Urinary Tract Infection

[rb_in_ca]

Hi,

Pardon the long post, but I want to give a complete picture of my symptoms to hopefully avoid a simple "men never get UTIs" response and try to actually start at getting a differential.

As pertinent background: I am a disease ecologist who frequently travels to very remote corners of the world---the places with emerging infectious diseases, malaria, etc. I also have been a habitual/compulsive masturbator---from age 12 to 23, normally 3-8 times per day, as many as 25 or so. Now I'm down to usually 2-4 times a day, rarely more than 8. I'm also married and enjoy a great sex life with my wife.

Since about the age of 15 (two years before I'd ever had sex), I've occasionally come down with symptoms that now seem to be exactly like UTIs (I figured this out after having a wife with UTIs). Basically the symptoms are a need to urinate, cloudy urine and pain (often intense pain) when *not* urinating (and no pain when actually urinating)---this has kept me up all night some nights and caused me to miss school/work on occasion. From age 15-21 I would have these about 3-5 times per year and I wouldn't treat it. It'd usually last 3 or so day and resolve on its own, though a couple times over the next few days the sides of my lower abdomen would start to hurt pretty bad and I'd run a fever of around 102F. I didn't talk to a doctor about this at the time as I was embarrassed. Usually (always?) this happened after masturbating several times in a row and often after I had to close off the tip of my penis with my hand to prevent semen from being excreted when I had to be in public shortly thereafter.

At age 21 I started my career in field biology/disease ecology and worked in a very remote jungle outpost for 5 months; there was no running water, I lived in a small tent and conditions were dirty and primitive. During this time I had probably 10 or so incidents like this (in addition to several other infections of various sorts). I was completely sexually abstinent at the time, thought I frequently masturbated.

Shortly after returning home I realized it might be UTIs and I started taking Cipro (prescribed for traveler's diarrhea) when it happened---and that always cleared it up within a day.

In subsequent trips to the field I've noticed an uptick in events as well, though to a somewhat lesser extent. When at home in America this usually only happens once or twice a year now.

Recently (over the past 6 months) I've had a resurgence in these events. Also, they now seem mostly decoupled from masturbation. They tend to happen more often after sex with my wife than after masturbating. I talked to my doctor about it and he did a rectal exam and said my prostate seemed normal and that UTIs were unlikely. He also ordered tests for several STDs and all of them came out negative. As I wasn't symptomatic at the time, he couldn't order a culture. These incidents seem to usually happen on the weekends when the doctor is out so I tend to take Cipro to ease the often unbearable pain and I've yet to be able to have a culture taken.

My questions are A: do you think these are UTIs? B: If they aren't, any clue what they could be? C: If they probably are, what should I do? Should I worry about them or just keep doing what I'm doing---taking Cipro when they occur and not really worrying about it?