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Non Specific Urethritis - Recurring for years
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Non Specific Urethritis - Recurring for years

Dr,

Diagnosed NSU after possible incident with non regular partner 6 yrs ago. Unsure if condom used.
Treated with 1g Zithro.
Then unprotect oral with regular partner (both ways). No exposure with reg partner took place after above incident before I took zithro.
Retest for NSU - Clear
Unprotect oral with regular partner both ways
Retest for NSU >5wbcs
Treated with 1g Zithro
Retest for NSU - Clear
No sexual exposure then retest few wks later >5wbcs
Treated with Doxy & Metrodiz
Retest months later (protected vaginal sex with reg partner twice) >5wbcs
Treated with 1g Zithro & Doxy
Retest 3wks later (no exposures) >5wbcs
Treated with Doxy & Metrodiz, no retest.
All sex with reg partner protected since then.
Retest for NSU 4yrs later - Clear.
Hand to genital exposure with reg partner.
Retest for NSU in private clinic 2months ago >5wbcs
Treated with 5days Zithro
Retest NSU - Clear.

1) I asked was my partner exposed to possible Mycoplasma Genitalium after my 1st zithro "failed" when she gave me unprotected oral. He said no. Is he correct?

2) Is this an sti? Not even sure the drunken incident even took place. Maybe its just guilt/anxiety?

3) 1g Zithro may not be sufficient to deal with Mycoplasma Genitalium if it was a cause. Is it safe to say this wasn't due to MG; based on fact it recurred twice having taken 1g Zithromax but on 3rd attempt of 1g Zithromax it went away for 4years? I.e If it was MG in first instance it appeared to be resistant to first two doses of 1g Zithromax so it would't have gone away on the third dose.

4) Could it be herpes? I have no symptoms. Should I get a type specific HSV test? Would it give a definitive answer for herpes?

5) My regular partner was checked before for Chlym & Gono. Nothing found. We want to commence unprotected sex, is it now safe?
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Hello,
Thank you for your post and welcome to our forum.  Here are your answers:
1) I asked was my partner exposed to possible Mycoplasma Genitalium after my 1st zithro "failed" when she gave me unprotected oral. He said no. Is he correct? MYCOPLASMA HAS NEVER BEEN CONFIRMED IN ANY OF THE TESTS THAT YOU MENTIONED, AND WOULD ALWAYS RESPOND TO AZITHROMYCIN.  IN ANY CASE, IT IS NOT USUALLY TRANSMITTED THROUGH ORAL SEX.  THEREFORE THE ANSWER WOULD BE NEGATIVE.

2) Is this an sti? Not even sure the drunken incident even took place. Maybe its just guilt/anxiety? NOT NECESSARILY.  NSU CAN BE CAUSED BY MANY THINGS, NOT ONLY SEXUAL INTERCOURSE.

3) 1g Zithro may not be sufficient to deal with Mycoplasma Genitalium if it was a cause. Is it safe to say this wasn't due to MG; based on fact it recurred twice having taken 1g Zithromax but on 3rd attempt of 1g Zithromax it went away for 4years? I.e If it was MG in first instance it appeared to be resistant to first two doses of 1g Zithromax so it would't have gone away on the third dose.
IT HAS NEVER BEEN CONFIRMED IN ANY OTHE TESTS; THEREFORE I DEEM IT UNLIKELY TO BE MYCOPLASMA.  IN MY EXPERIENCE IT ALWAYS RESPONDS TO AZITHROMYCIN.
4) Could it be herpes? I have no symptoms. Should I get a type specific HSV test? Would it give a definitive answer for herpes?
SYMPTOMS ARE NOT CONSISTENT WITH HEREPS.  THESE WOULD BE PAINFUL BLISTERS.  YOU COULD GET A PCR TEST FOR HERPES WHEN HAVING SYMPTOMS, AS WELL AS A BLOOD TEST, EVEN THOUGH THIS WOULD NOT BE VERY USEFUL AS WOULD NOT CONFIRM THAT THESE SYMPTOMS ARE RELATED TO HERPES IF POSITIVE.  ONLY IF YOU GET A NEGATIVE RESULT, WE COULD BE CERTAIN THAT IT IS NOT HERPES.
5) My regular partner was checked before for Chlym & Gono. Nothing found. We want to commence unprotected sex, is it now safe?
IF YOU BOTH HAVE BEEN TESTED FOR ALL STDs AND ALL TESTS HAVE BEEN NEGATIVE, WE CAN CONCLUDE THAT IT WOULD BE SAFE TO HAVE UNPROTECTED INTERCOURSE.  THE ONLY ABNORMAL FINDING IN YOUR CASE IS THE PRESENCE OF WHITE BLOOD CELLS, WITHOUT THE CONFIRMATION OF ANY SPECIFIC INFECTION.  ONE WOULD ONLY NEED TO TREAT THIS IF SYMPTOMATIC.
Kind regards,
Dr José
4 Comments
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Avatar_m_tn
Thank you Dr,

Two final questions regarding your reply if I may.

Is it even worth getting tested for herpes now? It has been 7years since this incident & I have never had any symptoms (i.e. blisters). Does a type specific test for herpes give a definitie answer as to whether you have it or not, leaving aside any issues with NSU?

If the NSU is still symptomatice despite following the correct line of antibiotic treatments & no new exposures would it still be retreated again by doctors & if so why?

Thank you again.
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Avatar_m_tn
Dr,

Just to add to my previous post I was never tested for Mycoplasma Genitalium as the clinics told me there is no standard test for it in standard sti clinics. Does this alter your opinion from that of your previous post? When you say it responds to Zithromax, is 1g single dose sufficient in your experience, as you seen from my posts my NSU was recurring?

Thank you again for your time, I would appreciate a reply to my last posts & this will be the end to my queries.
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Avatar_m_tn
Doctor,

Apologises for posting again but I would appreciate if you could reply to my 2 posts above when you have a moment.

Thank you
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