Desperate: persistent symptoms after STD treatment?

[frankmarcel]

Please help: 6 weeks ago I had protected (except hand-penis contact) sex with a CSW
That night I felt some itching and burning that worsened the next day, reddish testicles. Local Dr. prescribed Miconazole cream and a Fluconazole pill. A few days later, I felt pain in my right testicle, frequent urination, tingling penis after peeing. Another Dr. suspected Chlamydia, took 1g of Azythro.
Back at home a week later I had more pain and swollen scrotum. Saw my GP,  quick urinalysis came back clear (leukocytes=0?). She diagnosed epididymitis but gave me Cefixime 400mg and 10 day Levofloxacin.
Before the meds, went to a clinic and did a fast STD test (urethral swab, results in 20 minutes). All negative, Dr. said test sensitivity was 93% for C and 99% for G, suspect non-specific UTI (only after the swab I had burning pain urinating, went away slowly)
Felt slightly little better after 3 days, but by 10th day pain and swelling returned. GP gave me Cipro, stopped 5 days later bc of ankle pain. Switched to Amoxi with Clav. acid for 10d. Slightly better after 3 days, pain came back. Went to the ER one bad morning, urinalysis was clear.
By 10th day I masturbated and ejaculation really burned. Masturbated twice after that and only some discomfort and burning sensation afterwards.
GP says she doesn't know anymore. Never had any discharge so she rules out STD (the 1 time I had smthing was after being aroused, looked like precum).
Still epididymitis in right side, pain radiates to the left and under the scrotum too. I wake up ok swelling most at night
Off antibiotics for a week, will get results of generic (posttreatment test) urine culture in some days. Dr. wants a testicle ultrasound but appointmnt is in 3 months.
I am desperate: I don't think it's cancer, my main concern is: Can it still be infected with some STD? Most important, *can I pass it on*? Can I resume my sex life? And what do I have? Why doesn't it go away?
I am doubting the quality of my GP. Thanks

[Edward W Hook, MD]

Welcome to the Forum.  The symptoms you had immediately after your protected and therefore, no risk encounter of concern were non-specific and unlikely to be an STI. There are NO STIs that cause symptoms in less than 24 hours- none at all.  On the other hand, the trauma of masturbation, any creams or lotions that were applied, or perhaps even your own focus on the possibility of symptoms leading to becoming aware of normal sensations that you would have otherwise overlooked are all possible explanations for the sensations you noted.  Since then you have been repeatedly treated with antibiotics which would be effective for most STIs and have been repeatedly tested without demonstration of any abnormality.  At time time you can be confident that you do not have an STI and that there is nothing you acquire3d from the encounter you described which you can pass on to others.  This may be a problem which many health care providers are not aware of called chronic pelvic pain syndrome or CPPS.  It is well described in Wikipedia.

I would make the following suggestions:
1.  I would not take further antibiotics unless there is PROOF that there is something to treat.  You have been repeatedly treated and clearly this has not helped.
2.  I would give this some time, off of antibiotics to allow things to clear up on their own-perhaps this was all started related to the trauma of masturbation.
3.  You may want a second opinion.

I hope these comments are helpful.  EWH

[Edward W Hook, MD]

Sorry, I do not know any specific manuevers which can help this issue.  Logic is a big part of it and you can feel completely assured that not only was your encounter no risk for STI but that if you somehow had gotten and STI, then it would have been treated (several times over) by the medications you have taken.  

While anxiety cannot CAUSE pain, it can absolutely amplify normal sensations to the level where they seem quite painful. Of course the other posssiblity, which I presume (but am not sure) that your doctor has addressed include other causes of testicular discomfort such as prostatitis or a renal stone.  These are easily ruled out if your doctor is looking for them.  EWH

[frankmarcel]

Thanks Edward, I really sounds logical and most likely, it just is too difficult to overcome the paranoia.
I don't remember anymore what feelings were normal or not. For instance, I was looking at my testicles and realized I actually don't know their previous exact shape so it is difficult for me to know if there are lumps, but it does seem to be a possibility.
Rationally, I agree that I must just give it some time. Are there any (mental) exercises that could help me do this? I mean forget about the pain and symptoms for a few days to see if I improve?
What is difficult for me to understand is the real pain I feel in the testes. Can the pain be self created by the anxiety?
I will try