urethra infection

[mtg2u]

I made a bad choice and received unprotected oral sex from sex worker at massage parlor.  3 days later I started feeling discomfort in my urethra (no discharge but burning, tingling, and pressure in my urethra) and visited my primary physician.  He had me take blood test and urine test and put me on Doxicycline (for Chlamydia) and injected me with Ceftriaxone (for Gonorrhea) just in case

[donkeydonkeydonkey]

A related discussion, staph bacteria or mental problem was started.

[H. Hunter Handsfield, M.D.]

Probably there is no improvement on antibiotics because there is no infection.  White blood cells mean inflammation, not necessarily infection.  The causes of WBC in semen or in the prostate gland are largely unknown and most cases of prostatitis do not respond to antibiotics (although I do not disagree with giving it a try). In fact, the WBC in your semen might have nothing to do with the symptoms you described in your original message.  Further, I agree with your doctor that this isn't related to the oral sex event you describe, and no STD is known to cause such problems.

Follow up with the provider who prescribed treatment.  Or if uncertain s/he is on top of this problem, follow your original thinking about seeing a urologist.  But don't get your hopes up that a urologist or anybody else is going to be able to clarify this or treat it any more effectively.  Most likely the problem will just resolve on its own over time.  In the meantime, don't worry much about it. Most men with these problems have nothing that will ever seriously harm their health or that of a future sex partner.

HHH, MD

[mtg2u]

Hi Doctor,

Are you still here?  I just need you to answer below questions...  The reason i have white blood cells in my semen analysis is because i have infection...  My doctor told me that it is prostate problem but i really think it came from unprotected oral sex...

1.  I have been on Septra and Motrin(to reduce inflammation) for a week now but don't see any improvement.  Do you really think it is from Prostate infection not an infection from Oral sex?

2.  Do you recommend any diet to help get rid of infection?  What to eat and avoid?

3.  Any other treatment you recommend?

Any feedback will be greatly appreciated...

Thanks in advance,

[mtg2u]

Hi Doctor,

I received Semen analysis test result and found White Blood Cells in my Semen with no growing in last 48hrs.  I believe the count was about 20 - 25.  I was told that normal people have about 5 counts...  

What is the most common reason I have these white blood cells in my semen?  Could it be anything to do with unprotected oral sex that i had?  I still have alot of discomfort in my Uretha(burning, swelling tip when i have erection and this isn't psychological).  

I am getting treated with Septra at this point.  Do you recommend any other treatments?  Is there specific food i should intake and avoid?  

[H. Hunter Handsfield, M.D.]

I am not sure you have an infection at all.  It could be some sort of non-infectious inflammatory condition.  You don't say whether your providers found objective evidence of inflammation, aside from your symptoms--e.g., increased white blood cells in a urethral swab, urine, or prostate secretions.  In any case, the lack of response to antibiotics strongly suggests it's not an infection.  Whatever started this--and it might indeed have been a minor infection from oral bacteria, or inflammation related to irritation from saliva--at this point it is lilkely you are experiencing nothing more than increased awareness of otherwise normal body sensations.  Certainly skin color changes with sexual arousal and masturbation--which simply reflect the amount of blood flow to the tissues--are not abnormal, even if they appear to be new.

This sort of problem has been discussed a lot on this forum, and you're not alone.  In my experience, the best thing is to just sit tight, stop seeking repeated examinations or firm answers, and over time the symptoms probably will fade.  You can be certain you don't have anything that will ever harm you or a future sex partner.  Sometimes just knowing that a symptom isn't harmful is the most important step in resolution.

For these reasons, I doubt another visit to a urologist will be helpful.  But if you decide to do it, ask directly about this opinion; and be very hesitant about invasive diagnostic tests (for example, don't expect cystocsopy to show anything) and about repeated courses of antibiotics, which you undoubtedly do not need.

Best wishes--  HHH, MD