Aa
NGU or hernia
I had protected sex with a CSW last Nov 18 which lasted for 10-12 mins, did not have oral sex. On the same evening, I cleaned the entire groin area including the penis with an antiseptic in undiluted form. 11 days later, I got a slight ache in the right testicle. Out of anxiety, I took 1gram of Azithromycin. The following days, the ache was on/off mostly in the right testicle and now it is in the left. In between, I visited a urologist who examined my testicles, took a CBC and ultrasound. He said it is fine except that it could be the start of hernia. I do have a slight bulge on the right of the groin near the waistline. On Dec 20(32nd day after exposure) I took a STD screening test(blood, urine, urethral swab) for Gonorhea, Chlamydia(Antigen), Syphillis(RPR), Hep B(Surface Antigen), Hep C and HIV(1,2 with P24 Antigen). All the tests were negative, no bacteria was seen in the comp urine bacterial culture. However, blood, Leucocytes Esterase, Mucus threads were detected in the urine. The doctor said it is NGU and prescribed Cefdinir 600mg - 5 days, 1g of Azithromycin on the 6th day, 2g of Tinidazole on 7th day. I have completed the course on 29th Dec and the pain in the testicle persists. Both the testicles do not pain at once...either the left or right, not sure if they both ached together. I feel better when I lie flat, it begins to ache after standing for a while or a short walk. I am able to sleep well and do not have pains when I wake up. I do not have any discharge from the urethra, no burning feeling when I urinate. It hurts sometimes while I ejaculate.
1) Can the hernia on the right side cause pain to either left or right testicle?
2) Did my 1st dose of Azithromycin cause any incorrect results in the tests I took 20 days later?
3) I had sex with my wife using a condom, is she at risk?
4) What is your understanding of the problem that I am facing? Please advice?
5) How long does the medication need to work? Today is 3rd day after completing the course.
1) Can the hernia on the right side cause pain to either left or right testicle?
2) Did my 1st dose of Azithromycin cause any incorrect results in the tests I took 20 days later?
3) I had sex with my wife using a condom, is she at risk?
4) What is your understanding of the problem that I am facing? Please advice?
5) How long does the medication need to work? Today is 3rd day after completing the course.
MEDICAL PROFESSIONAL
This information doesn't chance my opinion or advice. There is no realistic possibility you have any infection of any kind. Just like you, the large majority of people with symptoms of psychological origin doubt that's the cause -- so your belief along those lines doesn't change anything as far as I am concerned. Don't get me wrong: I know the pain and discomfort are real.
Your symptoms could classify you as having the chronic pelvic pain syndrome (CPPS), which often is the result of genitally focused anxiety. The pain probably originates from anxiety-induced pelvic muscle tension. For more information, google CPPS (spell it out) and start your reading with the excellent Wikipedia article, and also look for information about it from the Stanford University Department of Urology. I suspect you'll find lots of parallels with your symptoms.
That will end this thread. Take care.
Your symptoms could classify you as having the chronic pelvic pain syndrome (CPPS), which often is the result of genitally focused anxiety. The pain probably originates from anxiety-induced pelvic muscle tension. For more information, google CPPS (spell it out) and start your reading with the excellent Wikipedia article, and also look for information about it from the Stanford University Department of Urology. I suspect you'll find lots of parallels with your symptoms.
That will end this thread. Take care.
Doc, Wish you a great New Year too. I really wish that my symptoms are purely due to psychological factors. Admit there has been lot of guilt and I have broken down so many a times. But the physical aches/pains taunt me with doubts such as epididymitis...can it occur on the 11th day after exposure? Moreover tests for 2 main causes chlamydia and gonorhea were negative. I am trying to move away from these thoughts..today for instance the left testicle was aching untill noon and then the pain moved to the groin where it meets the leg. I need your help with another question....is there a possibility that i have bacteria which is not seen in an urine culture? my doc said there could be organisms not seen in a urine culture. Hence he adviced, I should not have sex with my wife till it clears up. Please see below the list of tests/results in the comprehensive urine culture using urethral swap.
Mycoplasma hominis Negative
Trichomonas vaginalis Negative
Yeast Negative
Gardnerella vaginalis Negative
Neisseria gonorrhea Negative
Proteus spp. Negative
Staphylococcus aureus Negative
Escherichia coli Negative
Ureaplasma urealyticum Negative
Enterococcus faecalis Negative
Candida spp. Negative
Streptococcus agalactiae Negative
Pseudomonas spp. Negative
Culture report No pathogenic organism
isolated after 48hrs. incubation
Mycoplasma hominis Negative
Trichomonas vaginalis Negative
Yeast Negative
Gardnerella vaginalis Negative
Neisseria gonorrhea Negative
Proteus spp. Negative
Staphylococcus aureus Negative
Escherichia coli Negative
Ureaplasma urealyticum Negative
Enterococcus faecalis Negative
Candida spp. Negative
Streptococcus agalactiae Negative
Pseudomonas spp. Negative
Culture report No pathogenic organism
isolated after 48hrs. incubation
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
My first reaction was to wonder how there could be any question between NGU and a hernia! The symptoms are entirely different. However, I have now scanned your discussions on other forums and have a better understanding.
You're obviously having a great deal of difficulty getting beyond your anxieties over a sexual exposure you regret, and especially in distinguishing those emotional aspects from STD symptoms. As noted previously by Dr. Gonzalez-Garcia in the STD international forum, you had a zero risk exposure. The vague sort of testicular pain you describe is typical for genitally focused anxiety. I'm pretty sure your urologist was reaching for possible explanations for your symptoms. There is no way a urologist would miss a hernia if s/he specially was looking for one, nor am I aware that an incipient or developing hernia would cause symptoms like yours. Self-perception of slight groin swelling doesn't count for anything; on direct examination, a hernia swelling is present or it isn't.
The positive leukocyte esterase and urine threads do suggest the possibility of urethritis or perhaps a prostate gland problem, but the absence of abnormal urethral discharge is against urethritis. However, if indeed you have some sort of lower genital tract inflammation, it did not come from the sexual exposure described; and at this point it has been adequate treated (indeed, greatly over-treated!) and there is no possibility you still have anything that could ever harm your or your wife or any other sex partner.
To your specific questions:
1) I would not expect a hernia to cause testicular pain. I have already stated my best guess at the explanation of your symptoms, i.e. genitally focused anxiety, nothing more.
2) Azithromycin would have made any STD tests negative, by curing gonorrhea, chlamydia, syphilis, or NGU. There are no tests that can retrospectively diagnose these infections once they have been treated. But based on the exposure described, you can be sure you didn't catch any STD.
3) Your wife is not at risk, even if you had not used a condom. You can safely resume unprotected sex with her, and should do so. The genitally focused anxiety symptoms you describe often clear up with resumption of normal sexual relations, and for sure you have nothing that can harm your wife.
4) See above.
5) That the antibiotics have not made any difference is evidence that you have no infection. I don't expect either your recent or any future antibiotics of any kind to make any difference in your symptoms.
Perhaps these are not the opinion or advice you expected or hoped to hear. But please take these comments to heart. They are offered in a spirit of compassion, not criticism. If you're sure you have a swelling in your groin, definitely check out the hernia possibility -- but I'll be very surprised if you have one. Other than that, I'm confident you have no important physical illness.
I hope this has helped. Happy new year-- HHH, MD
My first reaction was to wonder how there could be any question between NGU and a hernia! The symptoms are entirely different. However, I have now scanned your discussions on other forums and have a better understanding.
You're obviously having a great deal of difficulty getting beyond your anxieties over a sexual exposure you regret, and especially in distinguishing those emotional aspects from STD symptoms. As noted previously by Dr. Gonzalez-Garcia in the STD international forum, you had a zero risk exposure. The vague sort of testicular pain you describe is typical for genitally focused anxiety. I'm pretty sure your urologist was reaching for possible explanations for your symptoms. There is no way a urologist would miss a hernia if s/he specially was looking for one, nor am I aware that an incipient or developing hernia would cause symptoms like yours. Self-perception of slight groin swelling doesn't count for anything; on direct examination, a hernia swelling is present or it isn't.
The positive leukocyte esterase and urine threads do suggest the possibility of urethritis or perhaps a prostate gland problem, but the absence of abnormal urethral discharge is against urethritis. However, if indeed you have some sort of lower genital tract inflammation, it did not come from the sexual exposure described; and at this point it has been adequate treated (indeed, greatly over-treated!) and there is no possibility you still have anything that could ever harm your or your wife or any other sex partner.
To your specific questions:
1) I would not expect a hernia to cause testicular pain. I have already stated my best guess at the explanation of your symptoms, i.e. genitally focused anxiety, nothing more.
2) Azithromycin would have made any STD tests negative, by curing gonorrhea, chlamydia, syphilis, or NGU. There are no tests that can retrospectively diagnose these infections once they have been treated. But based on the exposure described, you can be sure you didn't catch any STD.
3) Your wife is not at risk, even if you had not used a condom. You can safely resume unprotected sex with her, and should do so. The genitally focused anxiety symptoms you describe often clear up with resumption of normal sexual relations, and for sure you have nothing that can harm your wife.
4) See above.
5) That the antibiotics have not made any difference is evidence that you have no infection. I don't expect either your recent or any future antibiotics of any kind to make any difference in your symptoms.
Perhaps these are not the opinion or advice you expected or hoped to hear. But please take these comments to heart. They are offered in a spirit of compassion, not criticism. If you're sure you have a swelling in your groin, definitely check out the hernia possibility -- but I'll be very surprised if you have one. Other than that, I'm confident you have no important physical illness.
I hope this has helped. Happy new year-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
