Posted by HFHS M.D.-MS on February 20, 1998 at 17:42:49:

In Reply to: Non Specific Urethritis posted by Hunter on February 15, 1998 at 09:52:19:

: I am a 30 years old Engineer working in Nigeria . I was diagnosed about one year ago with Non Specific Urethritis .

The doctor prescribed an antibiotic to treat the disease . ( yellow pills , I think proxycyclin , name of the medicine is not written on the pills and the pills were given to me in a plastic container . I got the proxycyclin name from the nurse ) .

The mild clear discharge from the penis in the morning disappeared and so did the mild pain when urinating . However , after 1 - 2 weeks from stopping the treatment , I had the same problem again ( NSU ) which was confirmed again by the doctor through medical Lab test and culture .

I visited my doctor for more than 6 times during the past year and the same problem occured i.e. ( symptoms disappear and then appear after stopping the antibiotic ) .

Recently I felt a slight pain in my testicles and I think this is related to the NSU .

Please HELP me in treating this once and for all . I don't think I can have a proper medical treatment here and I will need about 6 months before I can actually travel outside Nigeria .

Is there any other stronger antibiotic that might cure the NSU ? Is the testicle pain related to the NSU ? I was told that Doxycyclin is more effective on the NSU but I don't know what dosage I should have and for what period ?

I also heard that NSU can cause infertility . is that true and how long can someone diagnosed with NSU be lfet untreated before it will cause infertility .

I am really in great confusion and frustration and I hope to hear your reply to this problem soon .

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Dear Hunter
Thanks for your question.
I am not familiar with the drug Proxycyclin and it is not in the Physician Desk Reference. It is probably in the family of tetracycline which is used to treat Chlamydia and urethral infections. As you know, Chlamydia is considered a sexually transmitted disease and is very difficult to culture. It grows inside live cells. Gonorrhea is also a pathogen and causes a very thick urethral discharge but is not covered by tetracycline and is currently about 35% resistant to Penicillin in the US. It has been quoted that approximately 60% of patients with cultured gonorrhea also has Chlamydia.
As you may know, urethritis in the US is divided into Gonococcal and Non Gonococcal Urethritis NGU. I presume the “Nonspecific Urethritis” you have been diagnosed with is Nongonococcal variety. Initial treatment of choice is Tetracycline 500 mg four times a day, Minocyline or Doxycycline 100 mg twice a day or Erythromycin 500 mg four time a day. This regiment should be for 7 days and to treat the sexual partner also. Persistent NGU should be managed by questioning about compliance and re-exposure, demonstrate recurrent urethritis with cultures and treat the cause if elicited. If no cause found, treat with erythromycin base 500 mg four time a day for 14 days. This is for presumed Ureaplasma.
Infertility is seen mainly in the female patient with Pelvic Inflammatory Disease ( 12% per occurrence). Scarring of the urethra (stricture) is seen frequently after untreated gonoccocal urethritis but the incidence per STD episode has not been determined in the literature.
Often the clear discharge and burning is related to frequent self examination or chemicals to which you may be exposing your penis (partners body fluids, fluids in condoms, spermacidal drugs used for birth control, local trauma) after the treatment is completed
As regards your scrotal pain, without specific findings (changes from normal that can be objectively found by physical examination), I doubt that the two problems are physically related.
Now for the necessary disclaimer. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
Hope info. has helped and Good Luck.
Sincerely:
HFHS-M.D. MS
* Keyword: Nongonococcal Urethritis