STDs Expert Forum
Trichomoniasis
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Trichomoniasis

I had mild symptom of discharge 6 months ago.  Went to the hospital they told me it was clamydia (chlamydia).   They gave me a shot of Rocephin and 10 days of doxy.Toldmy girlfriend she has to get checked...the doctor told her she tested negative.  My symptoms came back a week after the treatment.  I saw a mucous membrane in the urine in a glass.  When i ejaculate and urinate i get this burning down the urethra and the tip of the penis.  Go to a urologist and he tells me it is a undetectable prostatitis.  He puts me on levaquin which suprress the prostatis;however, tingling down the urethra is still there. I finish the levaquin and the symtoms (symptoms) come back 12 days later full force.  My girlfriend and I have sex and I see on her a frothy white transient white discharge and a yellow tan discharge on my pelvis.  
Is it possible that the antibiotics are suppressing the prostatitis and the cause is tricomoniasis.The merck manual says prostatitis is a complication of trich.  I am going for a cytology urine analysis. My doc says it might not come up. I have had 5 urine culture but no Cytology urine analysis.  Also i have always been on a antibiotic.  CDC reccomend Flagyl for repeat urinary tract infections
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Your symptoms are very nonspecific, and the odds are great that nothing serious is wrong.  Most persons diagnosed with "prostatitis" probably don't actually have a prostate gland infection; in fact, the American Urological Association now recommends the term "pelvic pain syndrome" for most men with symptoms like yours.  Although antibiotics often are tried, they don't work.

Trichomoniasis occasionally can indeed cause such symptoms, and if your partner indeed has an abnormal discharge, the possibility of trichomoniasis or other STD rises.  But you say nothing about how long you have been with your present partner and whether she has been examined, so it is impossible to judge the risk of trich or any other STD.  Nor do you say your age, which would have an influence; for example, bladder cancer--concern for which is implied by the plan for a urine cytology--is virtually unheard-of under age 40-50.

If your partner hasn't been examined, make that the next step; ideally the two of you should go together to an STD expert.  (Most urologists are not really STD experts--by which I don't mean criticism of your doctor, it's just a generalization that of course has exceptions.)

CDC recommends metronidazole (Flagyl) for nongonococcal urethritis (NGU) that does not respond to other drugs.  But it doesn't sound like that's what you have, at least no longer.  Metronidazole isn't recommended for any other kind of urinary tract infection, though.

Good luck--  HHH, MD
7 Comments
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Avatar_n_tn
dr,  in addition,  i am going for a semon culture tomorrow....will it come up in a semon culture?  my assumption is no because it is a parasite.  
Also, does it depend upon the person using the microscope to detect trich for the cytology analysis ?  That is if the lab technician has the experince to look for trichomoniasis.  My urologist is telling me it might not come up because it is hard to detect in men.  keep in mind,  i am on cipro now to suppress the prostatitis.
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Avatar_n_tn
also, my psa is .01 and my bladder under ultrasound is clean
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Avatar_n_tn
I have had these symtoms (symptoms) for a year.  I am 39 years of age. I have been with the same partner for a year.  It did not start until I was with her.  The urologist feels that trichomonaiasis will come up in a cytology report. The lab said that trich will come up in a cytology(fixed urine)analysis. The urologist also sent out tests for a urine culture(dip stick) and microscope test. I don't want to go on Flagyl without a diagnosis. I need it to show my girlfriend who is in denial.  The cultures comes up negative in me and her. She did get checked out.

I guess your right I need to see an std expert.  i can tell my urologist does not know much about this; however, he did clear me and said i definitly don't have kidney or bladder cancer.

Would you take the flagyl even if the report does not come back positive just to see what happens.
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239123_tn?1267651214
If you have trichomoniasis, your partner also has it.  I'm saying nothing about who had it first or who gave it to whom, only that if you have trich the two of you are sharing it.  Accordingly, it won't do you any good to take Flagyl unless she does so at the same time, and that shouldn't happen without her being examined.  So it seems you're going to have to address her denial before you get to the bottom of this (no pun intended).

Cytology will miss most trich infections.  If accurate, that statement is more evidence that your urologist is not well up on STD issues, and perhaps not on genitourinary infections in general.

HHH, MD
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239123_tn?1267651214
If you have trichomoniasis, your partner also has it.  I'm saying nothing about who had it first or who gave it to whom, only that if you have trich the two of you are sharing it.  Accordingly, it won't do you any good to take Flagyl unless she does so at the same time, and that shouldn't happen without her being examined.  So it seems you're going to have to address her denial before you get to the bottom of this (no pun intended).

Cytology will miss most trich infections.  If accurate, that statement is more evidence that your urologist is not well up on STD issues, and perhaps not on genitourinary infections in general.

HHH, MD

Addendum:  Sorry, I missed your statement that your partner has been examined.  If you both have really had a trich culture, not just a microscopic exam for the organism, than you can be pretty sure trichomoniasis isn't the problem.  But even culture isn't perfect and misses some infections.  If the two of you want to try simultaneous treatment with Flagyl, it likely wouldn't be harmful.  I don't really think it will help your symptoms, but it might be worth a try.

HHH, MD
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Avatar_n_tn
I want to commend you for the time and effort that you put in to this forum.  I know that no one is telling you this.  Some people are not getting good advice from their doctors on Std'S; however, I see that you are putting some of your spare time into answering these tough questions from patients who are afraid or embarrassed to ask their doctors.  Maybe it is because their doctors don't have the STD(or infectious desease experience) and patients are being misdiagnosed by their doctors.

I am going to try flagyl(emperically) next week after failed initial treatment(this is what is reccomended by the CDC).  I will not have sex for a month.  i am just going to wait for the Cystology(fixed urine) and microscropic unrine analysis no matter what(negative or positive). No matter what I will try Flagyl

I just want to say thank you.  You are giving back to society.  i will let you know what the results after i take Flagyl with Cipro for ten days.  I have a feeling this was misdiagnosed.
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A related discussion, Pain While urination was started.
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If you suspect you may have trich you need to catch it fast. Because it can easily get out of control and become life threatning matter. I thought I had bronchitis about a month ago. My chest walls were inflammed,and a severe pressure on my eyes... I thought I was going blind. Went back to the ER and was still misdiagnosed... I really think they didn't give a d*** because I didn't have rich peoples insurance. Well anyhow almost a month later I decieded to go to my GYN... and found out I had trich.. I had the same symptoms as your friend ... I was was prescribed flagyl... I am now on the second day of treatment... awaiting to return to normal... I have felt like hell since christmas... death was knocking at my door..and I do mean loud..
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