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Need to discuss some symptoms i am having. Took 2 pee tests,

Need to discuss some...

Need to discuss some symptoms i am having

Doctor's Assistant: Have you seen a doctor about this yet? What medications are you taking?

Took 2 pee tests, chlam and gon are negative, never been swabbed for trich, was given 7 days of flagil at 2 grams a day, symptoms are still weaker but prevalent after treatment

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Enlarged prostate, bladder does not fully empty. also took 7 days of sulpha. still have slight burning in my testicles and urinary tract occasionally. wondering if it is yeast and should take flucinozole (sp)

Doctor's Assistant: How long have you been dealing with the burning? Are you experiencing any other discomfort?

Itching, diahrea

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Answered in 21 minutes by:
3/3/2018
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,222
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
Verified

Hi,

Welcome to JA and thanks for this question. I'm sorry to hear about your symptoms. Actually, i would first get tested for prostatitis and also epididymitis with a semen culture and also an ultrasound. It is possible that you may have a simple bacterial infection which is resistant to common antibiotics and you may need stronger antibiotics in order to get rid of it. Secondly, some patients with enlarged prostates can have repeated attacks of bacterial prostatitis which can lead to this sort of problem and in that case you would need a prolonged course of antibiotics for a period of about 6-8 weeks. This is why a culture is necessary here.

Now regarding the yeast infection, yes it is possible that you could have developed a yeast infection which can present in a variety of ways in men. Burning in the testicles is one of the presentations and it would be difficult to test for yeast in your case, so it is worthwhile considering the use of fluconazole for a period of 7-14 days in order to eliminate the possibility of a fungal infection. However, i would go for antifungals if the above tests come back as negative.

But to answer your question, YES fungal infections are a possibility which can be considered after ruling out a resistant bacterial infection.

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Customer reply replied 1 month ago
i can get fluconazole over the counter, should i try that first to see if the symptoms go away?you are not worried about trich? i do not want to alarm my sex partner i may have a STI, i am worried about seeing a doctor and them just prescribing me more flagil...

Usually, trich would cause no symptoms in males, it would be very unusual for you to experience these sort of symptoms because of trich which is why it is down my list of possibilities.

If you do have fluconazole then you can certainly try it for a week and see if that helps.

Do you have any more questions?

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Customer reply replied 1 month ago
what dosage would you recommend -i can buy the 3 day canesten which i believe is fluconazole

Canesten is clotrimazole which is a different antifungal, fluconazole is usually available under the name of Diflucan. And if you have access to fluconazole then you can use a dose of 200 mg once daily.

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Customer reply replied 1 month ago
What over the counter anti fungal would you recommend at what doses? I'm in canada. I'd be going to a pharamasave to be precise

I don't think you can find ORAL antifungals in Canada, you can try using topical antifungals but I don't think they will be effective in your case. You do need a prescription for oral fluconazole, topical Canesten etc are not likely to help.

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Customer reply replied 1 month ago
Will the oral canesten help? I can get that

It is not ideal but it can be used in the absence of fluconazole. If you are using clortrimazole then the dose would be 10 mg 5 times a day for 7 days.

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Customer reply replied 1 month ago
When you say not ideal how do you mean? What are the chances of it working? Low so not worth trying? Or low but still worth a try?

It does NOT mean it wont work, it just means that it is not the drug of choice. Fluconazole is the first choice drug FOLLOWED by clortrimazole. The difference between the two in terms of efficacy is about 2-4% which means that both are effective in eradicating candida. The only difference being fluconazole is slightly better than clortrimazole. So it IS worth trying.

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Customer reply replied 1 month ago
Grappling / wrestling seems to make it worse
Customer reply replied 1 month ago
Grappling / wrestling seems to make it worse. PS I've had these symptoms for a month. Can a yeast infection last that long?

A yeast infection can last for months and even years in many cases if it is left untreated, so yes it is possible for it to last a month. And grappling/wrestling making it worse does not indicate any particular infection, that can happen with almost any infection, fungal or otherwise.

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Would you like to know anything else? Any clarifications or additional questions that you might have, i would be happy to answer them for you. If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.

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Customer reply replied 1 month ago
UPDATE: I took 3 days of flucanazole, all i could find at the time. the dose per pill was only 150 mg, so i took 300 mg day 1, 150 day 2, 150 day 3 and another 150 12 hours later (so 300 in a 24 hour period). the symptoms seemed to go down during this time, but a couple days later the symptoms seem to be creeping backshould that dosage have killed the yeast infection? or did i not take it long enough... i can try to find more
or would i be better off proceeding to look at the bacterial infections you mentioned?

It should have killed the yeast at this dose, if it did not work that means one of two things, the first one is that you could have a resistant yeast infection for which you may need a longer course of fluconazole usually 6-12 weeks or you could have another bacterial infection. In these situations it is ideal to get a culture done as that will tell us which organism is causing the infection and which drug would be ideal to treat it.

Do you have any more questions?

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Customer reply replied 1 month ago
Thank you doctor for your help!My last thought is this: I just peed and the symptoms went away. I think i might be hypersensitive to any symptoms down there as now i am paranoid.... do you think i am just being paranoid? Do you think i should just pee when i feel those symptoms, and if they go away good. If not a couple days of always peeing when i feel those symptoms, then get the cultures done?Or get the cultures now?

If those symptoms persist then you should get the cultures done, the symptoms appearing only intermittently and when you urinate they disappear could be a sign that the infection is settling down.

I would wait on the cultures and see if things improve over the course of the next few days and if they don't then get the culture done.

You're welcome, I hope I have earned a 5 star rating today, do remember to rate me by clicking on the stars above your screen as that is how we are compensated for helping you today. Any BONUSES would be well appreciated!

Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,222
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Customer reply replied 1 month ago
ok awesome, thanks!The Canadian medical system is very good for big things like cancer or heart disease, but for weird long term diagnoses like this, my doctor is always swatting me out the door under 10 minutes. I don't feel like she cares what I say or what i'm feeling I like the hands on "let's work together and diagnose this / i want to understand all the stuff that could be going on" -- that is not her approach.Thank you very much for patiently explaining this all to me!

You are more than welcome, Best of luck!

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