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Urethritis and clear discharge
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Urethritis and clear discharge

Thanks for the great service! About a year and a half ago a stripper performed unprotected oral sex on me. I normally wouldn't worry but she was a stripper. I got really worried so I went to see my GP about 1 week after. I wasn't having symptoms so he treated me with Azithromycin 1g and 1 pill of levoquin. He told me that would take care of everything. I still worried and I started noticing that the tip of my penis looked a bit red and I was getting a sting sensation on the tip of my penis a few times throughout the day, no burning during urination. I then decided to see a dermatologist. He looked at my penis and diagnosed me with Non-specific urethritis. He then gave me 2 weeks worth of Levaquin 500 mg 1 a day. I went back and he told me I still had it. He then prescribed me Biaxin which I did not take. He told me there was no test to diagnose NSU and that my partner was at risk for PID. Is that true? I then decided to see a urologist who right away told me that I did not have NSU. He did a urine test at his office and he told me that It was fine. He still gave me doxycycline for 10 days because he knew I was worried. He also said that all I needed to worry about was Chlamydia and Gonnarhea(SP?) I went back to see another Urologist for a 2nd opinion and he tested my urine for Chlamydia and Gonnarhea, both were negative and he took a swab from my penis the results for that were (No Beta-Hemolytic Streptococcus Group B or Gram Negative Diplococci isolated at 48 hrs) What does that mean? So he told me I was fine. I am still quite concerned because I have also noticed a clear discharge from my penis, especially in the morning 2-3 hrs after I have urinated for the first time in the morning. This discharge is crystal clear and is pretty slimy like pre-***. Sometimes it appears to be thinner and it doesn't happen every day. Could this be a normal secretion from the urethra. BTW, I am not circumsized. I have also had my urine analyzed microscopically. I held my urine overnight and it showed no WBC's it did show few bacteria and few mucous threads. Are these normal in urine? The urine was sent to a lab so there was a delay for the testing. If I did have an infection in my urethra besides Gon. or Chlam. what other tests can be done? Would a reg. urinalysis show an infection. It is hard for me to find a clinic that does microscopy on sight. In your experience what other types of bacteria can affect the urethra from the mouth? I have done some research and I have read that NSU can be diagnosed by finding PMNL's or WBC's in a first void urine specimen or by a swab of the discharge. Is this accurate info? Could I have an infection that does not show up in the urine? What should I do next and should I worry about the clear discharge? I also find that I am checking for discharge quite often and I pull back my foreskin a little bit. Sometimes I also milk my penis to check for discharge. Is this bad to do? Thanks in advance for your response!
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You have clearly been treated with many antibiotics, but still have the symptoms.  It is possible for an infection to be present and not show up in the urine.  There are many other types of bacteria other than gonorrhea or chlamydia that can cause your symptoms.

I would first investigate the prostate.  Sometimes prostate infections can be very difficult to treat and may require extended course of antibotics - sometimes as long as 4-12 weeks.  I would suggest a referral to a urologist for a thorough digital rectal exam.  A transrectal ultrasound can also be obtained to investigate for any abscesses (which won't be treated with antibiotics).  

The results from the urethral swab suggests there are no bacteria growing (i.e. this is a negative urethral swab).  

It is possible for your partner to obtain a PID from NSU - just because everything is thus far negative does not completely exclude infection.

Regarding the urine sample, it is not uncommon to a few bacteria in it.  The WBCs are key, and if negative, it makes a UTI less likely.  

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.
Medical Weblog:
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