Why do I have burning urine and pain in my testicles?

Dr Flo,
What causes pain in my testicle and burning urine? N K

Dear N K,
The burning urine and testicular pain most likely means that you have an infection. It may be due to gonorrhoea, chlamydia, trichomonas, or infection by other organisms. Most likely, you acquired the infection through sexual transmission from any partner you have had in the past three to six months.
You need to have a sample of the urine taken for analysis and culture in a good laboratory. You also need an STI screen including chlamydia and HIV tests. You would also benefit from a testicular ultrasound. You will be given antibiotics to treat the infection, depending on the results.
Abstain from sexual intercourse until you have completed treatment, and you have been retested and found to be cured. Any partners you have had in the past three to six months also need to be treated, for their own health’s sake, and also to prevent reinfection to you.
If it is not treated, the symptoms may actually reduce with time, though the infection is still present. The danger is that when the infection spreads to the testicles and the rest of the reproductive tract, this can lead to infertility in the long run.
The infection can also spread to the rest of the body, causing serious illness. Any time you have unprotected intercourse, you can spread the infection to your partner. In women, this can lead to infection in the reproductive tract and pelvic organs, and can also lead to fertility problems.

Dr Flo,
I have this persistent anal itch. I have tried some medication, but it does not seem to be reducing. I went to the hospital and was given a deworming tablet and anti-fungal cream. I applied the cream, but the itch did not stop. Then I went back to the hospital and was given another cream. Whenever I apply it, I’m ok. However, if I fail to apply it, it's itchy. Sometimes my stool has blood stains.
Wolf

Dear Wolf,
Itching around the anus (Pruritus ani) can be due to poor hygiene, skin tags, constipation, fungal infection, skin diseases like eczema or psoriasis, worm infection, sweating, and allergy/irritation caused by tissues, wipes, soaps or antiseptics.
You may also havehaemorrhoidss (veins that bulge or prolapse in the lower part of the rectum and anus). The walls of the veins stretch and get irritated, and easily get a tear and bleed especially when passing stool. The piles may be on the outside around the anal opening, or may “come out” when passing stool, and sometimes can be pushed back in. These are called external haemorrhoids. If there are too far up inside to be seen or felt, they are called internal haemorrhoids.
Symptoms include a painful or itchy swelling at the anal opening, and pain or bleeding when passing stool.
They can be caused by straining when passing stool, for instance, due to constipation or diarrhoea; any activity that causes repeated high pressure in the abdominal region such as a persistent cough and lifting weights. They are also more common in people who stand or sit for long periods of time, and also during pregnancy. Most of the time, they resolve easily with diet and lifestyle changes, and with treatment, although they can recur.
It would be advisable to see a surgeon because of the bleeding and persistent itching. There are ointments and suppositories that can help relieve the itching.
Also, avoid scratching yourself, take lots of fluids and roughage to keep your stool soft; clean up with water and wipe gently after passing stool; schedule time each day for a bowel movement, and take your time.
You can also take a sitz bath — sit in warm water for about 20min twice a day to help soothe the injured tissue. Also, exercise regularly, wear loose cotton underwear and avoid underwear when sleeping. If you have noticed that some foods worsen the itch, such as pepper, avoid them.

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