STDs Expert Forum
Frequent Urination & Burning Urethra for 4 months
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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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Frequent Urination & Burning Urethra for 4 months

Hello Doctor,

I have frequent urination (every hr) and burning urethra for 4 months now.I have gone thru 20 days of levo,20 days of cipro,1.5gm of azithromycin and finally Cystoscopy 5 weeks back.

The result in cystoscopy said mild chronic cystitis.I have been taken vesicare and xatral for 40 days now.I went to see the urologist again and he said it is NSU and gave me urogesic,cipro for 30 days and lyrica for 10 days. My bladder is in good condition with NO IC as per the pictures,my prostate is in good shape and size (thru DRE),I have done PPMT last week,there was no bacteria in prostate also.
I am certain that it all started with bacterial infection thru hand massage with vaginal fluid on the hand of masseuse.
My issue is that still we are only looking at symptoms and cannot pin point and treat the core problem. If this is non bacterial NSU,what should I do. I posted a question earlier also but we were on IC/Prostatitis route then which is ruled out now.Pls help.
239123_tn?1267651214
Welcome to the forum.  However, I'm afraid I can't help very much.

First, after expert professional evaluation and extended treatment, a distant online expert really cannot add very much.  You should trust your urologist and follow his recommendations.

Second, your symptoms are not consistent with any known STD, and I am confident you do not have have (and have never had) any infection from the massage and sexual exposure you describe.  No STDs can be transmitted by hand-genital contact.  If your symptoms are related to that event, it is because your anxieties over that exposure have amplified minor symptoms or normal body sensations -- not because of an infection.

Third, persistence of your symptoms despite the treatments you have had is additional evidence that no infection is the cause.

So continue to work with your urologist if the symptoms persist.  In the meantime, try not to worry.  Problems like this almost never turn out to be serious; you can expect no long term health consequences, for either you or any current or future sex partners.

Best regards--  HHH, MD
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I have been tested for the following with all these as negative

-White blood cells,Urine culture (all negative with no bacteria or WBC)
-STI tests, VD,PSA,HSV,HIV,PCR (all negative and non-reactive)

Also,the discomfort starts 30 mins after urination when some urine is collected in the bladder and maybe touches/pushes the urethra.This discomfort becomes very difficult to hold and is relieved only after urination.Sometimes there is burning after urination but for sometime and then it subsides.Hope additional info  helps.
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Thanks for your quick response and I do understand that it becomes difficult to provide advice distant online.Generally speaking, if we are on the route of NSU,what is the recommended treatment for NSU (if any) and are there any DOs and Dont's like alcohol,coffee,spicy food etc.? Also is there any merit in continuing Cipro for 30 days without any bacteria in any test.
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You said: "No STDs can be transmitted by hand-genital contact".Is this true even if she certainly had vaginal fluid on her hand when she was touching my genital & urethra opening,thanks.
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1/ You said: "No STDs can be transmitted by hand-genital contact".Is this true even if she certainly had vaginal fluid on her hand when she was touching my genital & urethra opening,
2/What is the recommended treatment for NSU and any Dos and Donts like alcohol etc?
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239123_tn?1267651214
I doubt you have NSU -- you might speak more with your urologist about it.  NSU does not cause interstitial cystitis, as far as is known.  

"You said: "No STDs can be transmitted by hand-genital contact".  Is this true?"  What, do you think we would intentionally give false information?  Of course it's triue.  

You definitely have no STD, period -- and that is the only topic for this forum.  I won't have any further comments or advice.  Do your best to move on.
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Dr Hunter,

Thanks and I really appreciate you responding to my questions, it's been very depressing lately due to this issue.

My question was pertaining to the vaginal fluid on hand of the masseuse which could ave triggered the bacterial infection, I assume the answer is that it is not a possibility or it is very remote possibility.

If it is not NSU, then based on symptoms and the tests done, is there any lead or anything else I can do to get to the real cause? It's very frustrating that with so much of advancement in technology and medicine, still we are not even able to get to the cause of a basic issue frequent urination and burning.

Thank you once again.
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239123_tn?1267651214
Trust me on this:  you have no infection whatsoever from the sexual exposure described above.  I do not know the cause of your current symptoms but I am absolutely certain you have nothing serious.  You may have to just learn to live with them, but you can be sure they will never harm you or any current or future sex partners.

As I have already said, this forum deals only with STDs, and at this time you have no STD. Therefore, this forum has nothing more to offer you.  I will have nothing more to say, and any further comments from you will be deleted without reply.  This is not an anxiety relief or counseling service for persons who will not or cannot accept our advice.
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I just want to respectfully disagree with your assertion that absolutely NO STD's can be transmitted via hand to genital contact.  For example: female has herpetic whitlow on her finger (it does happen!!!) and it is active while she engages in manual stimulation of the partner.  Herpes could certainly be a risk.  HPV and genital warts are highly transmissible!  Not as likely to be on her hand though...my Education tells me HPV prefers the mucus membranes and nether regions specifically;). I agree that the above poster needed to take your advice about trusting the urologist.  I do get concerned with the incorrect notion that herpes isn't spreadable unless an active outbreak....we know better!  
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239123_tn?1267651214
These are thoughtful comments and worthy of a response.  We have periodically addressed the issues you raise, but perhaps not for a while, at least not in any single reply.

Dr. Hook and I have never asserted that hand--genital exposure or fingering cannot ever transmit STDs.  We try to remember to say that it is theoretically possible but does not occur with any measurable frequency.  In 4 decades in the STD business, I have never seen a patient who appeared to have acquired genital herpes, chlamydia, gonorrhea, NGU, HIV, or syphilis by hand-genital exposure or fingering.  So for practical purposes, "cannot be transmitted" probably comes close to the truth for those pathogens.  And in any case, hand-genital exposure is not a plausible source of the clinical problem presented in this particular question.

That said, sometimes we do indeed cut corners in the interest of time, and based on the tone, anxiety level, and specific circumstances of an individual patient.  In retrospect, I should have replied above that STDs "are not transmitted" by such contacts instead of "No STDs can be transmitted...."

Your comments about HPV transmission are exactly right.  In many replies over the years we have noted that hand-genital contact or oral sex at times seems the best explanation for rare cases of genital HPV sometimes diagnosed in virgins.  But still, such transmission undoubtedly is rare.

Finally, as for herpes needing an "active outbreak" for transmission, we have never even hinted at that -- we ALWAYS advise that most HSV-2 infections are acquired from partners with asymptomatic shedding, without a recognized outbreak.  This is a little less clear for oral HSV-1, for which asymptomatic shedding is less common than for HSV-2 -- but undoubtedly asymptomatic oral HSV-1 accounts for at least some transmission.
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