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Abdominal fullness, urgency to pass urine after sex.

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hello, i had a sexual interaction with a male (im male) at the end of last august he gave oral then a little penis touching. Also he had tights on that probably were not washed in a while. my symptoms for a long time now have been lower abdominal fullness urgency to urinate sensation of "heat" of skin around right inner thigh, right hip, swollen epydidymus. I noticed that the fullness in my lower abdominal are has reposition my penis slightly lower into my crotch so that when i bend, my testes are forced against my inner thighs. Also have had swelling of the groin area lymph and noticing extra groin "meat" around the base of penis just have general discomfort for a long time now. I suspected trichomoniasis took flagyl from planned parenthood and it seemed to help the area, but not sure. in the same time period i think i infected my wite with whatever i have so that when i had intercourse with her after the flagyl symtoms of discomfort seemed to return, or maybe they never went away but the flagyl just "relieved" them for a short period. my primary care physisian is prescribing excercise and doesn't acknowledge the trich suspicion. I'm so worried that i have it and my wife has it, also worried now that having it this long (about 6 months now). Also, my face has been more red and feeling like it is wider. but the main symptoms are heaviness and fullness of the lower abdominal bladder area, burning skin sensation especially the right pubic area right inner thigh and right hip swollen epydidimus and tender sensitive testicles, weaker urine flow and heightened urgency to pee even with a little fluid present. Any help would be greatly appreciated. Visual signs on penis that were not present before are a small less than 3mm flat patch of whitish flaky area on the penis head not itchy or painful and also some small dark purple papules (about 20 or so) on my scrotum but more on the right side than left.

Category: Sexually Transmitted Diseases(STD)Specialist

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Category: HIV- AIDS Specialist
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Hello,
Thank you for your medical query at DoctorSpring.com
I understand your concern.
You definitely seem to be suffering from a bacterial infection probably from the oral sex episode. Were you wearing a condom while receiving the oral?
Besides the lymph node, do you have any tightness in the groin? Do you feel the groin muscles are in spasm? Is there any difficulty in urination? ( pain/ bleeding in urine )?
I will also request you to upload a picture of white patch and the purplish spots you mentioned.
You definitely need to get an ultrasound scrotum done to rule out bacterial epididymitis.
Feel free to discuss further,
Regards.


Patient replied :

hi doctor,
I dont have any blood in urine or semen now, but before i took the flagyl, my semen looked to be tinged red a little and felt a little pain after ejaculation. I don't know how to upload the pictures from here so didn't do that. I was not wearing condom during oral. now this much later i just feel a fullnes and heaviness in the lower abdominal bladder area and feel an extra flacidity to the penis and the testes also sensitivity and the heat i mentioned earlier. I feel weak urine and like my abdominal muscles arn't acting together to push urine out or whatever, it feels like my lower abdominal bladder area will just "fall out" and when i urinate the main influence on the urine is just gravity like i cant push it out faster by tightening my abdominals like before all this. i just dont feel well


Hello,
You need detailed investigations.
You may be suffering from prostatitis/ cystitis. Now that you mentioned about the tightness in the muscle, it raises suspicion of a bacterial infection. I will advise you to get a Urine routine and culture repeated, and also get a scrotal ultrasound done.
Regarding the patch and the spots, since there are plenty, please get it examined by a dermatologist.
I will recommend after giving the urine for testing, you should start Tab. Cotrimoxazole ( TMP-SMX ) twice dily for 7-10 days and let me know if there is improvement in your symptoms.
Hope this was helpful,
Regards.


Patient replied :

Hi Doctor,
Thanks for your suggestions, I know how difficult it can be to diagnose without seeing and hearing all the complete symptoms and when they occured thats why i was trying hard for a phone consultation before this because it would give me the opportunity to clarify sequence of events more thoroughly. I had a routine urine and blood about 4 mos ago and urine was normal the only anamoly was low platlet count in blood but the number was just under the normal range nothing extreme. I received another urine routine 1 wk ago and again normal. I had an ultrasound of the liver and and kidney and abdominal area (everything but the scrotal area) and they showed nothing. Recently my wife had a blood and urine exam and showed an out of range white blood cell count in her urine, but no bacteria and also her blood looked normal. I'm fearing the worst at least the worst from my point of view because it seems that for both her and i we can eat or not eat and our lower abdominal area is still big. I think i need to find a non obvious approach to get her to get a full pap smear examination. My psa is 1 so it is low and until the 2 weeks after my encounter my body always felt consistant and i could always accurately estimate the effects of my dietary excesses but now i feel as though if i overeat i feel the same or better and if i undereat i feel worse, it feels as though something as taken control of my genital and gastro intestinal area and im helpless. I will gladly take any more thoughts from you on this and then close discussion after that. Thanks again for all your help.


Hello,
That one incident did a lot of damage to your mental health.
It has obviously stressed you out completely.
You need to get the ultrasound scrotum, and the fact that she has wbcs in her urine, indicate an active infection which she could have acquired from you.
Overeating/ undereating can be both different manifestations of stress, or depression and you need to discuss this with a psychologist.
Please get the ultrasound scrotum and get back to me.
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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