Clear Discharge, Sore Testicle

[glass33]

Good evening. First I would like to say that I really appreciate all of the help and advice that yall provide. As far as my situation goes, it's pretty simple, but I am somewhat stressed about it. I am male, 27 years old.  About 2 months ago, I had protected sex with a woman. Before I put on a condom, there was some contact of genitals. After the condom was removed, there was still a little friction of both parts. About a month later I was feeling some slight itching, and a little discharge. I went to get a full std bloodwork checkup, I did not receive a swab.  Everything came back negative. I told them my symptoms and was still prescribed a round of antibiotics (amoxicillin). Everything was fine, and about 3 weeks ago around the first week of September I received unprotected oral sex from another woman. Just recently I started having a dull pain in my left testicle, and began to have a clear discharge from my penis. It is odorless, and not really bothersome, except for the fact its there and it concerns me. I have no pain when I urinate. Most of the discharge takes place after a bowel movement. I do occasionally have a slight discomfort in my urethra. My concern is could this be something from the first encounter that was overlooked? Or is this something more along the lines of a prostate issue? Thanks for your help.

[Edward W Hook, MD]

Glad that I could help. EWH

[glass33]

Hey Dr. Hook. Thanks for your insight on this matter. My plans are to keep an eye on  my current situation and if I see no improvment by a week or so, I will schedule a appointment with my primary. I really appreciate all of the help.

Go Blazers

[Edward W Hook, MD]

Welcome to our Forum.  I’ll be pleased to make some suggestions and comments.  My major suggestion however is that you should probably have these symptoms evaluated by a trained medical professional.   In doing so, I suggest that you make it clear that you wish to be evaluated, not just treated “just in case” as such treatment will not address the question of whether or not you have an STD/

The risk of having gotten any STD from your protected exposure 2 months ago is virtually zero and not something of concern.  On the other hand, while in general the risk of getting any STD from receipt of unprotected oral sex is rather low, there is a slight risk for gonorrhea (this does not sound like gonorrhea) or NGU which your clear discharge can be.  

NGU is best diagnosed with a swab specimen taken from the penis at least an hour after last urination. On occasion microscopic evaluation of urine collected just as a person begins to urinate can serve the same purpose but the swab is the preferred  approach.  With either method, one is not looking for bacteria but for white blood cells which are a sign of inflammation.  It is the signs of inflammation, manifest as increased numbers of white blood cells, which are the basis for the diagnosis of NGU.  While NGU associated with unprotected genital sex is caused by chlamydia about one-third of the time, NGU following oral sex  appears to result from oral bacteria  which are introduced into the urethra during receipt of oral sex, etc.) but are not typically tested for and despite optimal microbiological evaluation, in about 30% or more of cases there is no clear cause.  We also DO know that there are non-STD causes of urethritis (NGU) as well.  In most men NGU responds well to recommended treatment with doxycycline or azithromycin irrespective of cause.  

I am not sure you have NGU however and you should be examined.  Another possible issue is that you may be seeing normal prostatic fluid which usually goes un-noticed unless you are looking for it. this fluid is sometimes more likely to be expressed during bowel movements.  

Whether or not your testicular discomfort is related to your receipt of oral sex, or your discharge is unknown but this can and should be evaluated when you seek the evaluation I have suggested above.  

I hope my comments are helpful.  EWH