Urethra stinging and discharge, but tests negative.

Dear Sir/ Madam,

I am a 29 year old heterosexual male from the U.K.

I had a sexual encounter 2 months ago and I have had the following symptoms from around this time: clear urethral discharge (minimal but still present), stinging at tip of penis and just inside urethra, stinging when passing urine. I received unprotected oral sex, but did not have penetrative sex. There was however, unclothed sexual contact (foreplay) in which the genitals may have come into contact.

I have had two separate examinations in which urine and swab tests were carried out (for chlamydia, gon, urethritis). On both occasions they came back negative. I also had blood tests (for HSV, HIV and syphilis), these also came back negative. I have taken a two week course of doxycycline and a week of metronidazole (not at the same time). My symptoms neither improved, nor subsided with these antibiotics.

I am very anxious about both what is causing this symptoms and if I will be able to get rid of them. Not having a diagnosis is also very frustrating, as I don't know what can be done to move forward. On top of this the symptoms are very uncomfortable.

Do you have an idea as to what could be going on?

Thank you,

Sam

[S. Kaul, MD]

Hey Sam!

Well, without a clinical evaluation it would be difficult to determine the cause of your symptoms. Possibilities that may need to be considered include infections (STD’s or non-STD’s – probably resistant to the given antibiotics), inflammations, erosions, trauma/ injuries etc. I would suggest getting this evaluated by a urologist for an accurate diagnosis and appropriate management.
Hope this is helpful.

Take care!

[samuelp715]

Hi Dr Kaul, thank you so much for your reply.

Since my post I have been back to the GUM clinic and re-tested. I was told to hold my urine overnight, as this was deemed to provide more conclusive results. This time, for the first time, the urethral swab showed signs of inflammation and they therefore diagnosed this a NSU.

I was given 1g of Arithromcycin and told to drink plenty of water. I have not noticed any signs of improvement yet, although I only took the antibiotic on Friday. I am still very concerned about this however, as the Doxycycline didn't help whatsoever, and this antibiotic is given as frequently as Arithromycin to treat NSU.

Is there a good chance that there was just a resistance to the Doxycycline and the Arithomcyin may prove more useful, despite no improvements so far? Or, do you think there could be something else happening?

Kind regards,

Sam