Ongoing NGU/Prostatitis symtoms post massage

[jimmy042012]

Hi Doctor,

It's been 7 wks since my massage encounter (previously posted) and I am still experiencing some urethritis symptoms.

Wk 0, Massage+ body to body contact including her pubic area on my body, don't recall genital to genital contact. Received handjob.

Wk 1
Frequent urination, general discomfort in groin, tingling meatus (which has been ongoing)
Might have been some small spots /red patches on glans that didn't seem to amount to anything
Wk 2
Night sweats 1 night
10th day, Took Gonn/Chlam urine test (returned neg). No other NGU testing performed.

Week 4
Night sweats, 2 nights
Aching left testicle
Small amount of discharge
Prescribed Trimethoprim without exam by Dr for uti/epididymitis
Wk 5
Some thrush on glans/fs and sore mouth (presuming from Trimethoprim)
Examined by GP, confirmed thrush, thought testes were fine.
Blood test for anemia, PSA, etc (came back normal)
Night sweats, several nights
Itching, hot feeling around anus.
Urine sample (clean catch, mid stream), Dr said was normal (however was only 4 days after finished trimeth.)
Wk 6
Inflamed meatus (puffy, red, wet)
Some clear discharge after urinating (more viscous than urine)
Glans/foreskin seems permanently wet/lubricated
Itching, hot feeling around anus.
GUM clininc HIV rapid test neg, retested urine for Gonn/Chlam +swabbed for herpes, awaiting results.

My wife (who gave birth 6 months ago) has complained of sharp pains in her left ovary over 2 cycles, although we've only masturbated since my encounter.

Does it sound like NGU, despite the no-risk label?
In light of my ongoing inflammation/light, clear discharge, assuming I test neg for G/C again, should I get tested for urea/mycoplasma, trich etc?
Could my wife's pains be caused by bacteria from me?
CPPS could explain some things but could it really cause the inflammation and discharge I'm experiencing?

[Edward W Hook, MD]

I'm sorry these problems are persisting for you.  I agree that further evaluation is in order in order to distinguish if this problem is associated with inflammation or not.  The possible discharge that you have noted would be most uncharacteristic for NGU or any sort of STD-related infectious process.  STD-related discharge typical occurs before urination, not after.  I suggest that you go to a GUM clinic, preferably after not urinating and have a urethral gram stain or other test performed to evaluate for inflammation. If signs of inflammation (increased numbers of white blood cells) is present, then further microbiological testing may be in order.  If not, then this is almost certainly not a STI of any sort.  This in turn will answer questions such as could your symptoms be related to your wife's difficulties (which I doubt).  In the interval, I would not take antibiotics or spend a lot of time examining yourself-the trauma of repeat self examination is a common cause of the sort of symptoms you note,

I hope this helps. EWH

[Edward W Hook, MD]

If you test negative for the organisims you list, it is strong evidence that you need not worry further about NGU or other STDs.

WBC may be helpful but are not defintiive.

Nothing more to say.  EWH

[jimmy042012]

Thanks Doctor. Some last questions if I may before I arrange any further tests.

Would WBC count be a useful indicator for NGU like Trich, Urea/Myco or another type of fungal infection (yeast?)

Given my encounter was 7+ weeks ago and I've only had a week of Trimethoprim, could my body have possibly dealt with any STI infections by now, or would they remain until treated?

If I test and return neg for Gonn/Chlam, Trich, Urea/Myco and Herpes, would you say that effectively rules out a transmissible STI from my encounter?

[Edward W Hook, MD]

You could ask if a test for WBCs was performed.  If not, you could ask for it to be performed.

No the rash you noted are not likely to be from the encounter.  EWH

[jimmy042012]

Thank you for the response Doctor. I will certainly try to avoid making anything worse with further self examination. It's difficult with increased urine frequency, dribbling or the clear discharge not to pay more attention that normal.

I have recently visited a GUM clinic and gave a urine sample for G/C (didn't urinate since night before, first void) and have been swabbed (for herpes I believe). Would I need to ask for a gram stain specifically or would the lab see raised WBC for either of the tests (and report back)? It's a shame I didn't know what to request when I went in.

Also, I had 3 itchy, atypical spots on my body over the past weeks since. One on forearm, flank and base of hair at navel. One seems to have left a brownish bump ~2mm. Could they have come from my encounter?