Is this Epididymitis or not?

[pringle2k1]

A year ago I was diagnosed with non-specific urethitis and Epididymitis. My only symptom was ache behind testicle.

Tests for chlamydia and gonorrea were negative (swabs from throat, anus, penis)

Can one rely on the results of these chlamydia and gonorrea tests? (United Kingdom GU Med clinic)

A 10 day course of antibiotics cleared the problem (not sure which ones they were).

4 weeks ago, I developed the same symptoms and this time went to my GP. She again diagnosed Epididymitis.
She prescribed me 100mg once daily for 14 days of Doxycycline. She did a UTI urine test and results were normal.

After 4-5 days, the ache behind my testicle disappeared and i continued and completed the course of Doxycycline.

However, 2 days after the last tablet and the symptom is back.

There has never been any swelling or redness, sometimes there is tenderness if i feel around the testicle but it is immpossible to locate exactly where this ache is coming from.

Can i rely on the diagnosis of Epididymitis?

Do I need another check at the G U M clinic?

Throughout all of this i have only had 1 partner and he has never had any symptoms, neither has he been tested or treated.

I have read a bit more on the internet and thinking that perhaps this could be something else like a varicocele?

[Edward W Hook, MD]

When treatment is re-started following a relapse of infection, a person should receive a full course or even a prolonged course of therapy, not just a "top up".

As already mentioned I do not think you need to introduce an STD into consideration as the origin of your infection.  At the same time, I do recommend treatment of your partner at the same time you are treated.  Why the apparently contadictory recommendations?  Because if by some chance an STD were involved, I prefer to err on the side of conservative treatment as the best way to increae your chances of getting this problem behind you as quickly as possible.  EWH

[pringle2k1]

Thanks Doctor

Because the symptom has returned, does one need a complete new full course of antibiotics or a "top up" course?

My partner and I have been together 3 years, he has never had a symptom and this is the only recurrent problem i have had. What do you think of the hypothesis that one of us introduced an STD 3 years ago and he keeps passing it back to me?

[Edward W Hook, MD]

Straight to the questions embedded in your text:

1.  Yes, testing for gonorrhea and chlamydia in UK GUD clinics is very reliable.
2.  Your previous episode of epididymitis increases your risk for recurrence.  These recurrences, as well as your 1rst episode, may not be due to STD but some other bacteria and 14 days of doxy is appropriate therapy.  In some cases however, a longer course of therapy is needed for cure. Rather than go to the GUD clinic, I would suggest that you return to the GP.  While my guess is that you need longer treatment, you might want to ask your question about a varicocele or other urological abnormality at that time (I suspect if there were a varicocele, one of your earlier exams would have found it).
3.  That your partner has not been treated is an error.  Symptoms or no, he should be treated at the same time you are.  This could possibly contribute to your risk for recurrence although I doubt it.  

Hope this helps.  EWH