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This question is for my father. He is 81 years old and lives alone in India. He was diagnosed with Recurrent Urethral Stricture in 2001 by his Urologist. He was on Tamsulosin and Darifenacin for a lot of years and was fine until Sept 2016. In Oct 2016, he felt pain (4 on a scale of 1 to 10) in his penis. At times, the pain was more on the tip of his penis than shaft. Other times, the pain was felt throughout the penis (shaft + tip). The Urine culture indicated the EColi bacteria and he was given antibiotics. When the pain did not go away, his Urologist did a flexible cystoscopy in Nov 2016 and dilated his stricture. He had no pain until Dec 2017.
In Dec 2017, his pain was a 4 on a scale of 1 to 10. His Urologist did a Urine culture and the results indicated EColi infection greater than 10000 CFU/ml. Antibiotics were given and a repeat urine culture in January was normal.
His pain oscillated between a 1/10 and 2/10 in February and March. He was prescribed a few creams which made the pain manageable. When the pain persisted at 2/10 for a couple of days in the third week of March, the Urologist ordered urine and blood tests (11.22 PSA, positive for bacteria, urine had elevated WBC and leukocytes). A cystoscopy was performed on March 19, which did not find anything abnormal.
The elevated PSA took us down the path of ultrasound, MRI and biospy. The biopsy was negative for prostate cancer. For about a week after his cystoscopy (March 19- March 26), he felt no pain. This might be due to all the NSAID's he was give during his 5 days hospital stay (March 19-March 22).
His pain returned on April 2 and is currently between 1/10 and 1.5/10. Since the last few days, the pain is felt more in the tip of his penis than shaft. He saw the Urologist on April 9 and when I emailed his Urologist, he said that the pain will slowly recede. My father has no growth, no discharge, no changes in skin color or redness/rash or anything of that kind on his penis. His urine stream is fine. He has no pelvic pain.
1) Does UTI in December explain the penis pain in Dec-Jan?
2) Does the detected UTI on March 17 explain the penis pain in Jan-March?
3) Since several antibiotics have been given March 17 for his UTI, can the Cystoscopy itself be the cause of his current penis pain due to inflammation of his urethra ?
4) Any other reasons for his persistent pain? I would be grateful for any comments from you.
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