Persistent Inflamed & Irritated Meatus

[user0555]

Hello,

Thanks for any help anyone has to offer.

I've been suffering from an inflammed and irritated meatus for just over seven weeks now and I'm really confused as to what's causing it or how to fix it. I'm in a foreign country at the moment so access to healthcare and consequently explaining my problem in a foreign language hasn't been the easiest. For that reason, I'm writing here to see if anyone could lend some advice.

I suppose all of this started in late December when I received a sort of rough unprotected handjob from a sex worker. I believe she was using lube she had previously put in her anus to rub my penis. In other words, she was reaching to her anus to get the lube and then rubbing my penis with it. She rubbed the tip (meatus) with her thumb in a circular pattern, and did so pretty intensely although it didn't bother me too much at the time. A few days later I saw that the tip of my penis looked slightly different. It looked as if there were two pursed lips instead of a straight slit like before. But that was it. I had no other symptoms. I figured it was just a little traumatized after the handjob. But would go away.

Then in the month of January, I had quite a lot of unprotected sex with a girl who has since been tested and came out clean. In February, about two months later from my encounter with the sex worker and a few weeks after I stopped having regular sex in January, some real irritation started. I could best describe the condition as irritation and very slight inflamation of at the tip of the penis. It comes and goes in intensity but at its worst moments, it's very pink and burns slightly when I pee just at the tip of the urethra. The size of the pursed lips also vary depending on how bad the irritation is and also, along with the redness small bumps come and go. The bumps though however are ever so slight and usually disappear within a couple days together with the redness. They don't appear anything like warts or herpes sores. Spotted redness might be a better description. The other thing I noticed is that my urethra appears to be slightly wider and open, revealing the sensitive wet part of my urethra, almost as if my it's trying to breath. I think this might be why it gets irritated from rubbing against my clothing. I've also noticed more discharge than usual from my penis. I'm not sure if it's precum but basically, it's clear, has no scent, and a has the consistency of mucas and I've noticed more than usual when checking my underwear at the end of the day. The last thing that's different is that after I pee, I notice that there's a a little extra drip than usual, even after I clean up with toilet paper, the tip of my penis is moist.

Wearing boxers and walking (or any kind of movement really) aggravates it as I think my underwear ends up rubbing the tip of my penis. So I have switched completely to using tight underwear and stopped doing aerobic exercise. None of my symptoms resemble anything like the pictures of herpes or genital warts I have seen online and both the determatologist and urologist I have seen agree and dismissed the possibility of either. I was tested in February for HIV, syphilis, hepatitis B, gonorrhea, and chlamydia, and all of the tests came out negative. I also had two urine tests and both came out normal.

The dermatologist I saw first in February recommended soaking my penis in a warm mixture of water and sodium bicarbonate twice a day. It didn't help. The urologist I saw in March prescribed a cream that contains Gentamicin, Betamethasone, & Miconazole, which is supposed to clear up any irritation caused by a yeast or fungus infection. I used that twice a day for a couple weeks but the condition did not get any better and he then told me to stop using it. So basically, now I'm just wearing tight underwear, I don't use any lotion and am careful when washing it with dove soap ensuring that no soap gets into or near my urethra. I'm not having regular sex and when I masturbate do so in a gently manner only a couple times a week. However, I've noticed that the couple times I have had sex since this condition started, my penis was extra sensitive and I ejaculated rather quickly.

Part of me thinks that maybe it is an infection due to bacteria from the girls anus. Another part of me thinks maybe it's purely physical trauma. But I do notice that when I'm tired and have had a late night, the condition worsens which leads me to believe it's tied to the strength of my immune system. But really, this could be all in my head..I don't know.

So, if you've taken the time to read all the way to the end, thank you. I'd really appreciate any ideas on what might be causing this or what I could do in terms of treatment or other tests. Are there other STDs or STIs which could be the culprit that I haven't been tested for? Thanks so much in advance, I'm worried this might never go away.

[rbaker765]

{*dear mod, please do not remove - these are all references - none of them lead to any forums*}
gastrointestinal chlamydia bookmarks:
http://www.sciencedirect.com/science/article/pii/S0944501305000455
http://aac.asm.org/content/early/2013/10/01/AAC.01405-13.full.pdf
https://*****************/question/index?qid=20080525183613AALDMaW
http://www.ncbi.nlm.nih.gov/pubmed/24100498
http://motherboard.vice.com/blog/even-if-youve-cured-your-chlamydia-it-might-reemerge-from-your-gut-and-reinfect-you
http://jid.oxfordjournals.org/content/191/6/917.full
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772348/
http://aac.asm.org/content/45/8/2198.full
http://www.ncbi.nlm.nih.gov/pubmed/20155838
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3541825/
http://ard.bmj.com/content/64/3/512.2.full

[rbaker765]

Chlamydia Sufferers:

TRY A RECTAL SWAB FOR CHLAMYDIA INSTEAD (since it persists in the gastrointestinal tract).
In fact, there is ample evidence that become infected orally and that chlamydiae can be isolated from rectal swabs in the absence of anal intercourse. Jones and colleagues showed that may be positive in the rectum but negative in the urethra. Thus, we have proposed that chlamydiae can persist in the gastrointestinal tract and that they can be reinfected.

[rbaker765]

INFECTION OF CHLAMYDIA IN GASTROINTESTINAL TRACT.
(TO THOSE WHO GET FLUID FEELING/BURNING PAIN IN LOWER RIGHT QUADRANT)
Evidence from animal studies suggests that chlamydiae may persist in the gastrointestinal tract (GI) and be a reservoir for reinfection of the genital tract. We hypothesize that there may be a differential susceptibility of organisms in the GI and genital tracts. To determine the effect of azithromycin on persistent chlamydial gut infection, C57BL/6 and BALB/c mice were infected orally and genitally and treated with azithromycin (Az) orally (20, 40, or 80 mg/kg of body weight), and the numbers of chlamydiae were determined from cervix and cecal tissues. The Az concentration in the cecum and cervix was measured by high-performance liquid chromatography with electrochemical detection (HPLC-ECD). Az treatment cleared genital infection in both C57BL/6 and BALB/c mice; however, GI infection was not cleared with the same doses. HPLC data showed the presence of Az at both sites of infection, and significant amounts of Az were measured in treatment groups. However, no significant difference in Az levels between the cecum and the cervix was observed, indicating similar levels of Az reaching both sites of infection. These data indicate that antibiotic levels that are sufficient to cure genital infection are ineffectual against GI infection. The results suggest a reevaluation of antibiotic therapy for chlamydial infection.
http://www.ncbi.nlm.nih.gov/pubmed/24100498

[rbaker765]

Several studies have reported resistance of chlamydial isolates to antibiotics (reviewed in reference 99). Whether these data reflect direct resistance or phenotypic resistance manifested by altered chlamydial forms is unclear. Chlamydiae are capable of developing true genotypic resistance to antibiotics in vitro. For example, C. trachomatis serovar L2 mutants isolated from cell culture after several rounds of exposure to various fluoroquinolones consistently showed a point mutation in gyrA (encoding DNA gyrase subunit A), suggesting that DNA gyrase is the primary target of these antibiotics (29). However, a recent study described C. trachomatis isolates associated with treatment failure that were resistant to multiple drugs with diverse molecular targets (doxycycline, azithromycin, and ofloxacin at concentrations above 4 μg/ml) (115). This indicated the presence of a more global resistance mechanism such as the induction of a persistent phenotype that is refractory to multiple antibiotics, for example, through membrane alterations that affect drug intake. In some cases, the explanation for resistance could be more complex; certain genotypes could confer antibiotic resistance by encouraging development of the persistent phenotype. Such a scenario seems to occur in tetracycline-resistant porcine C. trachomatis strains, which produced large aberrant RB in response to the antibiotic at 2 μg/ml (66). Could the gyrA mutations that developed in cell culture in response to fluoroquinolone exposure (29) also favor the formation of a persistent phenotype, since alterations to DNA gyrase could inhibit RB-to-EB differentiation?
http://iai.asm.org/content/72/4/1843.full

[rbaker765]

REALLY GOOD CLOSEUP PHOTOGRAPHS FOR CHLAMYDIA SUFFERERS:
http://www.std-gov.org/std_picture/chlamydia.htm

[rbaker765]

it does not matter how Chlamydia is tested for routinely.... There are strains of Chlamydia that evade routine detection and live within the host.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3541825/

this study showed a significant reduction of symptomatic urethral infection and abdominal pain amongst nvCT-infected (Bjartling et al., 2009). This difference in symptoms would confer a selective advantage on nvCT, as patients would be less likely to seek diagnosis allowing greater opportunities for transmission. These data taken together...

http://connection.ebscohost.com/c/articles/77789303/first-reported-case-swedish-new-variant-chlamydia-trachomatis-nvct-eastern-europe-russia-evaluation-russian-nucleic-acid-amplification-tests-regarding-their-ability-detect-nvct

First Reported Case of the Swedish New Variant of Chlamydia trachomatis (nvCT) in Eastern Europe (Russia), and Evaluation of Russian Nucleic Acid Amplification Tests Regarding Their Ability to Detect nvCT