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Follow up on Recurrent NGU
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Follow up on Recurrent NGU

Dr. Gonzalez,

I wanted follow up with you on my status. I am still (7 months no) struggling with this recurring NGU. I have had no further contact since February. I have taken all the recommended antibiotics from your last email, that is, a new urologist prescribed me the metronidazole along with the doxycycline. It was just as effective as the doxy on its own but the infection keeps coming back. I get a bothersome almost itchy sensation in my urethra, slight burning when urinating sometimes, and a small amount of clear discharge in the mornings. Just recently, I went to a new urologist and he finally ran some tests for mycoplasma and ureaplasma (I know there is some controversey about these but...) in any event, a test finally came back positive for something, ureaplasma! Finally something came up! So, the doctor prescribed me 10 days of azythromicyn 250mg. Again, it was as effective as the doxy BUT this time, the infection came back only 2 days after finishing the prescription. This is the fastest it has ever came back. Usually after I take doxy for 10 - 14 days, it takes maybe 2 to 3 weeks for it to reach the level it has reached now only 2 days after the azythromycin. I was under the impression from the urologist, that azythromycin would take care of the ureaplasma! I am so concerned about the effects of this infection to my over all health and specifically my re-productive health. Do you have any other options? i am so frustrated and worried. What can you tell me about my overall health consequences? Will I ever get rid of this. All other tests get nothing on culture. No other std's come up positive. I am at my wits end! Please help!
1024580_tn?1331577721
Hello,
Thank you very much for your post and welcome back to our forum.  Sorry to hear that you are still suffering with these symptoms.  It is clear that what you have has now become chronic urethritis.  You ought to go back to see the Urologist for further advice.  Ureaplasma is frequently found and usually has no serious clinical implications, unless the patient has symptoms, like in your case, and should be treated.  However most of the times, if the patient is asymptomatic, we do not even bother treating it.
Ways of treating chronic urethritis is with long-term antibiotics for 3-6 months on a low dose (i.e. doxycycline or others), combined with anti-inflammatories, alpha-blockers, as well as medines that can change the pH of the urine to reduce the discomfort when urinating.  In addition to this, it might be worth having a test of cure to assess that the Ureaplasma has been erradicated.  It would be wise to discuss all of this with your Urologist.  Prostatitis should be excluded also.
Kind regards,
Dr José
3 Comments
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Thanks for your answer doctor. So you don't believe this would affect my fertitlity at all or cause any other damage? I have been off and on again different antibiotics for this since March of this year. Is that causing any harm? Prostitis has been ruled out as well. I have heard that test of cure are also controversial for this bacteria as tests still pick up the dna of this baceria although it is dead. Is there a test that can definitively test for cure? I am in the US. Lastly, will treating this with antiobiotics for 3-6 months straight take care of this? As long as I take a probiotic, I have very little reaction to them so I am willing to take them for this long. My only fear is that this is a resistant bacteria but since I feel better when on antibiotics, I guess it is not, correct? thanks for your time!
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1024580_tn?1331577721
I think that it is unlikley that this will have a detrimental impact on your fertility.  A test of cure should be reliable provided you waited long enough since the end of the course of antibiotics, at lest 4-6 weeks.
The fact that your symptoms do respond to the antibiotics is certainly a good sign and should clear the infection for good.  Probiotics are certainly a very good idea.
Best wishes,
Dr José
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