"Oh what a tangled web we weave"

[Omadon2001]

The title of this thread was coined by Sir Walter Scott

I was on holiday abroad last month. I thought I may have a UTI. It was mild but I paid to see a local Dr and was given antibiotics without any testing.
After one tablet I developed bad stomach ache but the symptoms had gone the next morning. I stopped the antibiotics as they stated that some side effects are dangerous and potentially irreversible.

Over the next week my symptoms then got worse. Frequent urination, urgency, painful urination, groin pain, testicular pain and a discharge from my penis.

That's the symptoms of Gonnorhea/ Chlamydia

Looking back at my bookings. My symptoms started 26 days after my last "encounter".
My last encounter was a massage. No sex. We did mutually masterbate each other.

The risks are incredibly low. But I can't be certain that she didn't touch me after touching herself and vice versa. Most gonorrhoea shows up within 14 days but it can take 28. You can get gonorrhoea without having penetration.

Just before I came back to the UK I started taking the antibiotics again. The stomach ache returned.
As soon as I was back in the uk I called 111 and was told to take 2 more tablets (taking the total to 6 out of the prescribed 14). By the time I stopped them I'd got bad stomach ache and pins and needles in my arms and legs.

I contacted my GP a week later as I still had symptoms. They did a urine test and sent it to the hospital. The results came back as "no significant growth". I assume they put the urine on a Petri dish but I can't be certain that they even tested for STI's

Another trip to the GP and more antibiotics. The GP admitted that the recent use of antibiotics could mask the results of the urine test as I'd not allowed enough time for the bacteria to potentially grow back again.

The new antibiotics caused the pins and needles again as well as the stomach ache. After 3 tablets the GP swapped me onto a different antibiotic.

I've just taken tablet 9 of 28 (of the third antibiotic in a month).I can't pee. It's 9am and I have urinated 16 times so far today. I still have testicular pain and a discharge. My GP reckons it's prostatitis.

However, I'm concerned that it could be either Chlamydia, trichomonas or Gonorrhoea. None of the antibiotics I've been given treat these bugs.

I can't tell my GP that I could have a STI as this would show up on my patient record - which my wife reads.
I can't go to the GUM clinic because I may test negative again if my antibiotics mask the results.

I can't stop taking these current antibiotics - just in case I do have Prostatitis (as it's states it's a potentially serious infection) and I can't get tested for Chlamydia & Gonorrhoea for another 3-4 weeks until these anti are out of my system.

If I take these antibiotics and feel no better then I should go to the GP again. But then they can't do a urine test until this are our of my system so I'll probably just get more antibiotics and the vicious cycle continues.

I've no one to talk to - apart from you lot   

If anyone as any advice or words of wisdom...

[HS4000Kestral]

I had Prostatitis - and yes it seemed like you could not stop peeing - it felt like an STI as all the symptoms were around the penis area, but in fact it was nothing to do with that.

I preservered with the antibiotics and it eventually went - there is a blood test you can do to check Prostrate - you can pay to have it done privately which is what I did ( also got them to do the STI's at the same time ) told my wife that it's a package and they test everything even thoughthere was no chance ( luckily enough the STI tests came up as negative but I wasn't expecting anything anyway).

Why will your wife see the results?

[RandomGuy99]

I'm really sorry you're going through this — it sounds distressing, both physically and emotionally. You’ve laid everything out clearly, and from what you've described, there are several key issues going on. Here's a breakdown of what could be happening and what steps you might consider, while balancing your need for privacy and ongoing symptoms:

---

### ⚠️ **Most Likely Possibilities**

#### 1. **Sexually Transmitted Infection (STI)**

* **Symptoms (discharge, testicular pain, urinary frequency/urgency, painful urination)** are classic for **gonorrhoea, chlamydia**, and **trichomoniasis**.
* While the risk from mutual masturbation is **low**, it is **not zero**, especially if **fluids were exchanged via hands**.
* Incubation for gonorrhoea is usually 2–14 days but **can occasionally take longer**.
* **Antibiotics (especially broad-spectrum ones)** can **partially suppress these infections**, leading to **false-negative tests** — especially for **urine cultures**.
* Most urine cultures **do not test for STIs unless specifically requested**.

#### 2. **Non-STI Bacterial Prostatitis**

* Prostatitis can **mimic STI symptoms** exactly and can be **hard to treat**.
* Symptoms include: pain, urinary issues, discharge, testicular pain.
* It’s usually treated with **a long course (4–6 weeks) of fluoroquinolones or trimethoprim**.
* **Discharge isn't typical** for prostatitis alone — that’s more indicative of urethritis.

#### 3. **Antibiotic Side Effects**

* **Stomach ache and pins and needles** suggest a **neurological or GI side effect** from fluoroquinolones (e.g. ciprofloxacin, levofloxacin).
* **Pins and needles** are especially worrying — they can signal early nerve damage from certain antibiotics, and should **not be ignored**.

#### 4. **Reinfection / Persistence Due to Incomplete Treatment**

* Starting and stopping antibiotics without completing a full course, particularly for bacterial STIs or prostatitis, **can cause persistence or resistance**.

---

### 🔍 **Why Tests Might Be Inconclusive**

* Most **GP urine tests** check for general bacteria (e.g., E. coli) but **do not test for STIs unless specifically ordered**.
* **STI tests at sexual health clinics (NAATs for chlamydia and gonorrhoea)** are very sensitive, but antibiotics can **temporarily suppress bacterial levels below the detection threshold**.
* You’d typically need **at least 2–3 weeks off antibiotics** for a **reliable STI test**.

---

### ❗️Your Dilemma: Privacy vs. Accurate Diagnosis

You’re concerned about STI testing showing up in your GP record (which your wife can see), but:

* **Sexual health clinics (GUM)** in the UK offer **completely confidential** services:

  * **They do not share results with your GP unless you explicitly request it.**
  * You can give a **pseudonym** or ask for your records to be confidential.
  * Even if antibiotics have reduced bacterial load, **GUM clinics are far better at detecting STIs** than standard GP routes.

---

### ✅ What You Should Do (In Priority Order)

#### 1. **Stop Fluoroquinolones if You're Getting Neurological Side Effects**

* **Pins and needles (neuropathy)** can be irreversible.
* You should **immediately tell your GP** about this specific side effect and **ask to stop the antibiotic**.
* If the current antibiotic is **not covering STI organisms**, and your symptoms are not improving, there’s little justification for continuing it.

#### 2. **Visit a GUM Clinic**

* **Go as soon as possible**, explain your antibiotic use.
* Ask for **urine NAAT testing**, **urethral swab**, and possibly **microscopy** — they can still get useful results.
* Ask for **empiric treatment** for gonorrhoea/chlamydia **if you’re symptomatic**, especially if the exposure is questionable but not zero risk.

#### 3. **If You Must Wait, Plan for Accurate STI Testing**

* You’re correct that tests may be unreliable until **3–4 weeks after stopping antibiotics**.
* But don’t keep cycling antibiotics unless:

  * They are **clearly working**, and
  * They **target the likely infection**.

#### 4. **Consider Referral to Urology**

* If symptoms persist, and no STI is detected, you may have **chronic prostatitis/chronic pelvic pain syndrome** (CP/CPPS), which often needs a **multidisciplinary approach** — not just antibiotics.

---

### 💡 Some Notes on Antibiotic Coverage

| Antibiotic    | Targets Gonorrhoea | Targets Chlamydia | Prostatitis Use | Side Effects           |
| ------------- | ------------------ | ----------------- | --------------- | ---------------------- |
| Ciprofloxacin | Sometimes          | No                | Yes             | Neuropathy, GI         |
| Doxycycline   | No                 | Yes               | Sometimes       | GI                     |
| Azithromycin  | Maybe              | Yes               | No              | Mild GI                |
| Metronidazole | No                 | No                | No              | Nausea, metallic taste |
| Trimethoprim  | No                 | No                | Yes             | Rashes, GI             |

You might be receiving something like **Ciprofloxacin** or **Trimethoprim** now, but **these won't treat chlamydia or gonorrhoea effectively**.

---

### ⚖️ Balancing Health and Privacy

* **Your health must come first.**
* If your GP isn’t an option, go **privately** or use a **walk-in STI clinic** — many don’t require NHS number and won’t inform your GP.
* **Keep written notes** of what you’ve taken, how long, and the side effects. This helps avoid blind prescribing in future.

---

### 🧭 In Summary

* **Yes**, it could still be an STI — **your symptoms strongly suggest it**.
* **Yes**, your antibiotics may be hiding test results but not clearing the infection.
* **No**, continuing antibiotics indefinitely without the right diagnosis won’t solve the problem.
* **Yes**, there are confidential STI testing options that **won’t affect your GP records**.

[DastardlyDick]

Why will your wife see the results?

The OP said she can read his patient record (presumably via the NHS app or similar). The app also shows test results.
Unless there are others reasons for allowing it, if it was me, I'd cut her access if I want to continue punting. It may be as simple as changing the password. 

[scutty brown]

stop prevaricating
go and see a specialist STI clinic as soon as possible and explain everything that's happened
They should be able to give you alternative antibiotics without waiting for new tests

which is the drug that's causing the reaction?

[Omadon2001]

Thanks for the helpful and informative replies so far.

Yes, my wife can read my GP notes online. I can read hers. Changing the password isn't really an option as she'll want to know why I've changed it and want to know the new one.

Ciprofloxacin and Ofloxacin caused the stomach pains and pins and needles.

I'm on Trimethropin now.

My local gum clinic has a call handler who takes the call and then passes it to a Dr/nurse. The call back may be an hour or three later. I can't take phone calls at work and I don't want them calling at home.

[KatieEdinburgh]

My local gum clinic has a call handler who takes the call and then passes it to a Dr/nurse. The call back may be an hour or three later. I can't take phone calls at work and I don't want them calling at home.

If you’re worried about her finding out maybe go to a private STI clinic. Either way do not leave it , it really could get much worse …

Edit: FWIW I think prostatitis or a UTI complication is much more likely a reason than STDs if you only did hand stuff with your recent booking. But if it IS gonorrhoea or chlamydia don’t assume it’s the last booking that given it to you - these things sometimes can lie dormant or not show symptoms for weeks or even months in men especially. Can have had it for much longer than you realise , in which case you might likely need further treatment (and wife too)

Don’t dose her without her knowledge tho , oh my god that husbands have tried this before makes me feel sick 

[RandomGuy99]

If you want some confidential advice, then my response came from an AI. You don't need to give it any personal details and you can just describe your symptoms. I am not saying it will be 100% correct but it might be a good way of educating yourself before you have a discussion with a kedical professional.

[scutty brown]

Ciprofloxacin is a high-risk drug
There's a significant mental health / suicide risk associated with it

[KatieEdinburgh]

If you want some confidential advice, then my response came from an AI. You don't need to give it any personal details and you can just describe your symptoms. I am not saying it will be 100% correct but it might be a good way of educating yourself before you have a discussion with a kedical professional.

Very obvious when your comment on this and other threads are AI no offence

Is filled with annoying ##### and stuff

Maybe don’t use it toooo much 

[RandomGuy99]

Very obvious when your comment on this and other threads are AI no offence

Is filled with annoying ##### and stuff

Maybe don’t use it toooo much 

##### No, I have turned my brain off and now use AI full-time #####

The #s are usually shown as #####bold text###### in my user interface, but I convert them to # to allow humans to copy and paste the text.  I am sorry if you find them annoying.

#####Today, UKP. Tomorrow, the world.######Shit! That was supposed to be #####secret##### Nothing to see here.

[Omadon2001]

I never considered the AI response - thank you.

Yes, I'm aware Ciprofloxacin (the the family of antibiotics that it belongs to) are potent and the Information Leaflet in the package was quite scary.

I've just tried my local GUM clinic in the hope that they could see me in a 1 hour time slot I have available on Thursday morning but I was number 17 in the queue and couldn't hold on that long . An added complication is that I'm in a "funny period" at work with shifts that makes it incredibly difficult to attend a GUM clinic

I'll Google a private STI clinic closed to where I live but I'm tempted to do a postal test. Yes, the recent/current antibiotics may mask the true result but I'm hoping the negative culture from the GP and a negative postal test will set my mind at rest.

Obviously then, when I clear of the antibiotics I can test again.

[scutty brown]

If your wife has access to your GP records have you got a plan in place for if/when she sees the GP tests ?

[Omadon2001]

If I test positive then I'll tell her.

It'll be a very awkward moment but it's only right that she goes and gets tested too

[Lou2019]

stop prevaricating
go and see a specialist STI clinic as soon as possible and explain everything that's happened
They should be able to give you alternative antibiotics without waiting for new tests

which is the drug that's causing the reaction?

Threads like this are pointless in my opinion, if I had a medical issue the last place I’ll be seeking advice would be on a forum of random unqualified strangers    . Even if somebody here was qualified, they’d have to have a good idea of your past medical history etc to be able to give you sound advice.

There’s plenty of places you can order tests from by the way (sorry I’m a random unqualified stranger giving advice  )

[Watts.E.Dunn]

But sometimes it isn't that straightforward and sometimes what other have experenced and have gone through can be very usefull Supportive information.

Sad to say that sometimes the medical profession may not be as helpfull as me might need it to be witness the pantomine some have just getting to see their GP..

Espically with STI's and illnesses that are similar in outcome and  a can mimic them and sometimes who the hell can be most of  us talk to d for some support and understanding..

I've got a bloody good lady GP and an exccllent practice of very kind and helpfull staff not all have such!!

[Strawberry]

Proper
Medical
Advice

I would go to the GUM and tell them what has been happening, I would guess they will then tell you how to proceed.

Yes the call back system can be a pain in the arse, I sometimes have things planned or it's inconvenient, but I tend to find a way to make it so I can accept the call and it tends to work out absolutely fine.

[SoapyTW]

Honestly, just stump up some cash and see a private doc and tell them not to share the info with your GP, or go to a GUM clinic and if you are really worried, give a fake name, dob, and use your punting phone number (External Link/Members Only)

[Watts.E.Dunn]

Is that all that asterisks are for?. AI sourced info?..


I've used Doxy and  Cipro all they did was to give me the shits!..

[RandomGuy99]

Even the AI saya go see a medical professional.

[Fookmefooku]

You know I'm more disappointed that this wasn't a Streetlight Manifesto related post.

But seriously man that sucks.

[fredhiggins]

Honestly, just stump up some cash and see a private doc and tell them not to share the info with your GP, or go to a GUM clinic and if you are really worried, give a fake name, dob, and use your punting phone number (External Link/Members Only)

This place sounds a good choice.

[Doc Holliday]

If I test positive then I'll tell her.

It'll be a very awkward moment but it's only right that she goes and gets tested too

I assume you and your wife are sexually active then?

The treatment you have received has been akin to 'shoveling shit on shit'.

Your first visit should have involved a urine test. This is vital for a suspected UTI

This may be accompanied by prescribing an antibiotic. Unless there were specific reasons, a first line antibiotic such as Trimethoprim is usually given. This is usually well tolerated with minimal side effects though may be prone to resistance.
This is pending the results of the urine test (usually within 48 hours in UK) to confirm an infection and also that there is no antibiotic resistance.

Ciprofloxacin is very much a second line antibiotic where firts line treatment has failed. Why the doctor chose to prescribe it especially without a urine test is puzzling.

Unfortunately you suffered the known neurological side effects and were right to stop it. However you should have done this in conjunction with further medical intervention to provide an alternative. The urine test is crucial in this decision but of course you didn't have one.

You should not have recommenced taking it, as the side effects will return (which they did) and also the break in between has the potential to create resistance issues.

Then it gets worse because NHS 111 told you to try it again. I am staggered by that advice.

You eventually end up at your GP and finally get a urine test. Both he and your first doctor should have questioned you about any potential sexual history risk. Did they do that? Or did you deny it? The test could also have then covered STIs.

It is extremely unlikely to be gonorrhea, from the scenario you describe, but it could have been ruled out and saved you all this speculation and worry.

Then it gets worse again as for some reason your GP prescribes Ofloxacin, which is also a fluoroquinolone antibiotic and likely to produce the same side effects ... which it did.

Finally you end up on Trimethoprim where is where you should have started, but in conjunction with a urine test. However this is obviously now quite a long standing and more serious situation and if it is not responding then it will require further testing and investigations to hopefully reach a more definitive diagnosis and not just randomly further prescribing. This will involve you being open and honest about your sexual activity for elimination purposes but as I say is extremely unlikely to be an STI.

Best wishes for a speedy recovery 

 

[Doc Holliday]

If I test positive then I'll tell her.

It'll be a very awkward moment but it's only right that she goes and gets tested too

I assume you and your wife are sexually active then?

The treatment you have received has been akin to 'shoveling shit on shit'.

Your first visit should have involved a urine test. This is vital for a suspected UTI

This may be accompanied by prescribing an antibiotic. Unless there were specific reasons, a first line antibiotic such as Trimethoprim is usually given. This is usually well tolerated with minimal side effects though may be prone to resistance.
This is pending the results of the urine test (usually within 48 hours in UK) to confirm an infection and also that there is no antibiotic resistance.

Ciprofloxacin is very much a second line antibiotic where firts line treatment has failed. Why the doctor chose to prescribe it especially without a urine test is puzzling.

Unfortunately you suffered the known neurological side effects and were right to stop it. However you should have done this in conjunction with further medical intervention to provide an alternative. The urine test is crucial in this decision but of course you didn't have one.

You should not have recommenced taking it, as the side effects will return (which they did) and also the break in between has the potential to create resistance issues.

Then it gets worse because NHS 111 told you to try it again. I am staggered by that advice.

You eventually end up at your GP and finally get a urine test. Both he and your first doctor should have questioned you about any potential sexual history risk. Did they do that? Or did you deny it? The test could also have then covered STIs.

It is extremely unlikely to be gonorrhea, from the scenario you describe, but it could have been ruled out and saved you all this speculation and worry.

Then it gets worse again as for some reason your GP prescribes Ofloxacin, which is also a fluoroquinolone antibiotic and likely to produce the same side effects ... which it did.

Finally you end up on Trimethoprim where is where you should have started, but in conjunction with a urine test. However this is obviously now quite a long standing and more serious situation and if it is not responding then it will require further testing and investigations to hopefully reach a more definitive diagnosis and not just randomly further prescribing. This will involve you being open and honest about your sexual activity for elimination purposes but as I say is extremely unlikely to be an STI.

Best wishes for a speedy recovery 

 

[Omadon2001]

Me and the wife are sexually active but I always wear a condom as she's not on the pill. Even so, if I test positive for a STI.in will probably tell her - even though the condom sound have provided protection.
 
Yes, it's a catalogue of errors from the NHS.

I tried to contact a private GP yesterday. There's not a lot of choice where I live. I left a message - they've not got back to me.

I've ordered a postal test. Even though I'm on antibiotics I'll do do the test. Whilst it may not be 100% accurate or will give me a little guidance on what to do next.

The good news is that after 11 Tremethropin tablets my urine is no longer cloudy - which I think is a good sign as Tremethropin doesn't test Gonorrea or Chlamydia.

I fully realise that no one on here is medically qualified (unless there's gum clinic nurse lurking anonymously). However some of you may have gone through something similar. Even if I don't find the answer on here are least I've got it off my chest.

Thank you to all who have responded so far

[Strawberry]

Me and the wife are sexually active but I always wear a condom as she's not on the pill. Even so, if I test positive for a STI.in will probably tell her - even though the condom sound have provided protection.
 
Yes, it's a catalogue of errors from the NHS.

I tried to contact a private GP yesterday. There's not a lot of choice where I live. I left a message - they've not got back to me.

I've ordered a postal test. Even though I'm on antibiotics I'll do do the test. Whilst it may not be 100% accurate or will give me a little guidance on what to do next.

The good news is that after 11 Tremethropin tablets my urine is no longer cloudy - which I think is a good sign as Tremethropin doesn't test Gonorrea or Chlamydia.

I fully realise that no one on here is medically qualified (unless there's gum clinic nurse lurking anonymously). However some of you may have gone through something similar. Even if I don't find the answer on here are least I've got it off my chest.

Thank you to all who have responded so far

Do you have unprotected oral sex with your wife?

[KatieEdinburgh]

I fully realise that no one on here is medically qualified (unless there's gum clinic nurse lurking anonymously). However some of you may have gone through something similar. Even if I don't find the answer on here are least I've got it off my chest.

Thank you to all who have responded so far

Doc Holiday is a doctor ?

Think it’s not likely you’ve passed anything to your wife by her giving you oral sex, the chances are very small so don’t freak out right away

as it sounds the symptoms are prostatitis or UTI related probably

Speedy recovery 

[RandomGuy99]

Doc Holiday is a doctor ?

or a dentist as Doc Holiday was.

[KatieEdinburgh]

or a dentist as Doc Holiday was.

 

[yandex]

Yes, it's a catalogue of errors from the NHS.

I don't mean to belittle your situation but this shit really annoys me. I should qualify that I work in frontline healthcare and the number of complaints we get from people who seem to think they have no responsibility when things don't work out how they expect is unreal.

I am making assumptions, but it doesn't sound as if you were entirely honest in your initial medical encounter, and you have not been honest with subsequent ones. This is not the fault of the NHS.

It looks you have convinced yourself you may have an STI, although this is really unlikely from what you say is your sexual activity. Have you also considered that if that is the case, you may have caught it closer to home? Sorry if that is an unpleasant thought but you will have to consider all possibilities if you do turn out to have an STI.

[Doc Holliday]

Yes, it's a catalogue of errors from the NHS.

Not really. I questioned the advice of NHS111 but as I said in my post this sorry saga began with the medic in which ever country you were in and everything else has then been 'firefighting'. You also took decisions without consultation. There have also been significant delays on your part and a reluctance to visit a GUM clinic.

You did not answer my question about whether anyone enquired about your sexual history and if so if you were honest about it?

As Yandex says your stance in trying to conceal this has complicated it all much further.

The good news is that after 11 Tremethropin tablets my urine is no longer cloudy - which I think is a good sign as Tremethropin doesn't test Gonorrea or Chlamydia.

I think you meant 'treat' and not 'test'?

That is not how antibiotics work. You will have looked up the current preferred regime for treating Gonorrhea, but in fact some years ago Trimethoprim (note spelling btw) was a first choice antibiotic for Gonorrhea, although it was combined with another antibiotic Sulfamethoxazole and known as Co-Trimoxazole or Septrin. Things move on though, especially in relation to Gonorrhea and drug resistance.

So in the highly unlikely event you have contracted Gonorrhea there is a fair chance Trimethoprim may be effective but not optimally.

 

[Doc Holliday]

It looks you have convinced yourself you may have an STI, although this is really unlikely from what you say is your sexual activity. Have you also considered that if that is the case, you may have caught it closer to home? Sorry if that is an unpleasant thought but you will have to consider all possibilities if you do turn out to have an STI.

I was going to post similar which is why I asked if they were sexually active 

[Doc Holliday]

Doc Holiday is a doctor ?

or a dentist as Doc Holiday was.

Or a gambling gun slinger? Or even a used car salesman?

Actually if you pay me enough money, "I can be anything you want me to be darling" 

The only certainty is I am an anonymous member of a punting forum 

EDIT btw it is Holliday not Holiday 

[Omadon2001]

Thanks for your input.

I'll hold my hands up and say I've not been 100% truthful to my GP and the foreign Dr I saw gave me antibiotics based on my assumption that I had a UTI. I really wanted to have a test before starting antibiotics.

My one and only urine test showed "no significant growth" but I've been put on more antibiotics regardless of this. I had a prostate examination. Nothing untoward was found but I've still be diagnosed with Prostatitis. Despite having antibiotics in my system at the time, despite mentioning this to the GP (and he agreed) he thinks I have Prostatitis. I would have preferred to have been retested a week later to see what bacteria showed up

The NHS is short of money. It's would imagine it's cheaper to dish out antibiotics (and easier) than maybe do a scan. I'm currently urinating around 40 times per day. The GP said we only need to worry when you can't pee at all.

In every industry there are good staff and bad staff.  If you're one of the good ones then I apologise. However my sister's 20 year battle with cancer and my wife's ailments and experience with the NHS show that it's often lacking.

Once again, I'll admit I could have been more honest but I need to balance a long standing marriage with what I divulge

[RandomGuy99]

**Prostatitis** is an inflammation or swelling of the **prostate gland**, a small gland located below the bladder in men that helps produce semen. It can cause a range of symptoms, including pain, urinary issues, and sometimes sexual dysfunction.

### Types of Prostatitis

1. **Acute bacterial prostatitis**

   * Caused by a bacterial infection.
   * Comes on suddenly and is usually severe.
   * Symptoms: fever, chills, painful urination, pelvic or lower back pain.

2. **Chronic bacterial prostatitis**

   * Also caused by bacteria but develops more slowly and lasts longer.
   * May come and go over time.
   * Symptoms: frequent urination, pain during urination, discomfort in the groin or lower back.

3. **Chronic prostatitis / Chronic pelvic pain syndrome (CP/CPPS)**

   * Most common type.
   * Not caused by bacteria, and the exact cause is often unknown.
   * Symptoms: pelvic pain, urinary problems, painful ejaculation.
   * Can be difficult to treat.

4. **Asymptomatic inflammatory prostatitis**

   * No noticeable symptoms.
   * Often discovered incidentally during tests for other conditions.
   * Doesn’t usually require treatment unless associated with other problems.

### Causes

* Bacterial infections (especially in bacterial types).
* Urinary tract infections.
* Nerve damage.
* Pelvic trauma.
* Stress or immune system dysfunction (especially in CP/CPPS).

### Treatment

* **Antibiotics** (for bacterial prostatitis).
* **Alpha blockers** to relax bladder muscles.
* **Anti-inflammatory medications**.
* **Lifestyle changes**, physical therapy, or counseling (especially for CP/CPPS).

[RandomGuy99]

I once got a UTI with frequent urination and pain when I peed. I went to the GP and they did a urine sample which was very cloudy and dip stick tested it and immediately gave me antibiotics which cleared it up. However, im hindsight I possibly had an STI. Nothing showed up in my regular STI test, which I had a month later.

[GreyDave]

   Panic seems to set in to us ..I had aUTI infection few years ago and thought the worst as it was a great session    thing was i had been wanked silly to get me up a few times and this iratated the uretha along my little friend I then made it worse by drinking loads of cranberry juice and the sugar in that added to the dilema i was panicing like a headless hen as the WG was a Hungarian who I suspected did BB to so all those various STI s came in to my head I popped round to the local clinic and had the Full Monty of tests and got a good talking to from the Jamaican nurse about how to behave    ====Few days later got text all clear ...Ive been back a few times since ....I too took some anti biotics I cant recall name of them now they were left over from my dental work I was told by dentist not to drink alchol and on reading the info they were used to treat STI too ...I took them and felt shite the nurse in the clinic was cross and clearly told me off and reasons why ....Some times we are just daft about how we behave...Hope you get sorted soon Sir    The Clinc Staff were maybe the best attuide of staff Ive seen of the NHS 

[Omadon2001]

An update...

I've been back to my GP. I told him I could hardly urinate. He says I should only go back if I CAN'T urinate 

I still have symptoms and I've just taken tablet 25 of 28. I have little faith that I'll get better with just 3 more tablets 🙁

However, I have paid for a Gonorrhoea and Chlamydia test. This has just come back as negative - but it could be a false negative because of the antibiotics that I still taking.

My hope is that because my GP did a culture and the specific Chlamydia and Gonorrhoea tests have come back negative that I've not got an STI - but it's going to be at least another 3 weeks until I can be 100% certain once the antibiotics have cleared my system

[RandomGuy99]

An adult man who is unable to urinate (acute urinary retention) is experiencing a **urological emergency** — the bladder is full but cannot empty.

There are several possible causes, and they generally fall into four categories:

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### **1. Obstruction of the Urinary Tract**

Something is physically blocking the outflow of urine.

* **Benign prostatic hyperplasia (BPH)** — enlarged prostate compressing the urethra (most common in older men)
* **Prostate cancer** — tumor growth narrowing the urethra
* **Urethral stricture** — narrowing from scar tissue (e.g., after infection, trauma, catheter use)
* **Bladder stones** — can lodge at bladder outlet
* **Severe constipation** — rectal mass of stool compressing urethra
* **Blood clots in bladder** — from trauma, surgery, tumors
* **Phimosis or paraphimosis** (in uncircumcised men) — swelling or tight foreskin restricting urethral opening

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### **2. Nerve (Neurogenic) Problems**

The brain, spinal cord, or peripheral nerves controlling the bladder aren’t working properly.

* **Spinal cord injury**
* **Multiple sclerosis**
* **Stroke**
* **Diabetic neuropathy**
* **Parkinson’s disease**
* **Post-surgical nerve damage** (e.g., after pelvic surgery)

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### **3. Medication Side Effects**

Some drugs can impair bladder muscle contraction or increase urethral tone.

* **Anticholinergics** (e.g., antihistamines, some antidepressants)
* **Decongestants** (alpha-adrenergic agonists like pseudoephedrine)
* **Certain antidepressants** (e.g., tricyclics)
* **Opioid painkillers**
* **Some muscle relaxants**

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### **4. Functional / Postoperative Causes**

* **Postoperative urinary retention** — after anesthesia or epidural/spinal block
* **Severe pain** or anxiety interfering with urination
* **Post-trauma swelling** in the pelvis or urethra

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### ⚠️ **Why this is urgent**

If someone cannot pass urine for hours and the bladder is painfully full, **they should seek emergency medical care immediately** — prolonged retention can damage the bladder muscle, cause infection, or even lead to kidney injury.

Here’s a clear **flowchart-style breakdown** of the possible causes of **acute urinary retention in adult men**:

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**START → Adult man unable to urinate**

⬇️

**Step 1 — Is bladder distended/painful?**

* **Yes** → Acute retention → Urgent catheterization & diagnosis
* **No** → Possibly chronic retention or low urine production (different pathway)

⬇️

**Step 2 — Look for obstruction signs**

* **Enlarged prostate** → BPH or prostate cancer
* **History of urethral trauma/infection** → Urethral stricture
* **Blood in urine or stones on imaging** → Bladder stones / clots
* **Severe constipation** → Rectal impaction compressing bladder outlet
* **Penile swelling or foreskin problems** → Phimosis/paraphimosis

⬇️

**If obstruction not obvious → Step 3 — Check for neurological causes**

* **Spinal injury or back pain** → Spinal cord compression
* **Neurological disease** → MS, Parkinson’s, stroke
* **Diabetes** → Diabetic neuropathy

⬇️

**Step 4 — Review medications**

* Anticholinergics (antihistamines, TCA antidepressants)
* Alpha agonists (cold/decongestant meds)
* Opioids
* Muscle relaxants

⬇️

**Step 5 — Consider functional/postoperative causes**

* Post-anesthesia (general/spinal)
* Severe pain or anxiety
* Pelvic trauma swelling

⬇️

**Step 6 — Manage & treat underlying cause**

* Relieve retention → catheter
* Treat obstruction, adjust meds, address nerve issues, or resolve swelling