uritis

[jkdenver]

hi,
I am 41 and have had the same sexual partner for 3 years now whom I believe is monogamous as am I.
I have returned to work 7 days ago and have just started to have an itching and swollen gland, with a thin white/yellow discharge.
I have no frequency issues and very slight burning on urination.

My wife did have a UTI while I was at home which she treated with antibiotics and we did have unprotected sex before we found she had the UTI.

Can you please advise on the best way to treat, I do not have access to a doctor for the next 3 months as I work in a remote area with no medial cover.

I believe this is not a STI. What other infections can cause this and is there a broad spectrum antiB I could use to clear
the problem.

Thanks all help is apreciated.

[Stephen Liroff, MD]

Hi! I have obviously been out of touch with the web site for the last 2 ½ weeks. Sorry if I increased your anxiety. Do not blame Med Help.
Given your situation, I would take metronidazole 500 mg. by mouth three times per day for ten days as well as the Cipro 500 mg. by mouth twice a day for ten days. Tetracycline 500 mg. four times per day  for 10 days would be my choice over the Cipro.
Your wife’s urinary tract infection is unrelated to your present problem.
S.A.Liroff, M.D.

[jkdenver]

The discharge i from the urethra, not under your foreskin. I and the burning is only on urination and is located at the tip and extends about 5mm down the urethra.

I would also add that there is constant itching, although I don't have any urgency to urinate.

I have had my fasting sugar tested recently and it is within normal limits and as far as I am aware I have no allergies other than penicillin.

My wife went to the doctor who informed her that she had a uti for which she had a course of antibiotics. I would however point out that my wife presented with a slight blood stain to her urine and soreness on urination, she did not however have any discharge.

Due to my location it is hard to get medication I can however get both ciprofloxacillin and metronidazole would either of these be of benefit.

kind regards

Andy

[Stephen Liroff, MD]

I am assuming that by “gland” you  mean “glans” (the head of the penis). The discharge is from your urethra or from under your foreskin? The burning is at the tip of your penis only (at the opening to the urethra).
If this is a discharge from beneath your foreskin and your glans in swollen, then I would first consider two things: allergic reaction or skin infection with a fungus. You could be allergic to a drug which she is taking, any lubricant, douche, chemical that one of you might gave used. If it is a fungus (candida, most commonly) then you need to  (1) retract your foreskin and wash beneath it twice per day and let the area dry out well before  bring the skin down again. Apply a topical antifungal cream such as Lotrisone  twice a day for two weeks. This works for an allergic reaction also.If there is a way to get checked for diabetes where you are located now, get that done (fasting blood sugar).
Most  CDC drug regimens (http://www.cdc.gov/std/treatment/2006/updated-regimens.htm ) recommended today involve an initial  injection of a cephalosporin (ceftrioxone). Here is one that  is all oral:
Cefixime  400 mg orally twice daily
   OR
Cefixime 400 mg by suspension (200 mg/5ml) twice daily
   OR
Cefpodoxime 400 mg orally twice daily

Take these for 10 days.
Add doxycycline  100 mg. twice a day for 10 days also.
Your partner should be checked also.
S.A.Liroff, M.D.