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Burning sensation in the tip of my urethra
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Burning sensation in the tip of my urethra

last october i received oral sex from a women. a few days later I started to get a burining sensation in the tip of my urethra and a clear discharge. my doctor ordered a swab test. all negative. he gave me some antibiotics. burning sensation went away. now in july i started to feel a burning sensation again. i havent had a sexually encounter since october. 1)can NGU be detected by a swab test? 2) since it didnt find anything what could it be? ive read that herpes can cause urethritis and burning sensation but iam positive i havent had any outbreaks. 3) should i get tested for herpes? why did it go away with antibiotics the first time?
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239123_tn?1267651214
Welcome to the forum.  Your question has some parallels with the one immediately preceding it.  Please read it so I don't have to repeat some basic facts about NGU following oral sex:  http://www.medhelp.org/posts/STDs/confused-about-ngu/show/1560405

Unlike the other questioner, it is apparent you did indeed have NGU following your exposure last October and the problem cleared up with antibiotics.  Recurrent NGU is quite a common problem, but generally that happens within a few weeks, and your current symptoms probably are unrelated to the previous episode or that sexual exposure.  As you found first time, NGU generally causes discharge as well as painful urination -- so if no discharge develops this time, that also would argue against recurrent NGU.

However, you are correct that herpes could be responsible -- unlikely but should be checked out.  HSV is responsible for a small minority of NGU cases (under 5%), and HSV-1 can be acquired by oral sex.  However, herpetic NGU usually is more painful than your description implies.  Still, it is possible that your current symptoms are due to a herpes recurrence.  I recommend you return to your doctor and discuss testing for HSV.  Do it very soon; reliable testing has to be done within a few days of onset.  Herpes NGU clears up on its own in a few days; it might be that the improvement while taking antibiotic was coincidental, not due to the antibotic (antibiotic) treatment.

Those comments respond to questions 2 adn 3.  Question 1:  There is no lab test for NGU.  The diagnosis is based on careful examination to look for abnormal discharge or other abnormalities, like redness of the urethral opening; and to examine a swab specimen under a microscope for elevated white blood cells.  If no WBC are seen, it is strong evidence against NGU.

Let me emphasize that herpes probably is not the problem.  But careful examination and lab testing are the only way to know.  I'll be happy to comment further if you want to report back with the results of professional evaluation.

Regards--  HHH, MD
11 Comments
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Avatar_m_tn
dont you think its kind of odd that ive never had a outbreak? the tip of my urethra is always burning with and without urination.  does it still sound like hepes NGU?
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239123_tn?1267651214
HSV could cause burning both with urination and without it, and it is possible that a herpes recurrence could happen only inside the urethra without external visible lesions.  An abnormality anywhere inside the urethra often results in pain primarily at the tip, so it is possible to have a cause that is not visible at the site of pain.

All this is speculation until you have been examined and tested.  There is no short-cut to a specific diagnosis; I can only suggest possibilities, not give you a definitive diagnosis.
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Avatar_m_tn
in my case which is more likely the cause? herpes type 1 or 2? as an STD expert have you seen or heard of anybody thats contracted  NGU herpes type 2  by oral sex without a visible outbreak ?
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Avatar_m_tn
how frequently does herpes type 2 gets spread by oral sex? is it rare?
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Avatar_m_tn
would the discharge from my penis in october cross out herpes? dont mean to sound persistant and annoying. but as you can imagine iam a little nervous.
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239123_tn?1267651214
HSV-2 is not transmitted by oral sex, only HSV-1.  And no, having a discharge does not rule herpes either in or out.

Please carefully re-read everything I have said so far in this thread, and concentrate on every sentence; you should find my opinion and advice reassuring.  For the third and last time, I will comment again if -- and only if -- you report the result of professional evaluation in person.  Any and all other follow-up comments will be deleted.
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Avatar_m_tn
good news doc .tests were negative for herpes 1 and 2. whats the next step? recurrent NGU infection or something else?
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239123_tn?1267651214
Presumably those are HSV blood test results, correct?

As I said above, NGU is not known to recur this long after an initial infection.  Therefore no STD is the likely problem.  If the symptoms persist, you'll need to be examined by your own doctor or clinic.
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Avatar_m_tn
yes sir, blood tests were negative for both types of HSV. Ive been tested for every STD. Except maybe syphilis and hepetitis (hepatitis). dont know if this could cause the my problem. weird thing is that it went away after antibiotics. is syphilis or hepetitis (hepatitis) caught after after receiving oral sex?
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239123_tn?1267651214
Those other infections are not an issue here.  I have nothing more to say; this thread is over.
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