sore penis still after treatment

[Khmer]

i had unprotected oral and vaginal sex in thailand. after this i had a (very) slight burning sensation when urinating and some slight irritation after masturbating and a feeling of needing to urinate a lot. i used cannesten for a couple of weeks and the symptoms seemed to pass. however whilst travelling a few weeks later i became quite sick (fever and swollen sore throat), and awoke one morning with some yellow discharge coming from my penis. i went to a local hospital (where they didn't speak much english) and after looking at my penis and throat they prescribed cefixime (I think - i know i was reassured when i looked it up on the internet and found it was the treatment for gonorrhea - ie it seeemd the doctor was on the right track) 200mg BD for 7 days. i took this as presctribed. the discharge and the sore throat etc have cleared. but my penis isn't right. this may seem a vague thing to say and i realise that my preoccupation with this problem may have an effect. however the glans of my penis is dry, thereby making my foreskin more difficult to roll back. also there is often dry white dead skin on the glans (except for the area around the tip of my urethra) that is more difficult than usual to clean off in the shower. in addition to this, when i masturbated last there was a burning sensation when i ejaculated, and the foreskin became quite sore.

hope you can shed some light on this. i'm feeling pretty desperate and worried that the infection hasn't gone or it is something else. the medical services in the country i am in  (language gap etc) are not ideal.

thank you

[brooky]

i think i have gonorrhea, im not sure.  Have yellow discharge coming out of my penis (underneath the foreskin). I have had this for about 2 years now after i had unpretected sex with my girlfriend. I need to know more about gonorrhea. Im to scared to tell anyone about my problem, that's when i thought abot lokking on the internet, and saw this website. i need a second opinion about what to do and who to tell, please someone help me, thank you.

[brooky]

i think i have gonorrhea, im not sure.  Have yellow discharge coming out of my penis (underneath the foreskin). I have had this for about 2 years now after i had unpretected sex with my girlfriend. I need to know more about gonorrhea. Im to scared to tell anyone about my problem, that's when i thought abot lokking on the internet, and saw this website. i need a second opinion about what to do and who to tell, please someone help me, thank you.

[steve88]

5 months ago my girlfriend told me she had Chlamydia and Gonorrhea.  It shocked me.  After I found this out I went to the clinic and just had chlamydia.  I was treated, but since my whole prception on things have change.  I am more cautious when I do everything, which has been good and bad.  I am more careful, but everything bothers me now. Now when I urinate I am always nervous of something being wrong, and every little cough and headache or anything out of being 100% fine bothers me. I never went back for another Chlamydia and Gonorrhea  test becuase they told me at the clinic that I should be fine after being treated.  I stop having sex, but recently when I masturbated and then urinated I felt a slight discomfort, not a horrible pain but I felt something.  Could this be something wrong or  just my mind.  I still havent fully recovered from this whole thing mentally and every now and then feel depressed of what happened five moths ago.  Can someone give me some advice please.

[steve88]

5 months ago my girlfriend told me she had Chlamydia and Gonorrhea.  It shocked me.  After I found this out I went to the clinic and just had chlamydia.  I was treated, but since my whole prception on things have change.  I am more cautious when I do everything, which has been good and bad.  I am more careful, but everything bothers me now. Now when I urinate I am always nervous of something being wrong, and every little cough and headache or anything out of being 100% fine bothers me. I never went back for another Chlamydia and Gonorrhea  test becuase they told me at the clinic that I should be fine after being treated.  I stop having sex, but recently when I masturbated and then urinated I felt a slight discomfort, not a horrible pain but I felt something.  Could this be something wrong or  just my mind.  I still havent fully recovered from this whole thing mentally and every now and then feel depressed of what happened five moths ago.  Can someone give me some advice please.

[H. Hunter Handsfield, M.D.]

It seems likely you in fact had gonorrhea; the quality of medical knowledge about STDs is good in Thailand, most providers there should recognize it, and cefixime is appropriate (although a single dose would have worked as well as 7 days treatment).

I have 2 thoughts about your current symptoms.  First, I strongly suspect infection with a fungus, of which the most common type is the yeast called Candida--i.e. candida balanitis.  (Balanitis is the term for dermatitis of the head of the penis.)  Your symptoms are typical and yeasts often are present under the foreskin, and broadly active antibiotics like cefixime sometimes trigger their growth, especially when taken for a week or more.

Second, 20-30% of men with gonorrhea also catch chlamydia at the same time.  That's in western countries; the risk may be higher in Thailand.  Gonorrhea therapy usually should include treatment for possible chlamydia, but cefixime is inactive against it.  That said, your symptoms don't sound like chlamydia.  I suggest getting checked out for yeast--but to be safe, also request a chlamydia test.

Good luck--   HHH, MD