Suggest Treatment For Severe Pain In Prostate

Posted on Wed, 22 Oct 2014

Question: I have had severe pain at my prostate for months now. Back in May I was diagnosed with diverticulitis. Doctors have been giving me antibiotics with no real improvement. Now when I urinate fecal matter comes out. Trying to get in for more tests this week. What do you think is going on? Very painful and scary, thanks for your help.

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Symptoms due to Chronic Prostatitis.

Detailed Answer:
Hello
Thanks for query , Based on the facts that you have posted it appears that you have Chronic Prostatitis with diverticulitis .You have been taking antibiotics with no improvement in symptoms .

Involuntary discharge of faecal matter and gas while passing urine is due to relaxation of the anal sphincter due to having same nerve innervation by by Pudendal nerve which supplies urethral sphincter .

Please note that Chronic Prostatitis takes long time to get cured hence one has to take appropriate antibiotics as per culture report for 3-4 months.

Please consult qualified Urologist for clinical and digital rectal examination and get following basic test done to confirm the diagnosis.
1) Swab test and culture of a fluid obtained from urethra obtained after prostate massage .
2) Ultrasound scanning of abdomen and Trans Rectal Ultrasound Scanning (TRUS)
3) Colonoscopy to see status of Diverticulosis.

Further treatment will depend upon the results of these test and final diagnosis.

Hope I have answered your query ,Please feel free to ask if you have more questions ,I shall be happy to address the same.

Thanking you with Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (46 minutes later)

Thanks doctor but I don't think I made my question clear. Fecal matter and gas come out of my penis when I urinate.

Answered by Dr. Dr. P. T. Patil (5 hours later)

Brief Answer:
Sorry for mis interpritation.

Detailed Answer:
Hello
Thanks for follow up . You have developed abnormal communication between rectum and Bladder or Urethra (Recto Urethral fistula or Vesico Rectal fistula) and is mostly due to involvement of urethra or bladder due to diverticulosis of colon

You need to consult qualified Urologist and Proctologist for detail assessment
,and get following basic tests done
1) Retrograde Cystourethrogram
2) Colonoscopy
3)Endoscopic examination of bladder and urethral passage
4) MRI of the pelvis .

This is dreaded complication and needs surgery to repair the fistula which will be jointly decided by the team of urologist and proctologist..

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (3 hours later)

Thanks Doctor XXXXXXX

Answered by Dr. Dr. P. T. Patil (47 minutes later)

Brief Answer:
Go ahead and get the tests done.

Detailed Answer:
Hello
Thanks for follow.Please get investigations done .
Thanks and Regards.
Dr.Patil.

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar