Dear fellow sufferers:

I would like to recount my bad recent experiences with the application
of a urethral cream treatment, and to recommend that everyone think
twice before trying this. Also, especially, I would like to ask please
if anyone else can share with me their own experiences with urethral
creams if any, or to offer any advice.

My history is that I have had prostatitis for about 6 years. It
started with an episode where I felt really bad with prostate pain and
fever, for which I took doxycycline after Cipro did not work. This
helped a lot, but did not cure the problem. Since then, I had periodic
episodes of dull pain which antibiotics seemed to help, plus worsening
ED (though Viagra did the trick, only at rather high doses). At the
time, I did have some problems with frequent urination, which seemed
largely food related; sugar in particular would trigger this. I tried
different antibiotics as well as antifungals, all of which may have
had some impact but did not help much and certainly did not solve the
ED. I had myself tested at several labs, but never found anything
until recently.

About 15 months ago, I decided to have myself tested at some of the
more sensitive labs round the US (though I can tell you that labs
vary, some are better than others in some things, none is extremely
good at everything). At Dr. Atilla Toth’s lab (one of the best,
which I liked very much) in New York, he found some trichomonas (in
the semen), and also he found chlamydia from a urethral swab using
Digital Immunofluorescence. I took 2 weeks of Flagyl, and retesting
(of semen) showed nothing. As for the chlamydia, I tested a few times
after that using PCR testing, and this never showed anything. Since
many people say that PCR testing is more sensitive than Digital
Immunofluorescence (DIF), which can give false results, I ignored the
chlamydia finding. Note however, that I am no longer so sure that PCR
is so accurate; in some of the reading I have done, it says that PCR
does not always detect chlamydia when it is there, because of some
change in genetic makeup or something; Dr. Toth says this also. So, I
may have had (or may have) chlamydia.

I decided to try treatment at Manila. There, of course chlamydia was
found again by DIF, and of course Feliciano believed this was a
problem. He did not find trichomonas, but I don’t think he used
sensitive testing methodology for this. Anyway, I was not symptomatic
when I went there except ED (my main problem at the time), and the
treatment did not change anything. Except, the many antibiotics
(especially lots of doxycycline) resulted in some mild irritation in
the front part of the urethra (surely fungal), which got better though
not completely with some Sporanox which I continued after leaving
Manila. Feliciano tested for chalmydia again before me leaving Manila,
using the DIF test, and did not find any. He claimed that he had got
rid of chlamydia in me, but he makes many claims that are not true.

My ED did not go away, though my mild urethritis more or less did, and
a few months later, I met a doctor whose name I will not mention. But
suffice to say that he is well respected among many prostatitis
sufferers, and I truly believe that his heart is in the right place.
Plus, he has helped several people that I have met, that I know for
sure; I just happened to be unlucky in that somehow his suggested
(relatively new) treatment did not work as hoped (to put it mildly).
Anyway, he tested for fungus using PCR and found candida dubliensis
(by PCR – cultures are not sensitive for fungus). He used some
methodology to test which antifungals the fungus would be sensitive
to, and said I need the new antifungal (LY30036 or something). He
recommended using a topical cream treatment of this new antifungal,
and he would make up the cream for me. I decided to try this new
treatment (he had only done it on less than 50 other patients, though
at the time I did not know this). The cream would be squeezed using a
syringe like device (without the needle), into the urethra through the
penis.

It is a decision that now I deeply regret, almost daily. It turns out
that the cream is a mixture of Nifuratel and Nystatitin (for vaginas
– he says the vagina is similar to urethras in this respect), as
well as the new antifungal. Nifuratel has antibacterial as well as (I
believe) antifungal characteristics. He helped me to apply the
treatments, I had about 4 or 5 in total. The first two ones resulted
in a little bleeding from just inside the urethra, though without
pain. (He said this was unusual and did not happen with other
patients.) The cream itself did irritate the urethra, nut did not
really hurt it. On the last day of treatment, I felt a sharp pain
right at the tip of the urethra a few hours after the treatment(at the
very part where the penis opens, and not where the bleeding had
occurred previously), which lasted just for a few hours and then went
away. This was the first time that this had ever happened to me.

A few days later I had one of my periodic attacks of prostate pain,
which were never that bad (dull ache was the main symptom). I did not
take antibiotics, and after a while it sent away. At this time, I got
tested at Toth’s again, and this time he found nothing except
the chlamydia by DIF again. I did take more doxycycline, and did not
retest afterwards.

Well, ever since that time, I started noticing a feeling of blockage
at the tip of the penis, and a reduced stream. There was no pain at
the time. But about 4 months after that, I had a sharp pain at the tip
of the penis again but worse than before. I also felt quite bad, so
bad that I decided to try both Zithromax and Diflucan 300 mg, both at
the same time. I felt better after about 2 days, and the pain receded.

I continued on both these drugs, and I was not too bad for a few
weeks. But then I had a similar attack again of pain the tip of the
penis, and this time the Zithromax/Diflucan did not help. All my
urethral symptoms started to get a lot worse – the pain spread,
I started to have a yellow discharge (sometimes), also my penis
started to curve a bit (which I attribute to possible urethral damage,
since there is no evidence of plaque on the surface of the penis).

Right now the pain is really quite bad sometimes, not just at the tip
of the penis but at other places inside the urethra also at times. I
don’t even think about sex since the pain in the urethra gets
worse with an erection. Clearly, a process was started or triggered by
the urethral cream application (either by the cream itself, or by the
abrasion on the urethral surface which caused some bleeding).

I just got tested with Dr. Toth again. He found this time trichomonas
as well as enetococcous faecalis, clostridia hastiforme and ome or two
others. No chlamydia finding this time. I am starting Flagyl again.

I am hoping of course that the removal of these bugs will eventually
lead to a remission of urethral symptoms. I would be extremely happy
with that.

I contacted the doctor who applied the urethral cream, and he of
course says he thinks what happened to me was a
“concidence”. To me, how can this be a coincidence when I
had had prostatitis for 5 years, and this urethral pain thing started
on the last day of this treatment? (I had never had real pain in the
urethra before that.) I am not sure exactly how it happened, but one
possibility is that the antibacterials in the cream changed the
mucosal flora in the urethra, causing other things like trichomonas to
attack that area more easily where previously they did not cause
symptoms. Or somehow, the cream weakened the epithelial barrier. Or,
the abrasion triggered some intense cystitis-like activity. I still
respect him and knows he has helped a lot of others, but I hope he
isn’t continuing this treatment. (He says there is no other
cases in the literature like mine. But to me, there is probably no
precedent of anyone in the literature taking a urethra without
urethritis already existing, and putting in the particular mix of
substances that he used with me.)

So right now, I will try to remove all bugs and see what happens.
Living with this thing is really awful. I welcome all comments on my
case; but especially, I would like to hear from anyone with (good or
bad) urethral cream experiences.

John