Recurrent urethritis symptoms with negative STD results

I am a 33yr old male. Over the last two years with almost every new partner I've had unprotected sex with I have experienced urethritis type symptoms which begin 12-24 hours after sex. These partners have typically been low risk females 25-35.

The symptoms are usually relatively mild, there is no pain on urinating, nor any discharge - but there is a constant sensation from the urethra, a tenderness basically. It is particularly pronounced after masturbation or further sex. Occasionally there has been discomfort extending to the testicles and into the glands area above and to the sides of the pubis.

I have been to STD clinics on several occasions after the symptoms begin to get tested. Some swabs have shown signs of white blood cell build up - i.e. NSU, so I have been given antibiotics. After a few days the symptoms clear up. Swabs taken on other occasions have not shown anything unusual. The results for Chlamydia and Gonorrhea have always come back negative. I have informed partners who have also been tested but with negative results.

About 6 months ago I had discomfort from the perineal area and was diagnosed with prostatitis. At this time there was also significant discomfort from the tip of the penis and through the urethra. I was prescribed Minocycline which was taken over a period of 3 months, this reduced the symptoms. However during this time I met a new partner and experienced a recurrence of the urethral tenderness and discomfort in the following 2 weeks after sex, which subsequently subsided. The treatment period finished a few months ago with the prostatis symptoms cleared up.

Recently I have begun seeing a new partner and hey presto the urethral symptoms are back. Despite my previous experiences of negative STD tests, these symptoms are still concerning and worrying. Once I get to 10 days after the exposure (start of next week) I will visit a clinic to get tested, but in the meantime I sit and feel uncomfortable, both physically and emotionally.

What is likely to be going on? Prostatis can cause similar symptoms to the ones I've experienced, as indeed I've experienced them - but it seems unlikely that sex would trigger prostatis when masturbation does not. Previous to experiencing these symptoms I was in a long term monogamous relationship for 5 years (no symptoms) and previous to that I had several sexual partners (never any symptoms like this).

Is it possible that my body has simply become more sensitive to the natural bacteria it encounters in a new partner? What is rarely mentioned in STD literature are non-specific bacterial infections that aren't Chlamydia or Gonorrhea and aren't tested for directly. Are these an issue? Can they be passed on if left untreated?

Any help or experience would be greatly appreciated.

[shaken2core]

wow, that's quite a story.  This has been happening for 2 yrs?  

I'm sure you've probably done your homework on NGU and you know that it's caused by a multitude of bacteria, and in many NGU cases there is never a causative organism found, meaning there are bacteria we do not know about that may be causing NGU.  

the puzzling part of your case is that you seem to get NGU every time you have unprotected sex, but it always clears up after antibiotics.  You could just be one of the unluckiest people ever and it just so happens that every girl you have sex with carries some kind of NGU causing bacteria, but that seems highly unlikely.  

If you were carrying some non specific bacteria, you would continually have symptoms, not only when you have sex, so you can probably rule that out also.  To answer your question though, if you are carrying around non specific bacteria, yes, you can pass it on.  

I would recommend having protected sex for a while to see how things go.  In addition, you and your partner should both get treatment at the same time, that way you can rule out any non specific bacteria that may be present in either of you.  Give that a try and have protected sex for at least a couple weeks after your treatment, and then see what happens.  

There was another member on this forum that experiences a similar problem as yours, but he was in a monogamous relationship and experienced NGU symptoms when he recieved oral sex from his sex partner, even after being with her for a year.  

I wish I could be more help to you, but the bottom line is that some of us are just unlucky when it comes to NGU and we can't seem to shake it once we get it.  Let us know how things turn out for you, it's always good to get feedback on follow up posts on your condition.  

[daniel78]

Thanks for the comments shaken2core.

Yes, this has been happening for 2 years, with probably 3/4 of the partners I've had.

The reason why I mentioned the particular experience whilst receiving treatment for prostatitis was because I wouldn't have expected to have had a problem with NGU whilst on Minocycline (before, during and after exposure). Which suggests that in this particular instance at least it's more likely to have been aggravation of the prostate (but a prostate that wasn't previously aggravated by masturbation during this treatment period).

So this raises the question - is there any causality between exposure to 'new' bacteria in the urethra and prostatitis? This would explain a lot, but I don't know whether it's possible.

For reference, since starting this thread yesterday I have noticed some very mild discomfort from the prostate, so it's conceivable the current urethral symptoms are connected to that.

As things have panned out, it doesn't look like my relationship with this most recent partner is going to continue, so I will be able to see what happens with these symptoms, and how they react to treatment or not once I've been tested next week. I will keep this thread updated, but would appreciate any further comments or thoughts in the meantime!

[shaken2core]

if a diagnosis of prostatitis has been made, then you could possibly attribute your symptoms to that.  However, it's odd that symptoms flare up in conjunction with unprotected sex with a new partner.  

When you say discomfort in the prostate, what are you talking about?  Perenium pain?  Difficulty sitting for long periods?  

You could still get NGU while on antibiotics.  It may affects you somewhat, but the antibiotics should soon kill off any bacteria, assuming it's effective against the bacteria in question.  That's one reason they tell partners to refrain from sex during treatement, to make sure there is no reinfection going on.

Prostatitis is one of those things that aren't clealy understood, but one school of though is that it can be caused by new bacteria which is introduced into the urethra and then makes it's way up to the prostate.  

I'm glad to hear you will keep us updated, it will greatly help others in your shoes.  

[daniel78]

Sorry shaken2core - I've only just seen your reply here when coming back to update the thread. In answer to your question, the discomfort in the prostate feels like a swelling in the perineal area. Not uncomfortable to sit down, but a little sometimes on my bike (I have a very narrow saddle!). It's not painful, more of a sensation that I'm aware of - as if someone was pressing on your arm. (When I first had the prostatitis the discomfort was much more acute - actual pain after urination and ejaculation).

So regarding the update - this morning I went to the clinic, spoke to the doctor and had a full screen including blood tests, urine tests and a urethral swab. The results from the swab and second urine test (mid-stream) came back immediately, showing no signs of any white blood cell build up or NSU. I will get the conclusive Chlamydia, Gonorrhea, Syphilis and HIV results in 8 days.

After a conversation with the doctor about my history and the results she thought there was essentially nothing to worry about and no treatment was necessary. If the problem continued and the tests proved to be negative I should consider seeing my GP and getting referred to a urologist. She added that anxiety could be behind some of the symptoms given that they occurred after new partners. This of course is possible - however I was much more anxious 10 years ago (when I knew less about STDs) when I had no symptoms after sex with new partners. I'm about as sure as I can be that I'm not imagining the symptoms. I am not by nature a hypochondriac - if anything the opposite!

I also asked about non-specific bacteria and Mycoplasma Genitalium, she said that the importance of these varies according to which doctor you talk to. The course of minocycline I was on for prostatitis would have knocked off any Mycoplasma that had previously been in my system, as would the previous Azithromycin I'd been given for NSU before that. I asked if it was possible there could have been a reinfection from my most recent encounter - she said that normally there would be testable NSU symptoms beyond the ones I'd experienced and that as a result it wasn't worth worrying about.

So - in conclusion - there's no real answer about what's been causing my symptoms. Now that it's 9 days after intercourse they have receded to the level where they are only just noticeable. It will be interesting to see whether they disappear completely given time. I will continue to keep this thread updated.

[hermanto]

"Prostatitis is one of those things that aren't clealy understood, but one school of though is that it can be caused by new bacteria which is introduced into the urethra and then makes it's way up to the prostate." = Oh No...

I will follow this thread...

[daniel78]

An update to this thread. All results came back from the clinic negative.

Over a month on, my symptoms have dissipated. I have the occasional sensation from the urethra, but this is very much the exception rather than the rule. Also my discomfort from the prostate has gone too.

So - it would certainly seem like nothing to worry about. I hope this gives other people who have been in a similar position with negative results some comfort.

Of course, given my past history, it's quite possible I'll have symptoms again after my next encounter (whenever that may be). If so I shall repost on this thread!

[gracefromHHP]

you planning on only having protected sex at this point to see if that helps?

grace