HELP PLEASE

[madmike451]

hi my name is mike i've had pain on the side of the head of my penis on and off for a year i keep going to the doctor and he keeps giving me tests for the clap but they always come up negitive then he tested me for herpes and it also came back negitive, i dont know what to do, my symptoms are, burning when i pee but not all the time, i also have to pee alot, and that pain on the head of my penis, please help me im so scared

[stillHurting]

Sounds like it could be NGU.  

Have you ever been treated with antibiotics?  Have you been tested for Chlamydia as well?  It's more common than Gonorrhea.

[madmike451]

what is NGU???

[stillHurting]

Non Gonococcal Urethritis.  It just means urethritis not due to Gonorrhea (clap).

You'll have to answer my other questions for me to be of much help to you.

[auntiejessi]

Most gonorrhea tests are run in conjunction with chlamydia tests, so if he was tested for one, he was tested for the other.

Have you had a prostate exam or a urine culture?

AJ

[stillHurting]

auntiejessi: I know typically the good G/C tests are just one combo test, but you'd be surprised how many people think they've been "tested" for something and then it turns out all they had was a gram smear, or even just a urinalysis.  That's why I always like to ask exactly what tests were performed.  Don't take this in any way personally though, I've seen your posts and your advice is typically EXCELLENT.  Superior to what people would get from many Drs, sadly.

In any event apparently he was tested for both, and they were both negative.  So here's my little copy/paste about this subject

Testing for causes of NGU beyond Chlamydia.

There are three main casuses of non-chlamydial non-gonococcal urethritis.  These are Ureaplasma, Mycoplasma, and Trichomonas.  They are not tested for with the typical battery of STD tests in the US, though they are in some other countries.

Tests are available through LabCorp, they are often not covered by insurance.

Mycoplasma/Ureaplasma, Real-Time PCR
http://www.labcorp.com/datasets/labcorp/html/chapter/mono/vm003300.htm
Number
138778
CPT
87801

Trichomonas vaginalis, Nucleic Acid Amplification (NAA):
http://www.labcorp.com/datasets/labcorp/html/chapter/mono/sm000300.htm
Number
188052
CPT
87798

These organisms are frequently transfered at the same time as the better known STDs like gonorrhea and chlamydia.  Gonorrhea has a high cure rate of about 98% (except for resistant strains, where fluorquinolone antibiotics might fail but cephalosporin types will nearly always work) and chlamydia 96-98%. However mycoplasma/ureaplasma recur about 20-60% of the time.  So recurrent urethritis is nearly never due to gonorrhea or chlamydia, unless the patient was reinfected.

Mycoplasma are harder to eradicate for a few reasons.  Many strains are resistant to antibiotics, especially tetracycline resistance.  This means doxycycline, a commonly prescribed drug, will often fail in treatment.  Resistance rates of 50% have been reported for ureaplasma and doxycycline.  M hominis is resistant to erythromycin, azithromycin, and clarithromycin.  Levofloxacin, another common drug, also has been shown to have a high failure rate for M genitalium.  This is why knowing which infection you have is very valuable in determining the correct treatment.

A urine culture is useful for ruling out a UTI, but be aware that it will not grow most STD types of bacteria, as the culture medium is not appropriate.  This includes ureaplasma/mycoplasma as well.

Don't even get me started on how wrong I think it is that most US doctors ignore these, disgraceful is not even a strong enough word.

[auntiejessi]

Oh I'm with you on that one, Still.  Doctors I know just throw either azithromycin or doxy at them, and if they still have symptoms, throw up their hands and say they don't know what to do.

Getting a further work up is imperitive if you still have symptoms.

AJ

[madmike451]

so should i just print this out and show my doctor im so confused i can go to my doctor cuz  i have insurence' i dont know if i can aford that other lab is there anywhere in phx az that i can go to??? what medication would be able to fix this???

[auntiejessi]

Your doc can order those tests, you don't need to go to a special lab.

AJ