Penis Pain, Test negative

[paranoid373]

I had unprotected sex with someone I trust as clean, though she is not sure of her husband's activities. I have had a slight pain at the opening of my penis since a few days post encounter. I also had a sore throat for 2 days (day 4 thru 6). No discharge. Urine screen found "blood and protein" in the sample. All tests sent in came back negative. Still feel the discomfort right now. Had been in a 20 year relationship prior to this. 25 years ago, had exact same profile. Always negative. Doc said it could just be "friction trauma". As you guys see this stuff every day, what do you suggest? Currently I am 10 days post event. More tests?

[H. Hunter Handsfield, M.D.]

You don't have any STD, and STDs are the only topic for this forum; we don't attempt to evaluate non-STD genital problems.  Your best bet is to continue to work with your own doctor on this.  But don't be too worried in the meantime.  Whatever is going on, it is not likely to be serious.

[paranoid373]

From doc: "We did a urine test for tradtional (non-STD) urinary tract infections and no infection was found. Let me know how things are after the doxycycline."

From you: "There is a good chance an infection doesn't explain your symptoms"

So, what are you thinking? and WHAT SHOULD I DO??

[H. Hunter Handsfield, M.D.]

Thanks for the follow-up.  Were any other tests done, such as a urine culture for non-STD bacteria?  Examination for urethral discharge?  Examination of a urethral swab for white blood cells?

A trial of doxycycline makes sense, but I urge you to not get your hopes too high.  There is a good chance an infection doesn't explain your symptoms, in which case no antibiotic will help.

[paranoid373]

Thank you for your response. This is an awesome service that you provide. Much appreciated. Here is the quote from the doc.

"I tested you for gonorrhea and chlamydia. Since you continue to have symptoms I will send in doxycycline 100 mg for you to take twice a day for 7 days."

Chlamydia trachomatis, NAA Negative    Negative    
Neisseria gonorrhoeae, NAA Negative    Negative

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

I doubt "friction trauma" can explain this; blood and protein in the urine certainly suggests something more.  Presumably the negative tests included gonorrhea, chlamydia, and perhaps other infections -- can you clarify this?  Assuming chlamydia and gonorrhea have been ruled out by testing, you still could have nongonococcal urethritis (NGU), even though that is somewhat unlikely without abnormal discharge.  Some causes of urethritis are caused by organisms not detected by routine testing in such situations, such as adenovirus, herpes, or trichomonas.  Sore throat could go along with adenovirus.  (Don't be too alarmed about herpes.  I mention it for completeness, but it is unlikely without obvious blisters/sores of the penile skin.)

For sure blood and protein in the urine should not be ignored, if those abnormalities continue to show up on urinalysis and no obvious cause is found.

You should also tell your partner about your symptoms and suggest that she get checked out for STDs, if that hasn't been done.  In addition to protecting her health, it might give a clue to your diagnosis.

Please return with a follow-up comment to let me know what turns up on further evaluation.

Regards--  HHH, MD