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PLEASE HELP ngu EPIPDIMITIS
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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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PLEASE HELP ngu EPIPDIMITIS

Good afternoon My wife was diagnosed with BV about 6 months ago -
I had received oral about 9 months ago 2 times
I tested negative for Ghonorea (Gonorrhea) and Chlamadya and Syphilis and HIV right after I was aware of my Wifes BV diagnoses about 6 months ago.  The doctor gave me 4 pills of azithro at the time  I did have sex with my wife before the pills and after without a condom.
9 months after my initial exposure and 6 months after my wifes BV i was diagnosed with NGU today - I have not had any other oral or any sex outside of the oral 9 months ago - I did get tested after the 4 pills of azithro was tested negative for all bacterial std's including NGU - However I have had sex with my wife after that test and now I was tested positive for NGU and negative for Ghonorea (Gonorrhea) and Chlamdya
1- does this mean that i got this from me reveiving oral?
2- is it possible i passed it to my wife and i got treated and got it back from my wife?
3have read that sometimes NGU is diagnosed as BV in women is that true?
4- What now - She has zero symptoms?
5- My doctor said i show signs of epipidtimis and he is treating this as well - If i told my wife that I had epipidtimis and that it was a non specific bacterial infection and that she should recheck her BV will that be considered a STD?
6- IF she goes to her OB and explains that I was diagnosed with non specific bacterial Epipdimitis without chlymidia or ghonorea (Gonorrhea) what will they test her for?
7- How do they find NGU in women? and what do they call it?
cannot believe I would get NGU from such a quick oral experince twice and that I would have passed it on and then got it back - how rare is that?
- The test  swab in the uretha and under a microscope Can this be anything else?  I know i did a terrible thing and I regret it everyday I  do not want to hurt my wife and our very small happy kids.  I need to see if I can get her help without letting her know where it came from.  Can the BV have caused this or anything else?

239123_tn?1267651214
Welcome to the forum.  Thanks for your your question.

Sorry for the somewhat delayed reply.  FYI, when there are several qualifying follow-up comments before there is a reply, on the moderators' home pages it appears the question has already been answered.  I thought Dr. Hook had replied and he might have thought I had.  Once the main question has been asked, it's best to await a reply before adding follow-up information.  (Not to scold you -- more of a heads-up to other users who might read this before posting new questions.)

Your question is rather complex.  The three main events here:  your extramarital oral sex event, your wife's BV, and your NGU may be entirely unrelated.  But even if they are connected, nothing need be said to your wife about the other event.  Both BV and NGU can sometimes appear in monogamous partnerships, and both events may be related to oral sex.  It is possible that certain entirely normal oral bacteria -- not STD germs -- can cause NGU or BV in couples who have oral sex with one another.  This entire area is somewhat uncertain, with ongoing research; what we believe we know today may change in the future.

Another point for you to consider, however, is whether your wife might have had other partners.  When one member of a couple finds a need for outside sexual release, often the other has done so as well.  Even though BV isn't an STD in the usual sense, when new BV appears in an apparently monogamous couple with no such problem before, the possibility the female has had a new partnership needs to be considered.

To your questions:

1) NGU can be acqured from either vaginal or oral sex.  Given the timing, more likely from your wife, not the outside parntership.

2) The sequence of transmissions and source of infection probably aren't possible to know at this point.

3) There has been speculation that some cases of BV and NGU may be related to one another, but this has never been proved. Overall, the frequency of NGU is no higher in the partners of women with BV, and BV is no more common in women whose partners have NGU.

4) Whenever a male has NGU, his regular sex partner needs to be treated, regardless of sympotms.

5) I'm skeptical you really have epididymitis, if you didn't have rather severe testicular pain.  A little minor discomfort or tenderness on exam usually isn't sufficient for the diagnosis.  I would guess your doctor treated you for epididymitis as a precaution, not because he was sure you had it.  In any case, STD related epididymitis is only caused by chlamydia and gonorrhea -- which you don't have.  Other causes of NGU aren't know to cause it.

6) She would normally be tested for all common STDs, especially gonorrhea and chlamydia, as well as trichomonas, BV, and other vaginal infections.  Given your history, she can expect negative results -- but better safe than sorry.

7) There is no well defined female counterpart to NGU in men.  Except in cases caused by chlamydia, most female partners of men with NGU have nothing wrong based on all available tests and exams.

As I said, this is a complex issue.  The best approach would be for both you and your wife to be under the care of a single doctor or clinic so your evaluation and care can be coordinated.

I hope this has helped somewhat.  Best regards--  HHH, MD
11 Comments
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Avatar_m_tn
BTW - I had zero symptoms - no discharge - no pain - nothing - Is this rare?
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Avatar_m_tn
I was just reading from your past help on these forums and appreciate your help.  Is it possible to have the NGU caused by the Herpes (both my wife and I have been diagnosed with genital herpes).  Also when my wife had her BV she used Metro gel and she went to her follow up with the OB and he said she was all cleared up and had a normal PAP as well - I asked her today if she is having any symptoms and she is not no discharge no pain no dyseria.  I do notice that she complains about heavy menstrual bleeding the first 2 days.  I just don't know how I could get a positive NGU and negative Ghonorea (Gonorrhea) and Chlymidia without any oral from my Wife only vaginal sex.  Is that possible for nongonnoncal and nonchlamydial NGU?  Sorry just freaking out about my family
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Avatar_m_tn
I also forgot to mention that I have been to doctors and urologist for hernia and have provided urine and blood samples (about 4 different occasions) and never had elevated WBC or leukocyte a always normal
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239123_tn?1267651214
Neither herpes nor a hernia has anything to do with any of this, and I doubt your wife's heavy periods are related either.
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Avatar_m_tn
Thank you for your reply.  I know my situation is complex.  My wife is a stay at home mom with two toddlers with her all the time and no help to have a chance to get out and have a affair.  so if I understand you correctly - if she went to her OB and asked to be rechecked for BV she might come back positive - however all STD'S will come back negative - again only if my positive is NGU without Chlamydia and Without Ghonorea (Gonorrhea)?  Also what are the consequences of not telling her?  I read on your previous post in regards to NGU without chlamydia - Ghonorea (Gonorrhea) their is no risk for anything in women - I assume that I do jot get reinfected?  Sorry for the many long posts.  And again thank you for your help in advance.
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239123_tn?1267651214
You correctly understand my prediction of what your wife's exam might show.  Your own tests for gonorrhea and chlamydia are reliable; and in any case, chlamydial NGU isn't transmitted by oral sex. It is true that there are few if any proved consequences of nonchlamydial NGU in female partners.  Gonorrhea can be very serious in women, but that's definitely not a possibility here.
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Avatar_m_tn
Thank again for your follow up.  On lat quick update.  I did confirm again this morning that the lab results for the Ghonorea (Gonorrhea) and Chlamydia was intact negative.  I also went to another std specialized doctor this morning to ask some follow up questions in regard the epididymis and NGU - he did examine me and told me he does not think I have epididymis based on the no Swelling of the testicles and no pain on touch just discomfort.  However he did say that based on my history he thought the NGU diagnosis from the prior doctor was a non std NGU and that is more common that what we find on the Internet and most doctors are quick to say std Is the cause of the NGU - he stated that NGU can be caused by many bacteria over 30 various bacteria and that most are not std related.  He thought that mine with my history was most likely caused by a unknown bacteria or even stress or any kind of irritant (lotion, shampoos, etc). I found this so hard to believe as there is nothing I could find anywhere that would agree with that statement.  Your thoughts on his statements?  He also said that with antibiotics I should clear up and if my wife has zero symptoms then I should move on with my life.  Again your thoughts?  Thank you in advance and this will be my last question.
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239123_tn?1267651214
It is true that there may be some NGU cases that are not sexually acquired.  As I wrote in the third edition of my book (Color Atlas and Synopsis of STDs, McGraw-Hill, 2011), "Initial episodes of NGU almost always acquired sexually, but exceptions probably occur."

I believe this is more rare than your doctor suggests.  Still, my guess is that he and I really aren't very far apart.  There is a middle ground:  certainly I have seen NGU in monogamous men, who may have had a urethral reaction to their partners' entirely normal vaginal or oral bacteria.  I would consider such cases to be sexually acquired, but not an "STD" in the usual sense as applied to gonorrhea, chlamydia, etc.  You might ask your doc whether he agrees with this perspective.

Having said that, all cases of NGU should be investigated and managed as if they were a traditional STD. Certainly that's true for the large majority, even if exceptions aren't all that rare.
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Avatar_m_tn
Thank you doctor!  one last question - Please let me know if I need to pay again - I do not mind as your help is valuable.  My question is in regards to Epidimytis - Can Epididmytis be caused by non Chlamydia NGU - So no specific bacteria NGU (when I called to aks the doctor if it was europlasma or any other specific bacteria he said that if chalamydia is not positive they just call it non specific NGU).  Can any of the "non specific" bacteria that caused my NGU cause epididmytis?  Other web sites report that europlasma can cause it - I have had scrotal pain getting worse for the last week or so (this could be from my ingenual hernia).  I wanted to know if I should take the doxy antibitotics?  After much research of your prior posts you have stated the epididmytis is only caused by Ghonorea (Gonorrhea) or Chlamydia if it was caused by a STD - Please let me know your thoughts.


Thank You
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239123_tn?1267651214
I stand by my original reply:  "STD related epididymitis is only caused by chlamydia and gonorrhea -- which you don't have.  Other causes of NGU aren't known to cause it."  That goes for Ureaplasma; any website that says otherwise is mistaken.  And epididymitis does not cause the vague sort of testicular pain you have described.  You should not take doxycycline; there is no need and it won't make any difference in your symptoms.
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