Worried

[JamesM00]

Dear Doctors,

I'm a male living in London UK. I'm slightly worried as the opening to my penis (urethra) is slightly swollen. I noticed this because when I pee it doesn't go out straight (occasionally it's also itchy and red, but this doesn't happen unless I haven't had a shower for whatever reason on that day, and even then it isn't always itchy or red).

It's actually been like this for years, I've had a few STD check ups over that time and have only ever been diagnosed with thrush and Non-specific Urethritis (NSU) and then given a tablet or cream to get rid of it. But nothing has ever gotten rid of the swelling. I believe I first noticed this after I was diagnosed for thrush, but it was a long time ago so I'm not completely sure.

I also don't have any burning sensation when I pee, unless I've washed down there a lot due to being worried about it.

So I was wondering what this could be? Are there any tests I should consider having done?

[Edward W Hook, MD]

You may have the problem or recurrent or persistnet NSU.  This problem can be a nuisance for persons who have it but does not seem to represent a health hazard for persons with the problem.  In the UK your GUM clinics tend to be superb.  If you have not been seen at one, you might do so to bring your situation to closure.  EWH

[JamesM00]

Thanks for the help. I have been tested a lot but mainly swab and urine tests / examinations (I believe these cover chlamydia and gonorrhea).

I'm almost always told I have NSU, given a tablet and then a few weeks later called for the full results which always come back negative. Is it possible it could be something that isn't usually tested for?

This started years ago after I had unprotected sex with a woman in Bromsgrove, UK. I was tested then (fullly screened I believe) and diagnosed with thrush (or NSU it was a while ago) but everything else was negative. Now the tests always come back as NSU and negative as above.

I haven't had as many of the blood tests for herpes and syphilis if that makes any difference? (I have been tested multiple times for HIV however).

[Edward W Hook, MD]

Welcome to the Forum. I'll try to help.  From the sound of things, the swelling that you notice has been present for years and you have been checked for abnormalities related to this on several occasions.  My suspicion is that what you are noticing is normal variation rather than a pathological process.  I cannot think of any STIs which might be associated with chronic urethral swelling.  Further, if you have been examined and tested in the past an no abnormalities seen, then there are unlikely to be any.  If there are concerns related to specific exposures or if you just want to be sure, then it is reasonable to get examined once more by a trained clinician and request STD screening (i.e. testing in the absence of specific symptoms) unless you have recently been tested.  Otherwise, I have little specific to offer and suspect that this is not a problem or a health risk to you or to your sexual partners. EWH