Aa
recurrent urethritis again....
Dear Dr Hansfield,
First a heartfelt thank you to you and Dr Hook for your professional candor and sensitivity towards all of us who need help. About a year ago received unprotected fellatio from my massage therapist. Long story short -got a painful urethritis, mucous like discharge, right testicular pain/swollen, and prostatic pain(perineal pain). Did not respond to doxicycline, azithromycin,cipro, or metronidazole. Swab was negative but not taken until 2nd visit to DR. Finally urologist gave Levoquin and symptoms resolved months later.
I attempted to answer my question by reviewing many threads, and you will probably feel the need to chastise me for asking but i must know i am not infectious to my wife. 3 weeks ago i played it safe and received an oil massage and happy ending. I touched the masseuse genitals as well but no exchange of fluids occurred. About 3 days after the event again I had pain at the tip of my penis often initiated by urination , watery mucous discharge, and pain behind the right testicle. Also experiencing sensation of sitting on a golf ball in the perirectal area at times. GP did not seem concerned, no tests, but gave me clarithromycin/metronidazole 10 day dose and symptoms(mostly penile tip pain sometimes hours at a time) still persist.
Could you please offer advise as to whether this could be a ureaplasm or myco? No way this is NG/Chlam right?
Do I need any further tests,treatments,follow up?? My GP does not seem to be an expert in this area .
I can live with the pain, I just want to know I am not infectious and can get on with normal sexual activity with my wife.
For all you do, I thank you.
Sincerely yours.
PS I have no psych history I am aware of ...
First a heartfelt thank you to you and Dr Hook for your professional candor and sensitivity towards all of us who need help. About a year ago received unprotected fellatio from my massage therapist. Long story short -got a painful urethritis, mucous like discharge, right testicular pain/swollen, and prostatic pain(perineal pain). Did not respond to doxicycline, azithromycin,cipro, or metronidazole. Swab was negative but not taken until 2nd visit to DR. Finally urologist gave Levoquin and symptoms resolved months later.
I attempted to answer my question by reviewing many threads, and you will probably feel the need to chastise me for asking but i must know i am not infectious to my wife. 3 weeks ago i played it safe and received an oil massage and happy ending. I touched the masseuse genitals as well but no exchange of fluids occurred. About 3 days after the event again I had pain at the tip of my penis often initiated by urination , watery mucous discharge, and pain behind the right testicle. Also experiencing sensation of sitting on a golf ball in the perirectal area at times. GP did not seem concerned, no tests, but gave me clarithromycin/metronidazole 10 day dose and symptoms(mostly penile tip pain sometimes hours at a time) still persist.
Could you please offer advise as to whether this could be a ureaplasm or myco? No way this is NG/Chlam right?
Do I need any further tests,treatments,follow up?? My GP does not seem to be an expert in this area .
I can live with the pain, I just want to know I am not infectious and can get on with normal sexual activity with my wife.
For all you do, I thank you.
Sincerely yours.
PS I have no psych history I am aware of ...
MEDICAL PROFESSIONAL
Putting all this together, it seems likely you have a prostate gland problem. I'm skeptical the initial problem was acquired by the oral sex event in the massage parlor. It is rare for sexually acquired urethritis to not resolve with the several initial antibiotics, and it could be that the symptoms finally resolved spotaneously, not because of the levaquin. Now I suspect the same problem has recurred. You current symptoms cannot possibly have been due to an infection acquired during your more recent massage event, "happy ending" or not.
I used the term "prostate problem", not "infection" or prostatitis, with care. Most cases of prostate inflammation may not be due to infection at all, but some other kind of inflammation. Antibiotics often are tried, but as you have found, they often don't make much difference -- which is part of the evidence that infection is not involved. Because of the way the nerves are distributed in the genital area, more internal problems, like prostate, tend to cause pain or discomfort at the tip of the penis -- so the location of that symptom does not necessarily indicate a urethral infection.
As far as potential harm to your wife, or to your health in the long term, you have no worries. Chlamydia or gonorrhea are not a concern. Prostate problems of this sort are not sexually acquired or transmissible; and in the slim chance I am wrong and that the initial problem indeed was sexually acquired, there simply are no sexually transmitted germs that could persist and cause harm in the face of the several antibiotics you have received.
Your experience with your primary care provider is fairly typical. Prostate inflammation and related issues are complex and often not well understood by GPs. Your use of "GP" suggests you might be in the UK (they're mostly known as family practitioners [FP] in North America). If so, consider a visit to your local genitourinary medicine (GUM) clinic for expert evaluation; or ask your GP to refer you to a urologist. I don't anticipate any surprises will be found, but evaluation by an expert likely will go far in calming your fears about long term health outcomes for either you or your wife.
Finally, long before coming to your closing comment, I did not suspect a psychological origin of this problem, even though such conclusions are common on this forum. Your willingness to "live with the pain" as long as there is no risk to your wife is a mature and healthy attitude.
In summary, almost certainly no STD is responsible for these problems and I see no risk of serious health outcome for either you or your wife. You may or may not have to live with your symptoms, but they should not be cause for great concern.
I hope this helps. Best wishes-- HHH, MD
I used the term "prostate problem", not "infection" or prostatitis, with care. Most cases of prostate inflammation may not be due to infection at all, but some other kind of inflammation. Antibiotics often are tried, but as you have found, they often don't make much difference -- which is part of the evidence that infection is not involved. Because of the way the nerves are distributed in the genital area, more internal problems, like prostate, tend to cause pain or discomfort at the tip of the penis -- so the location of that symptom does not necessarily indicate a urethral infection.
As far as potential harm to your wife, or to your health in the long term, you have no worries. Chlamydia or gonorrhea are not a concern. Prostate problems of this sort are not sexually acquired or transmissible; and in the slim chance I am wrong and that the initial problem indeed was sexually acquired, there simply are no sexually transmitted germs that could persist and cause harm in the face of the several antibiotics you have received.
Your experience with your primary care provider is fairly typical. Prostate inflammation and related issues are complex and often not well understood by GPs. Your use of "GP" suggests you might be in the UK (they're mostly known as family practitioners [FP] in North America). If so, consider a visit to your local genitourinary medicine (GUM) clinic for expert evaluation; or ask your GP to refer you to a urologist. I don't anticipate any surprises will be found, but evaluation by an expert likely will go far in calming your fears about long term health outcomes for either you or your wife.
Finally, long before coming to your closing comment, I did not suspect a psychological origin of this problem, even though such conclusions are common on this forum. Your willingness to "live with the pain" as long as there is no risk to your wife is a mature and healthy attitude.
In summary, almost certainly no STD is responsible for these problems and I see no risk of serious health outcome for either you or your wife. You may or may not have to live with your symptoms, but they should not be cause for great concern.
I hope this helps. Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
Thanks for the thanks. Glad to be of help.
As I said, I doubt any of this was explained by a bacterial infection and am not convinced any antibiotic was necessary. But if treatment was to be given, the drugs you had were just fine. Clarithromycin is just as effective for prostate infections and urethritis as is erythromycin (of which EES is one type).
As I said, I doubt any of this was explained by a bacterial infection and am not convinced any antibiotic was necessary. But if treatment was to be given, the drugs you had were just fine. Clarithromycin is just as effective for prostate infections and urethritis as is erythromycin (of which EES is one type).
This was definitely the best Doctor/patient interaction I have ever had! I cant thank you enough for your extensive knowledge and the kind manner in which you advise. If you could bear with me for a final question or two that evolved from your response, I will conclude with finality and peace of mind....
Did my GP prescribe correctly with the Clarithromycin/metronidazole? I read EES was prefered, so was I exposed to an antibiotic that would essentially not do the job?
Also am I correct in translating that you would not advise STD testing at this juncture? (I know the "happy ending" exposure was not risky) I am just so perplexed as to how this whole thing correlates within 48 hours of the massage......
I immensely appreciate your time and efforts.
Did my GP prescribe correctly with the Clarithromycin/metronidazole? I read EES was prefered, so was I exposed to an antibiotic that would essentially not do the job?
Also am I correct in translating that you would not advise STD testing at this juncture? (I know the "happy ending" exposure was not risky) I am just so perplexed as to how this whole thing correlates within 48 hours of the massage......
I immensely appreciate your time and efforts.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
