symptoms and testing

[ezramagee]

Hi Doctors. Just over a month ago I had protected vaginal sex with with a CSW in California.  I asked her if she was clean and she said yes.  3 and a half days later I was tested at a local STD clinic for all relevant STD's.  All tests came back negative.  I held my urine for about 2 hours before providing it.  It has been just over 4 weeks and yesterday I noticed clear discharge coming from my penis, usually proximate in time with bowel movements.  I have had this in the past.  Yesterday was just more than I was used to seeing and more frequent. Also, and this may be in my head, but I think I feel a slight burning when urinating, but it comes and goes.  My questions are:  1.  what are the chances my test was falsely negative re: the chlamydia?  2.  Do symptoms of chlamydia arise after one month or longer? 3.  Are the symptoms obvious or subtle ie does the burning "hurt" or is it more of a sensation?  4.  Was 3 and one  half days too soon to provide a test sample? I don't really want to waste the time and cost of retesting so your thoughts here would be helpful.

many thanks.

[ezramagee]

Thanks Dr.  I know I said that that was my last, but I have one follow up inquiry if you would be kind enough to respond to it.  Against your recommendation, I was tested again for Chlam and Gon (urine and swab).  The urine test results came in today as negative (the swab is still outstanding).  I had discharge again today, a little after urination and I did feel some pressure in my lower abdomen.  Is there a chance this is an NGU infection (the non chlamydial type) and if so what are the ramifications, if any, for a regular partner (female) and out of curiousity, if she is pregnant?  From what ive read on this site it seems non chlamydial NGU is more of an inconvenience and not something normally tested for.  many thanks. EM

[Edward W Hook, MD]

You are correct.  I see no need for further testing or for abstaining from unprotected sex with your regualr partner.  Take care.  EWH

[ezramagee]

Thank you doctor. Am I safe to assume from this that 1. you wouldn't recommend follow up testing and 2. I can have unprotected sex with my regular partner if my only sexual exposure is the one that I have described in my initial post?

That will end this thread for me.

Regards.

[Edward W Hook, MD]

No, the test works equally well with all urinations.

Yes, the test used a in Canada are state of the art. EWh

[ezramagee]

Appreciate you taking the time to answer this on the long weekend.  Your comments on the efficacy of testing are reassuring.  Would it matter if the sample was not my first urination of the day; i think it was my second but I did 'hold' it for two hours after my first or thereabouts?  Also, my tests were done at a clinic in a major city in Alberta Canada, do you know if the tests they use there are the same "current" tests you refer to?

I certainly did not mean to offend re: references to clean; my apologies if I did.

[Edward W Hook, MD]

Welcome to our Forum. First some general comments, then to your specific questions.  Your partner was probably right when she said she was "clean" (not that I like the term).  Most CSWs do not have STDs and further, even most unprotected exposures do not lead to transmission of infection.  Your exposure was protected and thus, virtually no risk for infection.   Further, your test results provide very strong evidence that you were not infected by this exposure.

As for your discharge, this is not an uncommon or abnormal experience. The act of having a bowel movement increases your intra-abdominal pressure and can lead to expression of prostatic fluid.  I suspect your sensation that there is more than "usual" is simply a manifestation of your concern.

Let's go through your specific questions:

1.  what are the chances my test was falsely negative re: the chlamydia?
Virtually zero.  Your exposure was virtually no risk and current chlamydial (and gonorrhea) tests are very, very accurate.  Believe your test results.

  2.  Do symptoms of chlamydia arise after one month or longer?
Occasionally and in fact, chlamydia can be asymptomatic. However, if symptoms are going to occur, they typically do so within two weeks of exposure.

3.  Are the symptoms obvious or subtle ie does the burning "hurt" or is it more of a sensation?  
The symptoms can be subtle and are sometimes overlooked or attributed to other causes.  My sense from your post however is that you are unlikely to do this.  Further, as I said above, your test was virtually no risk and your test results are to be believed.

4.  Was 3 and one  half days too soon to provide a test sample?
No, this was fine.

I hope you find my responses reassuring and helpful.  I urge you not to worry.  EWH