Concerned - Need Advice Please

[worfmg]

Dear Doc

Approx 5 days after one of the adventures (condom used throughout)  with a working girl, I developed an uncomfortable feeling in my urethra. It was never painful rather a slight burning sensation with frequent urge to pee. Never had either pain or this sensation (burning) while passing urine. Did not have any abnormal secretions either that could have referred to gonorrhea.  

As I was travelling,on the last day of my stay in that country, and almost 12 days after I first started having this sensation, I went to a hospital and was referred to a dermatologist. I was open with the doctor about the whole thing and my concern that I may have contracted either or both of the mentioned infections. He physically examined and felt around the area for any abnormalities but could not find any thing unusual. He then asked for a complete urine analysis and a 72 hour urine culture done. I gave the urine sample but as it was my last day there I traveled back to my home country.

4 days after the visit to the doctor, he called to let me know that the urine analysis and the culture had come back clear. He asked me to take lot of fluids and if the problem persists to see a urologist for prostrate abnormalities.

This was early February 2009. The urgency to urinate is long gone. I am back to 3 to 4 times a day. However after every 5 to 6 days for one day this sensation comes back and then vanishes for another week. During this 5 to 6 day period it feels as if I had nothing. May I please request your answers to the following questions:

1. Do you think 10 days was enough for Chlamydia and gonorrhea to show up in tests?
2. Were urine analysis and the culture enough to indicate these infections or should I go again get specifically tested for Chlamydia and gonorrhea even though the doctor I saw knew what I was suspecting before he prescribed the   tests
3. What I have described as the sensation does it sound like a STD to you?

Thankyou for your kind advice

[worfmg]

Many thanks for your answer and my apologies for not being clear in my description of the problem. I was never prescribed any medication since the urine tests came out clear and the doctor advised me to just take lots of fluids. Without any medication I happened to have come back to normal meaning that the urgency to urinate very frequently went away on its own and that the burning discomfort also subsided itself. This sensation though did not go away completely as after every 6 days of complete calm i.e. no such sensation at all I get this sensation all over again for a day or two max.  I may need to consult a urologist but through your opinion wanted to rule out STD's at least.

[Edward W Hook, MD]

There may be something missing from your post.  I do not see what infections you are concerned about and did not see that you were treated for gonorrhea and chlamydia until I got to your questions.  I doubt that this makes much of a difference in my answers however.  Before I get to your specific questions, I have to say that there is not much in what I have read to suggest that you have an STD.  You used a condom and if you used it correctly, even if your partner was infected, you would have been well protected.  This conclusion is further supported by the negative tests you , including the complete absence of inflammation on your urinalysis.   Finally, it sounds as though, despite any clear indication, you have been treated for gonorrhea and chlamydia infection,.  This therapy would have also cured NGU, eliminating any and all casual agents which might have been concerned about.  Now, on to your questions:

1.  Yes.  Tests for gonorrhea and chlamydia are typically positive after 2-3 days.  10 days is certainly enough.
2.   Typically the urine tests should be sufficient.  In addition, having now apparently been treated, any abnormality detected at this time would suggest a problem other than STD.
3.  Strange urethral sensations are notoriously difficult to sort out and far more often than not, turn out to be non-specific and not associated with infection or other abnormality.  Not sure if it pertains in your situation or not but anxiety can do this.

Hope these comments help.  EWH