Please help me Dr.

[susie139]

with my boyfriend for 10 yrs both have tested negative igg in the past for hsv2.  A little over a month ago I had protected sex with someone else. During this time the condom came off and unbeknownst to me I found it 3 days later. Ugh. 3 days after that I felt a burning down there and noticed that I had a milky white discharge coming from urethra.He tested for hsv2 and was equivocal at .97. He said he hasnt been with anyone in over 15 years and I am not sure I believe him. I tested negative for hsv2. 23 days post. I dont really see what I would call sores. Just red red areas.I called a friend who is an out of state doc and he treated my bf and I for gon and chlam and trich becuase we couldnt get to him for testing. after treatment my discharge from urethra subsided and boyfriends testicle started to swell. His testicular swelling went down in a few days. I have appointment with gyn in 2 days. yes initially 4 weeks ago I had a white urethral discharge. I took meds prescribed by the out of state doc. Antibotic appeared to clear up the discharge.I still have the burning in the vagina and overly red labia as well. :( Also the burning didnt really exist as much with urination as it did holding it. Nothing at all feels right down there.urethra still feels not right also.yes not big time pain, just alot of discomfort. Not much pain at all urinating and never was. . No the white was def from urethra ...

[Edward W Hook, MD]

Welcome to our Forum.  Your post is a bit hard to follow as it runs together and is longer than requested by our Forum rules.  Your situation, like that of many of our clients is complicated by your self-treatment for symptoms without really knowing what was going on.  As I understand it, your problems began when you had sex outside your relationship, during which a condom was "left behind" following sex for several days.  You became aware of the condom at about the time you had the white discharge from your urethra, after which both you and your BF were treated with cefixime, doxycycline and tinidazole without testing.  Since then you have had vaginal burning and redness (I know there are other details but these are the essentials, I believe).  Now you would like to know what is going on.

I have some thoughts about what this is, and is not, but what you really need is a though evaluation by a clinician who can look and see what is going on.  Here is what I think may be important to you:

1.  You do not have herpes.  You have not had an outbreak, your tests are negative (not that I would have recommended them) and herpes symptoms do not last more that 2-3 weeks following initial infection.
2.  If you had gonorrhea, chlamydia or trich the medication you took would have almost certainly cured it.  There is not a risk for re-infection since your BF was treated and you have not had sex since your treatment.
3.  Your white discharge 3 days after your exposure may have been related to the retained condom. This would  not be unusual.  
3.  What may be going on is a local fungal (yeast) infection. Such problems are common after taking antibiotics as you have and can cause the symptoms that you are experiencing (redness, irritation).
4. Anxiety/guilt may be heightening the symptoms. It is common for persons who are looking for symptoms to note normal sensations they would otherwise ignore or for the increased attention to make symptoms seem more severe..

What to do?  Do not worry further about STIs- your tests show that you do not have them.  Get seen by your GYN and ask if a fungal infection could be causing the redness and irrigation you are experiencing.  

I hope these comments are helpful.  EWH

[susie139]

ok so at 6 weeks post was tested for hsv2, hep b, hep c, chlamydia and gonorrhea, and HIV. All negative. Still having discomfort in urethra. Kinda aches and some discomfort during urination but doesnt feel like uti. No discharge. Had urine checked at gyno, no uti. Also had microscopic evaluation of it also negative. Also feel lower back pain and some abdominal pain around left side. Had a cbc done at same time and it revealed elevated wbc at 12.9. Also my glucose was raised which never happens. Any ideas? Still not sleeping with worry. Gyn said she feels it is just anxiety from what happened. This is real discomfort, not anxiety! Since I wasnt evaluated before treatment of gon and chlamd could this just be residual pain from that if I did indeed have it but was cured before testing? Have not had sex since treatment. I cant help but think that maybe the extremely rough fingering back in September may have injured my urethra or bladder? Is this possible? Please dissect this question as thoroughly as you can! I need help and I am not getting it from my doctor. If urethra was somehow damaged how long before it heals? Remember, a week after this experience i had white discharge from urethra. Then took doxy for a week, cefixime, and tinidazole and the discharge cleared but still having discomfort.

[susie139]

But I did go to the gyn. She said that I have no visible issues. My urethra hurts! and it has for almost 7 weeks. During the courses of antibiotics I took diflucan 3 times.

[susie139]

Should I go to the ER?

[Edward W Hook, MD]

This is not an emergency and not an STI.  You should work through this with your GYN.  EWH

[susie139]

Gyn or a urologist ?

[susie139]

She thinks I'm crazy. She told me I'm suffering from anxiety. It is reallllll pain I am feeling!

[Edward W Hook, MD]

There is no need to go to the same doctor repeatedly.  If you are not comfortable, seek a second opinion.  EWH

[susie139]

If I tested negative by culture for gon and chlamydia are these accurate 100 percent? I took a week of doxycycline 1 GM of azithromycin. 2 gms of metronidazole. Then 1.5 gms of metronidazole and 1 GM tindamax. Also took cefixime for 3 days. Would this treatment for sure have eradicated everything ?  Went to ER last night because of the pain. They did urinalysis. Normal but trace amounts of blood. Ct scan of bladder and kidneys because of abdominal and back pain didn't show anything. They said to see a urologist   Should i do this or am I now on a witch hunt for nothing? Do you think possibly I had one of those infections and it's just lingering discomfort from that that I need to be patient with? I am considering just taking a wait and see approach and trying to telax

[Edward W Hook, MD]

As you tell me (bit by bit) you have have had an extensive workup and been well treated if an STI were present.  A wait and see approach is quite reasonable now.  The tests for gonorrhea and chalmydia are highly accurate if you were infected which is unlikely.  Had you been infected, the treatment you've taken is highly effective as well.  As I said before STIs are not the problems here.  Your anxiety may be amplifying any residual symptoms which are present.  EWH

[susie139]

that is now my guess as well. Thank you for your time Dr.!

[susie139]

The saga continues. Still have major irritation. Tested for chlamydia and Gonorrhea at doctors office as well as urine tested twice. My thoughts had shifted to HSV2 because of the redness and irritation. I was tested for HSV2 (all through Labcorp) at 3 weeks, 5 weeks, 7 weeks and 10 weeks. All results have come back <.91 or negative. At this point should I continue to test for HSV2 or would you say I am clear. I would think by now it would at least show equivocal? He had tested at 3 weeks and it came back equiovocal (.97) then at 9 weeks and it came out negative (<.91) Since this time nothing feels right at all down there. Better but not right. I think his equivocal is what put me on this path. He still states he has had no contact with anyone but his wife in the last 20 years (and then me) :(

[Edward W Hook, MD]

Please stop testing for HSV.  There is no reason for you to think this is the cause of your irritation.  Your irritation is due to something other than an STI.  Are you working with the same doctor or a different one?  On one hand unfortunatley a certain amount of observation over time, as well as trial and error is needed to sort these things out.  EWH

[susie139]

Not working with any doctor at this point. She couldn't find anything although she didn't test for yeast. However I have tried diflucan and OTC anti yeast preparations already. It does seem better than it did. I guess I will just never know. A question about the hsv2 testing though. Wouldn't it be at least equivocal by 10 weeks if I did have it?

[Edward W Hook, MD]

I repeat, there is nothing that you have said in this thread that suggests hat you have HSV.  If you had acquired infection however at 10 weeks over 90% of persons who aquire a first HSV infection will have positive tests.  Eqivocal tests are meaningless and of no use.

As you point out, you  may never know what happened.  As I said earlier, your repeated self treatment complicates assessment.  There are many causes of genital and urethra irritation that are not STIs and sorting this out sometimes requires careful testing and the wisdom that comes with training and experience.  If your symptoms continue, I suggest that you see a doctor whom you trust and commit to working with them to sort this out.  In medicine we say that a doctor who treats themselves has a fool for a patient.  The same is true for patients who treat themselves.  The reason physicians go to school for nearly a decade of medical trainng before entering practice is to learn how to sort out the huge variety of problems for which symptoms may resembe one another.  

With this, it is time for this thread to end.  This will be the final answer.  Take care.  EWH