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[wbrazil]

Dear Doc,

Sorry for my poor english. I'm from brazil.

I'm 34 male.
1 month ago, went to a swing house, where I picked a woman. We didn't have sex, but i masturbate her and she gave me oral, besides, my penis rubed into her vagina. She hads lots of fluids, more then a woman usually has when she is arroused.

2 Days later, my urine started to burn and a little white discharge was found in my underwear. Went to the doc, he gave me Azithromicyn 1g, single dose.

Took it and after 3 or 4 days, no more burning, but, every morning a slight clear discharge on my underwear (i wear black underwear so it's easy to notice).

4 days later, went to another doctor who told me I was fine but gave me Cypro 1g x 7 days and asked me a culture + urine test. After 7 days, still the same symptom so i decided to do the exame.

Everything went fine (the only different thing was amorphous crystals on urine, but no infection and no bacteria). Went to another doctor who gave me doxocyclin 100mg 2x day x 7 days just in case.

Finished those 7 days and went for routine exames.
CBC count -> no alterations
PSA -> 0,98 ng/ml
C reactive protein -> 0.6 mg/L
Prostate mass -> 28g

Yesterday i took a single dose of fluconazole, just in case.

For 1 month i have the same symptom: Every day, after waking up and going to urinate, after 1 minute, i feel a little pressure on the urethra and, when I check my underwear, i can see a little clear discharge. Once i took it with my finger, it surely looks like pre-ejucalation fluid, sticky, no odor.

The only time i see those on my underwear before was after ejaculation or if i was aroused and had no sex. Semen color looks pretty normal, white with a little yellowish.

I thought of prostatitis reading the web, but since my PSA was normal and no alteration on CBC, i'm a little lost.

Could this be just normal fluid and since I'm stressed i'm noticing it too much? Would you worry?

Thanks so much

[Bhupinder Kaur, MD]

Hello,

Thanks for posting your query.

I can understand your concern for the colorless and odorless discharge on account of unprotected oral sex. The normal PSA levels for males less than 50 years of age is 2.5 and hence your PSA levels are absolutely normal.  This rules out any prostatic infection.

Colorless and odorless discharge from penis is usually caused by normal prostatic discharge which can be unprovoked or due to urethritis and prostate infection. Urethritis is caused by an infection with bacteria often the culprits being Nesseria gonorrhea or Chlamydia. Mostly it causes burning with urination, though some people do not have this and only have the white discharge.

Although you had got a CBC done but to rule out Chlamydia and gonorrhea, you need to get investigated. Nucleic acid amplification tests (NAAT), such as polymerase chain reaction (PCR), transcription mediated amplification (TMA), and the DNA strand displacement amplification (SDA) now are the mainstay of diagnosis for Chlamydia and Gonorrhea. You can get done PCR test which is quite specific for both.

Having said this; to be on the positive side, you have taken three rounds of antibiotics which should have cleared up any Chlamydia and gonorrhea. Hence you need to get PCR test only to rule out any recurrent infection or chronic and stubborn infection.

If the PCR test comes out normal then there is nothing much to worry.

Hope that this information helps and hope that you will get better soon.

Wishing your good health.

[wbrazil]

Dear Doctor,

Many thanks for you answer. I scheduled a swab test for tomorrow to see if any Chlamydia is found with PCR.

If it comes negative, should i just relax? Do you think I should get tested for Trich algo?

Many thanks!