Hematuria due to NGU, some other STI, or Anxiety?

[PaulTJ]

I am male in my late twenties with a longterm partner. I had never been unfaithful to my partner, who has been tested and is clear of all STDs. On a recent trip without her, while extremely intoxicated, I received oral sex (both on my penis and anus) for a short period of time from a transsexual prostitute. Following the encounter, I returned home and had sex with my partner (both vaginally and orally) twice within a few days. Afterwards, I was overcome with extreme anxiety about the possibility that I could have contracted an STI and, even worse, passed it to her.

About 7 days after the potential exposure, I started to feel a burning sensation in the tip of my penis with an increased frequency of urination. At first, I had assumed this was due to genitally focused anxiety, as I have read is possible. The symptoms worsened, and two days later I was tested at an STD clinic for chlamydia and gonorrhea. Both came back negative. A day later (now 10 days from exposure) I went to see my doctor about the symptoms. They took a urine sample which tested negative for the normal UTI bacteria as well as chlamydia and gonorrhea (again). However, the test did show an elevated level of RBC in my urine (4-10 /HPF). He prescribed a 7 day amount of Bactrim, saying there is still a possibility of UTI, though rare in males of my age.

I have not had any lesions that would suggest genital or anal herpes, though I find it difficult to check for the latter on my own. I keep seeing things that freak me out, but I'm well aware that I'm probably just looking for something that isn't there.

Based on everything I have read, including this site where I've found some similar cases, I'd like to believe that these symptoms are a result of my overwhelming anxiety and guilt. I admit that I have been experiencing a great deal of it, to the point that I've had trouble sleeping much...On the other hand, the RBC content of my urine seems to suggest that there is a real issue that is causing these symptoms (whether related to the encounter or not).

Is it possible that I have some kind of NGU that was not detected in the urine test, which is causing the elevated RBC count? Or is it likely that I contracted HSV 2 and have yet to get sores? From what I understand, in both cases it should be WBC count that is up (mine was normal), not RBC.

Thank you in advance for your time and advice.

[Life360_Dave]

I cant advise the bactirm but maybe ask you doctor why he thinks a high RBC indicates an infection as its only measuing air!

[Life360_Dave]

RBC has nothing to do with any std. Its only showing the  amount of oxegin in your blood and the normal range is like 4.5 to 5.5 so im not sure your test at 4-10 means as 4 is ok.
High levels are associated with smoking or a lung infection not any std. So please take RBC out of the equation.

[PaulTJ]

Thank you. This makes sense to me. Though my results showed 0-4 as normal range for RBC and 4-10 as high. I'm not sure why my doctor saw RBC as a sign of infection, in either case, based on what you're saying. If RBC is out of the equation, it would seem unnecessary for him to prescribe Bactrim.

[Life360_Dave]

Hi, oral sex is fairly low risk for acquiring std,s and your penis irritation symptoms are not consistend with an active infection. When a person contracts std,s like gono there would also be a white puss discharge. The discharge inticates infection. The oral anal is really not something to worry about
The oral penis sex is a risk for gono, syphilis and herpes and i would suggest to test for these for your partners protection. Anxiety often heightens the feeling that there is an infection.

[PaulTJ]

Thank you for your answer. I understand that my symptoms are not entirely consistent with an active infection. However, the RBC count is of concern, because it suggests that something is off - right?

I have already tested negative for gono and chlamydia, as mentioned. I am awaiting results from the herpes blood test, but from what I understand, that will not be conclusive. I was less than two weeks out from the potential exposure when blood was take, so I realize I'll need to be tested again. I'm also aware that I may test positive for HSV1, as I vaguely remember having one or two cold sores as a teenager (none since). A positive test for HSV2 would be the only conclusive result as far as I can tell. From what I've read, it seems unlikely (though possible) that I would contract HSV2 from receiving oral sex. I am now more than two weeks out from the potential exposure and have not developed any sores or had any other symptoms consistent with HSV2, only a burning sensation in my urethra and frequency of urination.

My big concern at this point is whether the RBC in my ursine is indicative of some bigger.

I also would like to resume sex with my partner. Given my circumstances, does it seem excessive to wait long enough and retest for HSV2 and/or syphilis before resuming? Though I want to be safe for my partner, it seems that could potentially take another month and even then would not be entirely conclusive.

[PaulTJ]

...I should add that I am now on my third day of taking Bactrim. The symptoms (burning urethra and frequent urination) have not subsided. They are slightly better today than the previous two days, but are still very apparent and very uncomfortable.