Small Amount of Discharge

[ensor]

I'm married 15 years and have never cheated on my wife.  I would be surprised if she has.  But I'm concerned about some persistent symptoms.

I'm 48. Four weeks ago, I had non-specific groin pain, also a small amount of clear-to-white urethral discharge.  (Maybe 2-3 spots daily on my underwear.  I've had chronic epidiymitis for nearly 20 years but never had discharge as a result of this condition.  My doctor believed I was having a flare-up of epididymitis and gave me a presciription for 500 mg of Levaquin for 7 days.  I took the full course and noticed on day 6 that I still had some discharge.  On day 7, I didn't get to the bathroom fast enough (I've had frequent urination for 4 years) and peed a little in my pants.  In the wet spot, there was clear mucus.  This struck me as strange, because infection symptoms usually disappear in the early stages of antibiotic treatment (true?).  The mild groin pain continued, so I went to a urologist, who wasn't very helpfull.  He second-guessed my earlier diagnoses of epididymitis despite my history of testicular pain.  Years ago, I had also been diagnosed with prostatitis (what an earlier doctor had detected as a "mushy prostate) although subsequent exams did not show the same abnormality. My current urologist did not do a prostate exam on this visit.  He treated me nicely but dismissively.  He said "prostatis diagnoses are always a fallback position" and remarked that small amounts of discharge are not unusual (the first I heard of that).  He stated that because I was in a monagomous relationship, I wasn't at risk of STDs.

The discharge has returned along with a mild burning, only at the urethral opening.  There is NO burning sensation with urination. I don't like distrusting my wife and am wondering if I should get tested for chlamydia.  We have a moderately active sex life (twice a week) including oral, vaginal and (sometimes) anal without condoms. (Wondering if e. coli could be involved here.).

[H. Hunter Handsfield, M.D.]

I agree exactly with your urologist (although I hope not dismissively).  Clearly you are at no risk for STD, and except for the discharge your symptoms don't suggest STD.  You are getting to the age when prostate problems are increasingly common, and certainly that could cause everything including the discharge.  "Clear mucus" also suggests infection isn't the problem.

I won't speculate further, since this forum is strictly limited to STD issues, which clearly is not the problem here.  Continue to follow up with your own doctor(s).

Good luck--  HHH, MD

[ensor]

Thanks, doc.  Just a quick follow-up.  Many Web sites claim that "clear" discharge is indeed a sign of chlamydia.  Am I missing something in your interpretation or is the information on these sites just plain wrong.  Also, would Levaquin at the dose discussed have, indeed, wiped out any bacteria-related discharge -- chlamydia or not -- by Days 6 or 7?

I'd greatly appreciate a quick note on the above.  

[H. Hunter Handsfield, M.D.]

Wrong.  Chlamydial discharge usually is cloudy.  But it's all over the map; urethral discharge can be clear, cloudy, or otherwise from just about any cause.  Obviously chlamydia (or any other STD) is impossible, if your and your wife's sexual histories are correct.

I will not comment on treatment.  You don't have an STD, and that is where my advice ends.