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STDs (Expert Forum)
Prostatitis -- don't know what to do -- please help
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
Prostatitis -- don't know what to do -- please help
by unknownSpace, Jun 22, 2005 12:00AM
Dear Dr. H,
First of all, thank you very much for your help.
I am a 21 yrs old male. The story began in Oct 2004, I had sex with a sex worker. First, I performed oral sex to her witout protection, then I had protected virginal sex with her. Because I did not eject, she changed a new condom and performed oral sex to me (protected). However, I still couldn't eject, then I had virginal sex with her again. Still I couldn't eject, she changed another condom, then oral sex, then virginal sex...totally condoms were changed 3 times.
Finally when I had my mind again, I was deadly afraid that I might got STD, because during the change of condom, her viginal fluid might get into my body through the tip of my penis.
3 weeks later, I consulted a health provider. I was tested for Chlamydia and gono (both sample taken form uretha), HIV, VDRL, TPHA, HSV2, all came back negative.
However, there were pain in my uretha, 6 weeks after the exposure I was tested again for trich and Chlam (both from VB1 sample), VDRL, TPHA and HSV2. All back negative except the trich, then I was treated with 2 weeks antibiotic (I don't know what the drug is but may be Flagyl).After 11 days there's still pain in my uretha and scrotum. 8 week after exposure I was tested again for Chlam, Gono (both semen sample) and trich (VB1 sample, antigen test) The Trich test came back negative but the Chlam test showed weak reaction. Then the doc gave me a new antibiotic for 2 weeks.
But my bad luck did not stop there. one week later, there was pain in my left testicle. I went to emergency room then the doc gave
First of all, thank you very much for your help.
I am a 21 yrs old male. The story began in Oct 2004, I had sex with a sex worker. First, I performed oral sex to her witout protection, then I had protected virginal sex with her. Because I did not eject, she changed a new condom and performed oral sex to me (protected). However, I still couldn't eject, then I had virginal sex with her again. Still I couldn't eject, she changed another condom, then oral sex, then virginal sex...totally condoms were changed 3 times.
Finally when I had my mind again, I was deadly afraid that I might got STD, because during the change of condom, her viginal fluid might get into my body through the tip of my penis.
3 weeks later, I consulted a health provider. I was tested for Chlamydia and gono (both sample taken form uretha), HIV, VDRL, TPHA, HSV2, all came back negative.
However, there were pain in my uretha, 6 weeks after the exposure I was tested again for trich and Chlam (both from VB1 sample), VDRL, TPHA and HSV2. All back negative except the trich, then I was treated with 2 weeks antibiotic (I don't know what the drug is but may be Flagyl).After 11 days there's still pain in my uretha and scrotum. 8 week after exposure I was tested again for Chlam, Gono (both semen sample) and trich (VB1 sample, antigen test) The Trich test came back negative but the Chlam test showed weak reaction. Then the doc gave me a new antibiotic for 2 weeks.
But my bad luck did not stop there. one week later, there was pain in my left testicle. I went to emergency room then the doc gave
Doctor's Answer
by H. Hunter Handsfield, M.D., Jun 22, 2005 12:00AM
, Jun 22, 2005 12:00AM
There's obviously more information coming in a comment I haven't seen yet. But your risk of STD from that exposure was low, and based on the test results you don't have any infection. I doubt you have prostatitis either, even though many doctors make that as a "wastebasket" diagnosis; most "prostatitis" in men your age isn't a prostate gland infection at all. (A wastebasket diagnosis is when a clinician can't come up with a clear answer and makes an assumption about the diagnosis.) Your urethral pain more likely is psychogenic, i.e. anxiety magnifying normal body sensations. But I wait to see more about your testicular pain.
HHH, MD
HHH, MD
To continue, there was pain in my left testicle, no swollen. I went to emergency room then the doc gave me two weeks of minocycle. It did not resolve my problem. Niddle like pain were in urethra, scrotum, and near anus.
On Feb 2005, I was diagnosed with Prostatitis (Staphylococcus was found) and hospitalized for 5 days (no fever). After checked out from hospital for 10 days, EPS culture was performed and no germ was found this time. But the niddle like pain was still there in urethra and scrotum. Although the doc told me the pain came from my anxiety, but I didn't think so.
Anyway, I went to another urologist, I was performed a prostate ultrasound and Cystocpoy, both came back noraml. However, E. Coli was found in semen culture as well as in middle stream urine culture. Now I have taken Levofloxacin (400mg once per day) for 5 weeks already, and the syndrome still there, niddle like pain in urethra, penis, public hair area and scrotum, tingling feeling in the skin of public hair area, penis and scrotum.
Doctor, could you please answer me the following questions:
1. In a full STD screen, what kind of test should it include? Did my doctor give me a full STD screen? Did my doctor do those tests in the right time (after incubation period)? (Sorry to say, I am living in asia area, and there's no STD specialist I can find, only urologist and dermatologist)
2. Regarding the Chlamydia and Gono test, which kind of sample will give the most accurate result? sample from urethra swab, urine, or semen?
3. I couldn't stop thinking that my chronic prosatitis is coursed by Trich or Fungi besides bacteria, since I did have sex with a sex worker, but several urologists said that the chance is very low that they denied performing trich / fungi test for me. Dr. H, what's your opinion?
4. If I insist on getting a trich and fungi test, what kind of test will give me the most accurate result? Where should the sample be taken? using EPS or semen?
5. 5 weeks of levofloxacin still couldn't get rid of the symdrome, I am afraid that besides E. coli there's still another kind of germs. My semen culture test says there's heavy growth of E. coli, can it happen that E. coli is growing too heavy so that other germs couldn't be seen by the operator?
6. How long should I take antibiotics? till all symdrome disappear?
7. One of the urologists I consulted use the semen culture instead of EPS culture to diagnose my prostatitis, is it correct?
8. After I stop my antibiotic, how long should I wait before another culture test is performed? and should I get an EPS culture or semen culture? Which one is better?
9. If I don't recover after a long period, should I get my prostate removed? does it affect my fertility?
10. Is prostatits an infectious disease? is it related to my sex worker exposure?
11. Besides taking antibiotics, what else should I do? Which else tests should I be performed? Doctor H, I am very stressful at this moment, please give me some help.
Thank you for you help and the creator of this forum, this benefits people a lot, espically for those who couldn't consult a STD specialist in their living area.
1) You had a very complete STD evaluation, especially in view of the low risk nature of the exposure you describe.
2) The sample for chlamydia and gonorrhea testing (urethral swab, urine, etc) is less important than the test method. Since you had a urine specimen ("VB1"), the test almost certainly was a nucleic acid amplification test, which is the best kind available. You can be 99% certain you never had gonorrhea or chlamydia; and 100% certain that if you did, it was cured by the treatments you received.
3) The urologists are right.
4) No need to test for trich.
5-11) I don't think your current symptoms indicate an infection or any other serious problem, except for the anxiety you obviously are experiencing. I do not think additional antibiotics will help. As I said initially, "prostatitis" often is not a distinct entity (the American Urological Association classifies men with your symptoms as "pelvic pain syndrome" rather than prostatitis). My suspicion is your next best bet is a visit to a mental health professional (which I suggest out of compassion, not criticism). But I can't second-guess your own doctors; you should follow their advice. (And good God, no, you don't need your prostate removed!)
Good luck-- HHH, MD
i'm sry to post this here but everytime i try to post its always full.
9 days ago I had unprotected vaginal and oral