Epidydimitis/prostatitis - what do I have?

[darkaurum]

Ok, 6 weeks ago had a risky encounter.  Blowjob, covered, but touched penis with hand that took condom off.  

Week 1 - urethritis symptoms, frequency, urethral awareness.  should be noted was extremely anxious.  tested 6 days out (culture and PCR) for chlamydia and gonnorhea, negative

Week 2 - urethritis symptoms gone.  Tested again at 14 days out, negative.  clear discharge from penis while defacating, though not plentiful.

Week 3 - a case of balanitis - went away with more careful washing drying of penis after urination.  Urination 'dribbly'.  Discharge while defacating also present

Week 4 - chlamydia swab test + urine test, again -ve.

Week 5 - pain in right side of scrotum.  Doctor examines me, says I have epididimitis, gives me 10 days of doxycycline 100mg, 2 times per day

Week 6 - bad pain in prostate, pressure in perineum 5-6 days into Doxycycline treatment.  After I stopped masturbating, pain in testicle and prostate seemed to be falling off.  Went to see doctor, she prescribed ofloxacin because I had a tender swollen prostate, after I finished my doxycycline.  I'm about to finish my doxy, but because I've resumed masturbating, there is discomfort in my scrotum again.  



My questions are as follows:

1. If i've still got discomfort in my scrotum.  Does that mean that the doxycycline didn't work?  Could I have made the infection stick around longer by masturbating?  I took all my pills faithfully.  Should I hold off on masturbating?

2. I've heard that ofloxacin is effective against chlamydia and gonnorhea, as well as other organisms.  Can I rely on this drug to clear me up in two weeks?  My doctor told me to come back in two weeks, and she could give me more if I'm still not feeling 100%. Would you recommend a longer antibitic (antibiotic) course even if I feel better?

3. I've had sore eyes (but no redness inside, itching, or pink-eye) for the past two weeks.  It should be noted that when they started, I was on Ativan, and I've been off it for a week now, and they've gotten a bit better, but there's bags under my eyes and they're still not 100%.  Should I be concerned about having autoinnoculated myself with an STI?  Would the oral doxycycline have cured that?

4. I had sex with my girlfriend once the day after this happened, with very careful condom use.  After that, we didn't have sex anymore.  She got tested (cervical swab, I think) four weeks later.  Would such a test be conclusive, or would you recommend she go on antibiotics as a precaution, or further testing?  The reason I ask is that I've tested negative multiple times, and here I am...

5. Can my muscle aches, fatigue, occasional nausea and chills be explained by prostatitis?  In all 6 weeks, I still haven't had a proper fever.  I've been told by two HIV specialists that my risk is very low, so I'm not worried about that.

6. And FINALLY:

If I feel better, when should I consider it safe to have sex again?  How long should I wait for a test of cure for bacterial STD's?



Thanks,

darkaurum

[Kevin Pho, MD]

To answer your questions:

1) It is possible that the continued discomfort means that the antibiotic has not completely eradicated the infection.



2) Ofloxacin is more effective versus gonorrhea.  Doxycycline, or azithromycin, is effective against chlamydia.  A longer course is suggested if the symptoms persist.  



3) Tough to say without examination.  If there is a combination of urethritis and uveitis (i.e. with the eye symptoms), then you may want to consider Reiter's syndrome with a referral to a rheumatologist.



4) If the chlamydia test was negative, it would be unlikely that antibiotics would help.



5) It is possible that your symptoms can be explained by prostatitis.



6) You can get retested for STDs to ensure it remains negative.  Condoms will always be recommended in the future to prevent transmission.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

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