Persistant symptoms of Urethritis

[felix425]

for the past 9 days I have had the symptoms of urethritis


1) Can the irritation show up the next day after probable exposure.

2) What else can mimic the symptoms since you don't think it usually occurs receiving Oral.

3) Does 2 gram dosage of liquid Z-max provide the same benefit as a Z-pack of azithromycin. Took it 8 days ago and did not produce significant symptom change.

4) HIV exposure doesn't produce these symptoms , does it

5) After taking the azithromycin, took i.5 gram dose earlier today and some diarrhea developed, does this interfere with its absorbtion. Is there any benefit to taking 250mg per day for the next 4 days.
    
6) Yesterday, I also took 2 doses of 500 mg cipro in case of GU
   discharge was very slight and clear.

7) First day of symptoms also noticed very mild rash symptoms on shaft that lasted 1 day.

8) does prostatitis mimic urethritis.

9)Is there any benefit to also taking a 2 gram dose of Flaggyl.

10) can symptoms persist even though infection has been cleared?

Thank You for your response

[H. Hunter Handsfield, M.D.]

You need to clarify your symptoms so I can understand whether you are likely to have urethritis or not.  If you're only speaking about a sense of irritation and/or urinary urgency, you probably don't have it.  Almost all sexually acquired urethritis has an overt, clearly abnormal urethral discharge.  If you have that, see a provider with STD expertise right away.  Also, the kind of sexual exposure or risk is important in interpreting symptoms, so provide that information as well.  I'll also add that lack of response to azithromycin is strong evidence against an STD as the cause of your symptoms.

Each of your questions could take several minutes and a full paragraph.  Here are some extremely short replies, pending more information about your symptpoms and risks.

1) No, 1 day is too soon.  2) Almost nothing mimics true urethritis (i.e., if discharge is present).  Without discharge, chemical irritation, allergy, and anxiety probably are the main explanations; with bacterial UTI a distant possibility.  3) Azithromycin suspension and pills are equally effective.  4) No, HIV is not a cause.  5) Stop taking azithromycin; it won't help, and it probably will prolong your gastrointestinal symptoms.  6) You probably didn't need cipro.  7) Penile rash probably is unrelated to your urethral symptoms.  8) Prostatitis is a confusing and difficult diagnosis; urethral discharge and painful urination are not the usual symptoms.  9) I can't judge the usefulness of Flagyl without more information. 10) Yes; persistent symptoms, especially without discharge, do not necessarily mean persistent infection.

Good luck-- HHH, MD

[felix425]

Doctor thank you for your response.

To provide you with more detail.

Possible exposure was from unprotected oral sex and tingling sensation was the first symptom. Meatus was not red

Symptoms were penile irritation, very slight discharge in AM, some aching in the testicles. Symptoms seem to be lees during the day.
At no time were the symptoms overt or severe

I would have thought if it were an STD, that The meds I took already would have been adequate.

Can trich be a possibility even though oral causation and could I benefit from the flaggyl anyway pending an appointment next week with a urologist should this not clear up.

Thanks again

[felix425]

Also forgot to ask if Gonnorhea resistant to cipro is active in the USA.

Can a single 500 mg pill of cipro really be adequate to resolve GU and how long before symptoms improve.
Thank You

[H. Hunter Handsfield, M.D.]

Doesn't sound like infectious urethritis.  Trich cannot be acquired by oral exposure.  Yes, if you had an STD, the meds you have taken would have cleared it up.  Rather than seeing a urologist, consider just sitting tight and waiting for your symptoms to gradually clear up over time.  The chance you have anything that will ever cause you any significant harm are just about zero, and you definitely have nothing you can transmit to a sex partner.

HHH, MD