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Tested negative, symptoms back

Received unprotected oral sex from female sex worker July 16 Friday. Had sex with my partner July 17. Began experiencing symptoms July 18.
Burning/tingling at the tip of penis, this processed to pain in my left testicle.

Was tested on July 21 (Wednesday) for chlamydia , gonorrhea, syphilis, hiv and was given 7 days of doxycycline.

Symptoms went away after a week of meds and all test results came back negative.

I resumed sex with my partner and 2 days later symptoms have returned but are even worse. A constant tingling at the tip of penis and my left testicle feels as if it were punched. This has been pretty constant for the entire day.

Can you please to figure out what else could be going on here? Did I give something else to my partner that she passed back to me? Could this be a UTI?
1 Responses
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4859015 tn?1360119889
Well, lots of things are possible. Most of them are outside of STI field. Your risk for STI exposure was low but since you're experiencing symptoms, it may be worth another check.
Tingling of your penis tip is more often caused by non-STI causes (anxiety, irritation, dehydration, allergy, etc.)
A constant prolonged pain in your testicle is most probably completely unrelated to STIs. But it should not be ignored. It may be a sign of prostatitis, or some other medical condition, possibly surgical. I would definitely check it up with an urologist.
If you are concerned with STI risk, I would recommend retesting for chlamydia and gonorrhea.  But there is no use testing without your partner (you seem to have already learned that).
Take care and keep us informed on your progress.
Helpful - 0
18 Comments
Did I test too soon for chlamydia and gonorrhea(5 days)? Could I have gotten a false negative from this?

There is something called NGU that you could have - it's a non-specific infection in your urethra, and can be caused by normal mouth bacteria, strep, different viruses, etc.

When you tested, did you get tested for white blood cells in your urine? If you have those, you have NGU. Your partner would need to treat for that, too.

You didn't test too soon, but did you wait at least an hour from your last urine? Give them the first part of your urine stream? Those are the things that cause false negatives.
Could a NGU cause the pain I am experiencing in my left testicle?

I was only told that I was tested for chlamydia, gonorrhea, syphilis and HIV. I do not know about being tested for white blood cells - would that tell specifically what would be causing an NGU?

When I tested I waited a few hours from my last urine. And yes I peed directly into the cup and only stopped once it was full.
It might cause that pain, but a lot of other things - many not related to sex - could cause that, and all of them warrant an exam by your doctor.

You could have a prostate infection - that could explain the pain at the tip of your penis, too - or epididymitis. They might or might not be related.

If they sent your urine for testing, they might find the bacteria responsible. Since you took the doxy, it might be hard to find that now, but definitely follow up with your doctor about this.

It might not be an STD, but something like prostatitis where ejaculation is triggering pain. Are you able to masturbate to ejaculation without pain?
There are too many things possible in your case. What really bothers me is the pain in your testicle. While it may be STI-related, it is more often not.
I would stress my advice to see a doctor and rule out epididymitis (inflammation inside your testicle) or any other serious conditions. Once those are out, you may take your time in searching the cause of your symptoms.
White blood cells in urine is suggestive of UTI but it doesn't tell you the cause of the inflammation.
Anyway, seeing a doctor is a good idea.
So today I went to my Dr. they ran a urinalysis for UTI AND Bladder infection. Everything came back negative (Results Below). Would this test have picked up a NGU as well or anything else I could have contracted from unprotected oral sex?

Specific Gravity Urine
1.029

PH
6.5

Leukocyte Esterase
Negative

Nitrate
Negative

Protein
TR

Glucose
Negative

Ketones
Negative

Urobilinogen
Negative

Bilirubin
Negative

RBC
Negative

Still experiencing a lot of pain in my testicle, they prescribed doxycycline for 10 days and told me to follow up after.

I’m very worried after the gonorrhea/chlamydia test came back negative and now the urinalysis. What else could be going on here? What am I missing?



Okay, let's start with the basics.
NGU ends in U which stands for urethritis which is inflammation of urethra. Normally, inflamed cells of urethra lining produce proteins and those are detectable in urine. If the inflammation is severe, urethra lining may be damaged and some blood may be present in urine (RBC).
In your test proteins and RBC were negative which rules out any sort of urethritis.

Your testicle, however, has nothing to do with your urethra. You may have inflammation inside testicles or in your prostate which is completely unrelated to any STIs (most of the time they are not).

Did your doctor rule out surgical problems with your testicle? That is more important.
Stop looking for STI and keep looking for the cause of your testicle problem. If your testicle pain doesn't get any better on doxy in three days, you should return to your doctor and make him find the cause (at least rule out it is not a fluid build-up, or a looped tube, or a blood clot or any of those rare things they like to show in medical dramas; most likely it isn't)
Hey dude! Ill chime in here as well :)

As said above, it is safe to say that STIs are not a problem here at all. Anxiety can manifest the symptoms of STIs so try to relax. NGU can be caused from non-sexual means but the test do not indicate this to be honest.

The pain in the left testicle could potentially be something called Epididymitis. This is not often caused by STIs but not always. I have had it (on my left testicle) and it was NOT related to STIs. Get a doctor to have a feel and treat accordingly. At the same time try to relax. Do not let the stress and anxiety manifest any further. As aunt jessie says... Guilt does not equal risk.
Did you tell your doctor about your testicle pain? Did they examine your testicle?

Your urine test has ruled out any infection in your urethra. Make sure they have examined your testicle.
Yes he examined my testicle by hand and said he couldn’t feel anything and put me on the doxycycline and said to see what happens after that.

The pain is still persistent , should I get an opinion from another doctor?
Well, epididymitis is often treated with doxy, so that may be why he gave you that. See how you feel after that. If it's not better, get a referral to a urologist. The pain from epididymitis can linger for a long time, but you should feel some improvement.  
If I have epididymitis , wouldn’t that have been from an infection? That would should have shown up in the urinalysis?
It is often from an infection, but it can be something causing urine to flow into the epididymis. It can also be from injury or trauma.

https://www.mayoclinic.org/diseases-conditions/epididymitis/symptoms-causes/syc-20363853

You could also have something going on with your prostate - has that been examined?

Do the doxy for 10 days, and see how you are. I know you are anxious about infection because of the oral sex, but you've tested negative for everything STD it could be. It's either unrelated now, or symptoms caused by anxiety.
Also, make sure you are drinking enough water, and laying off caffeine and alcohol. This is important.
Hey guys, I’m on day 7 of the doxycycline, symptoms seem to have gotten better overtime but came back today after sex with my partner last night…What am I missing here?

Is Mycoplasma Genitalium a concern from unprotected oral? Would that have shown up in the urinalysis?
MG causes urethritis and your tests ruled out urethritis. Doxycycline would have treated it; so, if you ever had MG, it would not cause your symptoms while you are on doxy.
You really shouldn't try to self-diagnose, it is something that doctors should do. It  could be a bunch of other bacteria or it could be no bacteria at all. There is little point in taking guesses.
How do I figure out what other bacteria it could be if the urinalysis is ruling out urethritis? What else should the dr be looking/testing for?
We told you many times: there may be epididymitis or prostatitis or other testicle conditions (varicocele or twisted testicle) or inguinal hernia or what not.
You don't have STIs from the described exposure, it is high time stop looking for one. Go see a doctor and sort out your testicle problem. Do not try to self-diagnose.

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