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STDs (Expert Forum)
Recurring Urethritis Problem/Question
Answered by
University of Washington
Seattle - WA
This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomoniasis, Warts, Yeast Infection.All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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Recurring Urethritis Problem/Question
by needsomehelp, May 18, 2005 12:00AM
A few weeks ago I noticed that when I milked my penis there was some slight discharge from it - but only when milked. It was whitish colored in morning, then cloudy/clear throughout the day. It never burned when I urinated.
I am in a monogomous relationship, so I don't think chlamydia or gonohrrea were the culprits. I took a single 1g dose of zithromax, and so did my girlfriend. The problem cleared up in about 3 days. To lower any transmission of anything we used condoms when we had sex.
It was all clear for about 4 days, then yesterday morning (and this morning) I noticed the same exact type of discharge in the morning- white in color when milked, then a very little (and cloudy/clear) when milked throughout the day. Still there is no pain while urinating and no discomfort in general. Also, it doesn't seem to be discharging through the tip of the urethra on its own, only when milked.
We still haven't had unprotected sex because I'm scared that I'll give something to her. I'm also worried about this recurring problem because discharge from your penis just isn't normal.
A similar thing happened to me about 2 years ago while I was single (just about exactly the same situation w/ morning discharge) and I tested negative for chlamydia and gonohrrea - even the NP said I was probably overreacting. But, that time, I took a 1g dose of zithromax and it all went away for good.
Like I said, I'm very confused about what this could be and I'm worried about transmitting some kind of infection to my girlfriend. Any ideas or help would be greatly appreciated.
I am in a monogomous relationship, so I don't think chlamydia or gonohrrea were the culprits. I took a single 1g dose of zithromax, and so did my girlfriend. The problem cleared up in about 3 days. To lower any transmission of anything we used condoms when we had sex.
It was all clear for about 4 days, then yesterday morning (and this morning) I noticed the same exact type of discharge in the morning- white in color when milked, then a very little (and cloudy/clear) when milked throughout the day. Still there is no pain while urinating and no discomfort in general. Also, it doesn't seem to be discharging through the tip of the urethra on its own, only when milked.
We still haven't had unprotected sex because I'm scared that I'll give something to her. I'm also worried about this recurring problem because discharge from your penis just isn't normal.
A similar thing happened to me about 2 years ago while I was single (just about exactly the same situation w/ morning discharge) and I tested negative for chlamydia and gonohrrea - even the NP said I was probably overreacting. But, that time, I took a 1g dose of zithromax and it all went away for good.
Like I said, I'm very confused about what this could be and I'm worried about transmitting some kind of infection to my girlfriend. Any ideas or help would be greatly appreciated.
Doctor's Answer
by H. Hunter Handsfield, M.D., May 18, 2005 12:00AM
, May 18, 2005 12:00AM
Persistent/recurrent urethritis symptoms are common, and occur more often after nonchlamydial NGU than after chlamydia. They do not apparently ever lead to any dangerous outcome of any kind either in patients or their partners--no infertility, no tubal infections in women, no cancer, no nothing.
The usual approach is to start as you have, to treat both the patient and his partner. If symptoms then persist, longer courses of different antibiotics usually are tried, but only for the patient. I suggest you discuss with your provider; s/he likely will agree you should be treated with a tetracycline (e.g., doxycycline) for a week, maybe as long as 2-3 weeks.
It almost certainly is safe (for both of you) to resume sex with your wife. Sometimes condoms are recommended for the first few weeks, not to protect her from anything, but to increase confidence that if your symptoms persist, it isn't because you re-acquired an infection from her. But the need really isn't known.
The main thing is to not worry very much about all this. As to whether you are "overreacting", if your symptoms are subtle, perhaps the NP is right. Certainly many men with apparent chronic/recurrent urethritis don't actually have it, but have unimportant symptoms magified by anxiety. But I can't judge this as well as you or your provider can.
Good luck-- HHH, MD
The usual approach is to start as you have, to treat both the patient and his partner. If symptoms then persist, longer courses of different antibiotics usually are tried, but only for the patient. I suggest you discuss with your provider; s/he likely will agree you should be treated with a tetracycline (e.g., doxycycline) for a week, maybe as long as 2-3 weeks.
It almost certainly is safe (for both of you) to resume sex with your wife. Sometimes condoms are recommended for the first few weeks, not to protect her from anything, but to increase confidence that if your symptoms persist, it isn't because you re-acquired an infection from her. But the need really isn't known.
The main thing is to not worry very much about all this. As to whether you are "overreacting", if your symptoms are subtle, perhaps the NP is right. Certainly many men with apparent chronic/recurrent urethritis don't actually have it, but have unimportant symptoms magified by anxiety. But I can't judge this as well as you or your provider can.
Good luck-- HHH, MD
Doctor looked at my urine under a microscope and said it was "totally clear" and sent me on my way. I can back the next week, trying not to urinate before I went in. He looked at the "discharge" after milking it and said it was normal glandualr fluid and to not worry about it. I then (over the course of a few weeks) had 3 swabs done for chlamydia which were all negative, and one swab for gonorrhea which was also negative. One place looked at a urethral swab under the microscope and said there was no red blood cells, no nothing. Over this time I was given 2g of zithromax, doxycycline 100mg twice a day for a week, and 2g of metronidazole.
From what I know, that should have taken care of most reasons for urethritis. Yet the pattern persists of semen looking "discharge" upon first milking, then clear the rest of the day.
So I guess I'm trying to trust my negative STD testing. And even if I did have some kind of false negative that all the medication should have knocked it out. Andalso trying to take comfort in and believe that I didn't have anything in the first place. My last exposure was unprotected oral sex in the middle of february. Unprotected vaginal sex in early october.
Keep in touch if you find anything out. Or you too Doc if you have any further wisdom to impart. Best of luck.