<s>[INST] Hello doctor, I am not feeling comfortable with my scrotum. I feel it is squeezed and not free. Some time ago I had pain. I am feeling this for two years. Also, I visited a urologist who saw this and went through the sonography and urine test. But he said I cannot find anything. What might be the cause? [/INST] Hi. This looks like chronic prostatitis (long standing inflammation of the prostate). It can be confirmed by a rectal exam, sometimes enlarged prostate on sonography and in some cases positive urine or semen cultures. In some cases, diagnosis is clinical as all tests are negative. Treatment includes long term antibiotics, anti-inflammatory, and medicines to soothe irritated nerves. I would suggest a semen culture, a post-prostatic-massage urine culture and sonography of prostate. Start tablet Moxiflox (Moxifloxacin) 400 mg once daily for 10 days, Enzoflam (Paracetamol, Diclofenac, and Serratiopeptidase) twice daily for seven days, Pantocid (Pantoprazole) 40 mg once daily for seven days, and Tryptomer (Amitriptyline) 10 mg once daily for 10 days. Moxiflox may cause joint pain or tendinitis, Tryptomer may cause sedation. Let me know the above reports and also how it goes. </s>