General Question

[mladams]

Basically I started being somewhat concerned when I started having a bit of abnormal discharge from my urethra.  It's clear and sticky and very little of it and there is no pain when I urinate.  There is a little discomfort in my urethra from time to time but nothing terrible.  I'm going to get tested on wednesday but I'm just a bit concerned.
The other thing I wanted to know is about my chances of having genital herpes.  I've never had sores or anything abnormal like what is associated with herpes.  I have had unprotected oral sex but not with anyone with open sores. Any other sex has always been protected.  I've actually only penetrated two people and both were protected and STD free.  The last year I was in a monogomous relationship with someone who is STD free.  I've read that you can have herpes without signs and wanted to know what the chances are that I could have contracted it.

[Edward W Hook, MD]

As said 3 days ago "If you have NGU and your doctor gave you the proper medication (there are several) then you can be treated with little chance of recurrence, as long as you are not re-exposed to an infected partner."

You inidcate that you plan to see a urologist.  If your discharge does not resolve with the doxycycline, that is a good idea.  

We are now in the realm where you are beginning to repeat yourself.  It is time for this thread to end.  There will be no more answers.  Take care.  EWH

[mladams]

So is NGU a permanent thing or will it go away now that I'm treating it?

[Edward W Hook, MD]

It does not make a difference.  EWH

[mladams]

I also wanted to mention that I'm taking it every 12 hours for 10 days. In case that makes a difference.

[mladams]

I guess what I'm most concerned about would be this, is NGU permanent or can is it something that's cured with the right medication?  I really don't want to have to deal with this forever, it's just irritating. The medication he gave me was Doxycycline HYCL and I started taking it today.  Like I said I'm just concerned about it being permanent cause I'd really like to just treat it and move on if possible.  I think I will seek out a good urologist around me cause I'm not real comfortable with what my doctor has told me, other then the testing he had done for STDs.

[Edward W Hook, MD]

If you have NGU and your doctor gave you the proper medication (there are several) then you can be treated with little chance of recurrence, as long as you are not re-exposed to an infected partner.  While you do not know that you have NGU, since this is both common and a concern, you need to find a doctor who feels comfortable diagnosing and managing NGU and other genitourinary infections.  Such a doctor will also be presumably be comfortable with diagnosing other reasons for your discharge as well.  There are many doctors who can do this.  This includes urologists as well as STD specialist and many other types.

Please let me know which medication your doctor prescribed and whether of not you are taking it.  EWH

[mladams]

So I just got my results back today and I'm clear for everything! I even had him run the Herpes tests.  He did not look for possible NGU however.  When I asked him he said he didn't know that he could run any other tests.  He sent a prescription for an antibiotic but my concern is that it's bacteria that will recur and not go away.  I don't want to just stop irritation I want it to clear up and go away.  Should I go to a urologist or have a second opinion? If I give you the name of the medication can you tell me if it will clear up a NGU issue? I have to get the name from the pharmacist though.

[Edward W Hook, MD]

Your doctor may have had your urine specimen looked at for white blood cells and if so, he can tell if you have NGU from that.  I would ask him.  EWH

[mladams]

I went to the doctor today and he set me up to get urine tests for gonoreah and clamydia and blood tests for syphillus and HSV.  My guess is that they will come back clean. When I get the result should I request an NGU test?  Do any of the urine tests he sent me for detect anything other then the corresponding STD?  I was intent on asking for an NGU test specifically but I had so many questions that it was the only thing I forgot to ask specifically.  The symptoms I had mentioned before (discharge and discomfort) have subsided for the most part but I'm sure that does not mean the issue is gone.  If the symptoms are gone will the doctor still be able to find what they need from an NGU?
Your help is greatly appreciated.
Thanks,
Matt

[Edward W Hook, MD]

Welcome to the Forum.  If you have received unprotected oral sex and now notice an abnormal discharge and slight discomfort from your urethra, I would suggest that you go on and get checked for non-gonococcal urethritis (NGU).  NGU, as the name suggests can be caused by a number of different things including the introduction of mouth bacteria into the urethra during oral sex.  It may present with the symptoms you describe and is diagnosed by showing increased numbers of white blood cells in a swab specimen taken from the urethra or by microscopic evaluation of a urine specimen collected at the beginning of urination, not once the stream has started.  Both tests are most reliable if you have not urinated for at least an hour before the specimens are taken.  If this is NGU, it is easily treated.  Alternately, what you may have notices may be normal genitourinary secretions which do occur from time-to-time.  

Regarding herpes, given your commitment to condom protected sex and modest number of partners to date, it sounds as though your risk is low. However, the infection is common with HSV-1 being present in over 60% of adults and HSV-2 (the virus which causes most genital herpes) being present in about 1 in 5 Americans.  For both infections, the majority of people who have the infections are not aware that they are infected, either because they either acquired it without knowing in the past or, most often, because they misidentified their herpes as something else.  In your case, I susect you do not have HSV however, if you wish to be sure, an IgG, type-specific test such as the HerpeSelect will usually provide reliable results.

Hope these comments are helpful to you.  Please let us know what your check-up shows.  EWH