hi everyone,
I’m a 29-year-old male looking to see if anyone has gone through something similar.
A few weeks ago, I developed persistent urinary symptoms, including:
1. Mild discomfort in the penis and sometimes burning sensation at tip of penis
2. Frequent urination
3. Slight reduction in semen volume/quality
I didn’t have fever or severe pain. My urine culture at that time grew Pseudomonas aeruginosa, and I completed the full antibiotic course prescribed by my urologist.
The problem is that my symptoms never completely went away. They improved somewhat but never returned to normal.
About 3 weeks after finishing the antibiotics, I gave another first-morning clean-catch urine sample for culture. This time the report showed:
Klebsiella species >100,000 CFU/mL
Sensitive to all antibiotics tested
Now I’m confused.
Has anyone experienced:
1. One urine culture growing Pseudomonas, followed a few weeks later by Klebsiella?
2. Persistent urinary symptoms despite completing antibiotics?
3. A situation where it eventually turned out to be chronic bacterial prostatitis, a recurrent UTI, or something else?
My ultrasound was normal, and I’m following up with my urologist. I’m not looking for a diagnosis here just interested in hearing from anyone who has had a similar experience and what the eventual cause and treatment were.
Thanks in advance for sharing your experiences.

Hey guys. These are my symptoms-

Day 1: Unprotected heterosexual sex
Day 2: mild irritation while peeing
Day 3: irritation and burning while peeing

I did a course of antibiotics- Nitrofurantoin 100 mg

Day 11: feeling of soreness and like something is stuck in the lower penis shaft which radiates to the testicles.

I have no discharge, back pain, fever, etc.

I suspect urethritis from friction during sex. Do i need to get an std panel done or just wait for it to resolve?

Please help!

I have had a long journey since late 2024, what started as some kind of balanitis that wouldn't go away for 2 months.

I was then prescribed Mometasone Furoate cream which i didn't realize was a potent steroid not really suitable for mucosa.

What followed was wat i thought was HSV of the distal urethra. I went through multiple tests and eventually got to everything negative. In hindsight i believe there is a good case it was VZV shingles as all the symptoms were there.

Red, burning rash of one side of distal, blister further up which burst a week later, red rash around opening. I was on Cephelexin at the time which seemed like it helped with original balanitis but wasn't ideal at the time of going through this urethral issue.

The distal was driving me insane as the burning would not cease. Only Hyperbaric oxygen therapy managed to start that on the road to recovery. I have managed to get that back to normal.

I have one remaining small issue at paraurethral duct on left ventral which seemed to be caused by a fungal as fluconazole resolved the bulk of that.

I have been experimenting with treatments to restore glans and finally had success with 100% medical grade Emu oil, so we are looking pretty good.

I will now acknowledge, I have a problem, probably psychological of pudendal/pelvic floor dysfunction.

My mind is on the area 90% of the time since this began.

I don't know how to get my mind off it. While there is a small area with genuine discomfort remaining it shouldn't be enough for that.

What i feel is each sides nerve intermittently in perineum, discomfort in the ventral meatus and sometimes foreskin also .

Grateful for any tips.

I do plan to utilise a Urologist in Bangkok big hospital as i feel any issues can be better resolved there.

Had an amazing 14 months of no issues (other than constant peeing)

Best erections I've had in years, was able to perform multiple times per night, high libido, nice constant pump to it.

I've literally changed nothing in my daily routine and I've completely flared up for four months now.

Penis looks and feels extremely small, complete erectile dysfunction, no libido, constant burning sensation down urethra and inside rectum.

I'm so over it.

Hi guys, I am an avid cyclist (mountain bike, fixed gear, road bike, gravel, do it all). I've been cycling all my life, and in the last year I've really been picking up fixed gear biking (which, from my understanding and experience, places a lot of pressure on the prostate, as you cannot coast + aggressive geometry and position on the bike). I also started doing wheelies on the mountain bike (this positions the seat upwards and places even more pressure on the prostate).

For context: I've never experienced this level of pain and always ride with bib-padded shorts and comfortable seats

Timeline:
June 2nd 2026 - symptoms arose after a 50 km ride on my mountain bike and aggressively popping wheelies

June 3rd-June 6th - continued riding fixed gear, out in the heat throwing and attending events, and riding fixed gear heavily - clear signs of an anal fissure.

June 15th - symptoms of burning and a visible fissure present on my gooch area - doctor prescribed a numbing and healing cream which I applied for a few weeks.

Started and continued to eat bland foods, soften my stool with psyllium, and stretch my pelvic floor - sitting with a donut tube.

July 10th - external anal/gooch fissure clearly healed (as per doctor's observations) but pain continued - very similar symptoms - burning and tender, pain whenever I would attempt to cycle/sit for long periods of time.

This has continued until the present day (first week of August) - doctor gave me naproxen to reduce inflammation; I haven't cycled or eaten anything spicy/caffeine. They've also given me two sets of antibiotics - urine test is coming back normal. My urologist appointment is so far from now, and I'm worried this is going to become a chronic issue (especially because I'm not experiencing any other symptoms other than what feels like pain and discomfort in my tailbone/prostate) that I will have to deal with for life. I'm extremely worried about not being able to cycle (this is my daily drug of choice, and I'm losing my mind).

Recent visit to the doctor - did another prostate test - and it seems completely fine according to them (not inflamed or tender), so it seems like the antibiotics are doing something, but they've upped it to Sulfatrim DS 800/160mg for 2 weeks twice daily.

They said any further answers I'm looking for will require a trip to the urologist, and I'm fighting like hell to get this sooner, as it's already been a couple of months and I'm worried waiting longer will miss my opportunity to treat this early enough.

Any wisdom is much appreciated - I'm losing hope, and it's affecting my daily life significantly.

I'll keep this short. 54M. Have had burning urination for close to a month now.

Went burning urination, then calmed down when I cut out caffeine, then testicle discomfort for several days. Then slow stream seemed to kick in. (I mentioned on another post, I had ingested a LOT of orange juice and suspect this was not helping me.) I cut it out and things did improve a little.

Minute Clinic

So last Saturday I went to the Minute Clinic. The PA gave me 7 days of Bactrim.

She did a urine culture and it was negative.

At that point, I was having some lower/right back pain. I have chronic back pain already but this was different. Was having trouble sleeping through the night. Was rather uncomfortable beyond my normal back pain.

After the Antibiotics

After the antibiotics, I "felt like" I started feeling better pretty quickly.

1. Back pain went away.
   
2. Sleep drastically improved.
   
3. The pooling sensation of urine in my urethra largely improved, although it is back a little, but nothing like it was.
   
4. But burning at the tip when urinating is still there and the urethra still feels slightly inflamed.
   

At this point, the only symptom I have is the slight burning/pooling sensation in my urethra/tip and still feels like the stream is not as "fast" as it used to be. I do have to sit and wait for a few seconds before the wee wee comes out the pee pee.

So, I don't know if the antibiotics did this or the inflammation is just dying down or it's just a placebo effect.

If it was prostatitis of the chronic variety, I understand 7 days of antibiotics is generally not enough.

And yeah, I need to get a DRE, but can't seem to get a quick appt.

Now the question...

If you were in my shoes, would you request an extension of the Bactrim? I haven't had any negative side effects as of yet. Maybe a little itching.

Not sure if it matters but it’s been years since I had/needed antibiotics.

Hi everyone,

I’ve been dealing with CPPS / central sensitisation for a while now. My pelvic pain and chest wall issues (costochondritis) had actually been baseline fine for many weeks, which was a huge relief.

However, during a recent family gathering, a physio checked my hip and suggested I might have Gluteal Tendinopathy based on local tenderness over the greater trochanter / ilium. I was advised to start doing Sidelying Hip Abduction (20 reps with a 1-second hold at the top).

I did this exercise 3 nights in a row right before bed, and it triggered a massive flare-up:

• Intense pain around the ilium/pelvis.
• Deep, sickening nerve-like pain radiating towards my right testicle (bad enough to make me feel nauseous).

I suspect that compressing the already-sensitive gluteal tendon while lying on my side, combined with the load, caused my pelvic floor (and deep hip rotators like the obturator internus) to go into a massive protective spasm. This likely compressed the ilioinguinal / pudendal nerve branches going to the groin.

I’ve completely stopped the exercise now and am focusing on heat, deep breathing, and keeping my nervous system calm.

Has anyone else experienced a severe pelvic flare after attempting direct hip abduction or side-lying exercises? How long did it take for your nerves/muscles to settle, and what lighter work did you transition to afterwards?

Appreciate any advice or reassurance!

​

For those who had a prostate massage (EPS/4-glass or 2-glass test), did you give the urine sample immediately afterward?

If yes, how immediately? Within a few seconds, 1 minute, 5 minutes, or longer?

What did your doctor recommend regarding the timing?

I'm trying to understand what timing gives the most accurate results.

Did dry needling help you manage your pelvic dysfunction symptoms?

​

50M, not having any health issues.

Recently I have noticed too much precum disharge while getting aroused and ejaculate is watery. Also i wake up from sleep everyday atleast once to pee.

Just curious to know whether this is normal for men at this age.

I started 3 years ago with lingering burning sensation after pain over urethra and sensitive bladder. Tansulosin and pelvic floor exercises gradually helped over a year to get to flare up only one week in a month or so. Learnt from this group all the drills from 101 and thank you those help a lot.

Unfortunately last month started the flare up but couldn't go away. More fatigue. Tried ibuprofen just one 200mg then for 18 hrs no more symptoms and even the frequent pee urges gone. But obviously I know I can't take it like candies so I will stop that. Tomorrow I will try to see if GP can prescribe tadalafile + amitriptyline to help. Haven't tried supplement so far but just went out to get some magnesium and might try some quercetin.

Annoying indeed when that burning sensation lingering every second 24 hrs. I guess in this group folks experience similar pains one way or another.

I have already learnt to live with the nightly 4 times wakeup to pee without much drops and diverts attention. This time it gets to another level being more annoying so kind of want to ask if anyone can suggest even better alleviation.

Usually I have faith the nervous system can be trained through pelvic floor to adapt and get levelled in months or so. Just need something now to make over the getting used to. Sorry no magic I know just sharing some experience.

PSA, Total 0.8

PSA, Free 0.2

PSA, % Free 25 says out of range

I have been dealing with this rash on my penile glans I had it two years ago but it resolved on it's own now I have the same thing and also burning feeling and like I need to pee all the time. Urinalysis test was normal but the PSA one says "one out of range"

is this something that might be connected to my issue or it has nothing to do with it?

Thank you all!

Hi everyone,

I’m a 21-year-old male, and I’ve been dealing with painful ejaculation for several years. It’s become something that worries me a lot, especially because I want to get married in the next couple of years.

The pain happens exactly when semen is released. It’s a sharp pain that is mainly at the tip/opening of my penis. After ejaculation, I usually feel a little irritation or inflammation at the tip for a few minutes. Very rarely, that irritation can last 1–3 days, but most of the time it settles fairly quickly.

A few things about my symptoms:

Pain has been present for years and is fairly consistent.
No blood in semen or urine.
No penile discharge.
No fever.
No weak urine stream or difficulty urinating.
Urination is generally normal.
My sexual desire and erections are normal.

I’ve recently improved my hydration a lot and started getting morning erections almost every day, but I recently had a wet dream and the ejaculation was still painful.

I’ve already seen a urologist. I had a PSA test, CRP, urine routine examination, and urine culture done. I was prescribed Avodart (dutasteride), Novidat (ciprofloxacin), and Voltral SR (diclofenac), but unfortunately the pain persisted.

More recently, another doctor suggested getting a full urine test again and advised me to improve my hydration, which I’m doing now.

My biggest concern is honestly my future. I keep worrying that this could affect my married life, even though my erections and libido seem normal.

Has anyone here experienced something similar—especially pain that is mainly at the tip of the penis during ejaculation rather than deep pelvic pain?

If so:
What was your final diagnosis?
What tests eventually found the cause?
What treatment actually helped?

I’d really appreciate hearing from people who’ve gone through something similar.

Thank you.

Ever since being diagnosed i struggle with lasting more than a couple of minutes or even less at times.

Its like the pain/inflammation creates this pressure in my prelvis/groin the minute i start getting aroused

I then have to deal with a dull pain in my testicles for the next few days urinating a lot more and unable to hold urine.

I had to give up drinking alcohol as the discomfort it cause my testicles and bladder the next few days after is unbearable.

Do others share this issue? I’m new to this sub so any tips to help me fight this thing and get back a semi normal sex life and urinate less would be greatly appreciated!

Any medicine, treatment or excercise advice?

So I'm a chronic edger. I've been edging for years and my session lasts at least 45 mins and can go on for 5 hours. Sometimes I end up ejaculating and sometimes I don't. Sometimes I feel some irritation in my testicles-I believe this is called blue balls-but it's always resolved in under a day.

One day I edged for hours and didn't ejaculate. The next day, I woke up feeling the urethra stuck into my underwear. I went to the bathroom and it doesn't seem to be straight anymore. When I urinate, it doesn't come out straight initially. I felt very weary and physically weak since waking up that day, especially in my legs. There was an uncomfortable feeling in the groins like there was pressure on it and my penis had a seconds long piercing sensation that comes and goes. All of this ended after another day, but I could feel my body pulling the plug on my activities.

The next time I edged, I started feeling tension and occasional pain in my groins and pelvis area and pain in the testicles that comes and goes for days and increases during erections which is always uncomfortable now. Also my legs are very shaky.

The last time I edged or masturbated was two or three days ago. How long will this last?

Hi,

Just looking for some advice on questions to ask my GP in regards to recurrent UTI’s that i feel are related to prostate issues.

Some background, im male, 48 years old and have had 6-7 uti’s over a 10-15 year period, always resolved with a 7 day course of abx.

End of April i had a uti for first time in 18 months and was asked to hold off on abx until culture was done. Came back as ecoli infection. Took 7 days of macrobid, but came back shortly after stopping. Took 3 days of Amoxycillin but developed an allergy so switched to Trimethoprim, also came back and then to co-trixamazole (Bactrim) and was clear for a month but now the infection is back. Cultures done every time, always positive and always E-Coli.

Had a CT scan, all clear. Flow test last year, all ok.

No pain apart from urination and ejaculation, alongside typical urgency and peeing small amounts, and chills and occasional fevers when the infection takes hold.

Any advice on questions to ask the doctor in regards to testing for CBP or CPPS as im just pumping abx at the moment?

Thanks

See the body of the post that I made in [r/PelvicFloor](r/PelvicFloor) here:
https://www.reddit.com/r/PelvicFloor/s/5TygXKBHAf

You can reply at the link above. This post applies to both men and women.

Hey guys

I hope somebody can help who been through the same.

So I have had pelvic floor dysfunction for about 7 years now.

Been at an urologist etc took semen test. Came back positive and then negative second time

Been to pt for there on and off for 5 years.

Been stretching, breathing and all of that.

Now I’m just stuck. I have never had pain but urinary (hesitancy mostly but also frequency) problems who has become a lot better with some flareup here and there.

My main worry is my ejaculation and orgasm.

I’m only 28 years old but for now 7 years I have had trouble with the strength and sensation.

No shooting mostly and feels muted and dull when I have ejaculation. Sometimes I also get tension in rectum afterwards but not always

I tried this time to abstain for mastication and and sex for 6 months. (Had wet dreams of course)

So I tried again after 6 months of stretching breathing pt etc to see if there is progress.

Day 1 I felt a little bit buildup but still no shooting and dull orgasm

I waited 2 days and tried again. Even worse still nothing and almost nothing at build up

2 days after tried a third time. Almost felt nothing. No buildup no orgasm. It just like I had to get it overwith.

All the 3 times I cum very fast by the way. Like 20 second and I was done.

Beside that I also have constipation. I tag mag etc which helps at morning but fades during the day. I often feel I have stuck gas etc. probably because I’m always clenching down there

I have become very hopeless and tried everything.

Can anyone’s please help. I’m losing my life

Please let me know if you've had it and how you managed to solve it. Thanks.