Pain in Penis and Perineum 6 months after infection cleared up. Please help.

Penis and Perineum Pain for 6 Months after infection. Please help.

I am male, 23 years old, caucasian, 210 lb. No underlying conditions that I know of. I am in an extremely difficult position.

Background: Roughly 6 months ago I went to the ER with pretty severe pain in my perineum and penis which had ramped up over a few days. I was given urine tests as well as a rectal exam (no prostate issues found) and was diagnosed with a bladder infection after they found bacteria in urine. I was given extra strength bactrim for 7 days. Initially, it cleared up, in fact I felt better the morning after taking the antibiotics, but the symptoms quickly returned, although lessened. Specifically, the sensation is a dull ache that moves around to different parts of my penis (frenulum, glans, and sometimes shaft) as well as into the perineum and back of testicles. When it is present at the tip of my penis, as it most often is, I notice a redness around my urethra and frenulum. I am completley clear of infections as far as I know as no tests have come back positive. I have seen seven doctors, including a urologist, had a litany of tests, including a cystoscopy, and nothing has yielded any answers. My bladder is apparently fine with no sign of Interstitial Cystitis or any other conditions. I am now on month 6 of this pain and am starting to lose hope. As it has progressed, I have noticed slight pain in my feet as well that seems to sometimes accompany the penis pain. On top of this I have developed a strange tightness/pressure that moves around from the bridge of my nose into my cheeks, teeth and jaw, maybe related maybe not, I don’t know at this point. I have no idea what is happening to me, the seven doctors that I have talked to have no idea what’s happening to me, and I have not been able to find anything online regarding this experience.

The infection was, according to my urologist, most likely caused by the fact that my foreskin is too tight. I understand there are varying degrees of Phimosis, and mine is not the worst, but I have never fully retracted my foreskin. He recommended a circumcision to solve the issue as betamethazone stretching did not work for me. The thing is, I am absolutely mortified at the prospect of having this surgery while my penis is in pain essentially 24/7. I have no idea if it will help solve the issue or make it worse. The anxiety surrounding this issue has worsened my mental state to the point of panic attacks and two separate dissociative episodes. I am extremely desperate. I’m lost and don’t know what to do. If anyone has any shred of an idea or want’s more information about my health please just ask, ill tell you anything you want to know. Thank you and I hope you are all healthy and safe during this time.

Tight foreskin is most likely causing your symptoms. Even slight phimosis causes inflammation, penile pain, and other issues in that area. Follow your urologist’s advice - get circumcised and move on with your life. Try not to delay the treatment you were recommended.

p.s. You may want to check your prostate once more. I had my prostate checked half a year ago and there were no issues. Fast forward to 2021, another prostate exam gave me severe pain. It can creep up on you like that.

I would not be getting circumcised right now as this may only add to the issues that you currently have.
What it sounds like you need, in terms of the more ‘global’ issues you are dealing with, is to have a good GP / PCP who you can work with in an ongoing way to overcome what it is you have going on.
They may refer you to other health professionals but you should always go back to update where you are and discuss ways forward and the options for what to do next.
Until you get this kind of positive professional working relationship in place you may continue on the spiral that you are currently on, and that is not a positive place to be …