STD question

[steve0815]

Hi Doctor,

I'm a 32 year old male, and having the following symptoms since yesterday. I noticed a pus-like, liquid discharge from my penis yesterday, that turned into a clear, liquid discharge today. I have no burning pain or sensation when urinating, but last night, I got fever that persisted throughout today, around 100F. The discharge is not very much, but noticeable when you look at it. I'm scared that I could have caught an STD, although hopefully not possible (see below).

I'm in a mutual monogamous (long-distance) relationship, and my girlfriend and I are having unprotected sex since October of 2007, after revealing our (all negative) HIV- and STD-status to each other. However, these STD-tests apparently did not include Gonorrhea or Chlamydia.

My concern is, that one of us had an STD without symptoms, and brought it into the relationship. My questions would be:

1.) If I brought it, is it possible that I didn't have any symptoms for years ? Before I met her, my last sexual intercourse was back in January of 2005. Since we're dating, we've had protected sex for almost 6 months and, as mentioned before, unprotected since October.

2.) If she brought it, is it possible that I caught it from her without having any symptoms since October ? I understand that there is a certain incubation period, but would it be that long ?

3.) However, since I'm not sure if my symptoms even suggest an STD, I still want to mention that the last time we had sex was two weeks and one day before the symptoms started, but that was the end of a 2.5 week period where we had sex every day.

I would appreciate your comments on this, since I'm really scared now. I will definitely visit a doctor tomorrow, but for my peace of mind, I would like to know if an STD sounds likely in this case.

Many thanks -
Steve

[Edward W Hook, MD]

White blood cells in the urine are suggestive of any of the processes I mentioned above, as well as a possible urinary tract infection.  Given those results, i would have thoughtthe doctor would have started you on some presumptive therapy. You may want to call and ask him about this EWH

BTW, NGU is an STD, we just are unsure what is causing it

[steve0815]

Doc,

Thanks for your reply. I just returned from the urologist, who took a urine sample and two swabs from my urethra. After analyzing the urine sample, he said it contained a noticeable amount of white blood cells, which is an indicator for an inflammation. However, he has to wait for the lab to come back with the result from the swabs, which will not be any earlier than Tuesday.

Is the presence of white blood cells suggesting an NGU (as you refer to it) or can it still be an STD ?

Thanks for all your help
Steve

[Edward W Hook, MD]

Having a discharge from the penis is highly suggestive of an STD.  You need to be evaluated by a physician who will test you for gonorrhea, chlamydia and non-gonococcal urethritis (NGU- as indicated by the present of white blood cells in the discharge).  All are readily treated but knowing what you have will be very helpful in helping to let your GF know what she should be treated for.

AS to where this came from, several comments.
1.  Many of our patients see penile discharge but delay seeking care because the "thought it would be worse" i.e have more discomfort associated with it.   Thus your symptoms do fit.
2.  At this point it is impossible who originally infected whom and how long they've had it.  These STDs can be asymptomatic and overlooked in both men and women for long periods of time (yes, even years), only to become symptomatic at a later date.  In addition, one partner may have the infection, clear it themselves and then have it show up in their partner.
3. The important issue now is to get an accurate diagnosis.   Seeing your doctor is the right thing to do. It would be best if you could avoid voiding before you see him/her of if that is not possible, have let at least two hours pass between your last urination and seeing the doctor.

Hope this helps.  Good luck.  EWH