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NGU after unprotected sex

I'm a 38 year old male. 8 weeks ago I had unprotected oral and vaginal sex with a stripper. 3 later I was tested for Chlamydia, Gonorrhea, and UTI (urine sample) & Syphilis (blood), and HIV (rapid test) – all negative.  I plan to go back in a month to retest for Syphilis & HIV.  Is that necessary, given the timing of the test?

I was given a 1g single-dose of Azythromycin since I had irritation after urinating – lasting 30-60 minutes. 2 weeks later the irritation was still there, and took 2G Metronidazol for suspected Trich -- but never tested.  Symptoms have improved, but now 3 weeks after I'm still feeling mild irritation – down to 5-10 minutes after urination.  I’ve never had any discharge or rashes.  Should I test for Trich or feel confident that the meds have worked?

I've been consumed with anxiety. Spent hours online reading about NGU, STIs, etc. -- and am now worried about M. Genitalium & Mycoplasma, which I understand can cause urethritis. From your posts I understand that it my symptoms could be anxiety, but I’m wondering, how likely could that be?  

I’ve also read that a 1G dose of Azythromycin is the recommended treatment for MG (and other bacteria) -- but it can be hard to cure and extended AZ  treatment or Dioxy are sometimes needed.  I have an appointment with my GP next week to talk about what’s next. Should I feel confident that the AZ and Metro would have cured an MG infection or would you recommend further treatment and testing?  

My greatest concern is the toll this has taken on my relationship.  I have not had sex with my wife since this encounter 2 months ago – literally avoiding any physical contact with her out of fear of passing something on.  After testing negative of the STDs and treated, is it safe to resume unprotected sex with my wife?  Can I move on from this?  
Thank you for all you do on this forum, Doctor.  This is truly an invaluable service for the many people who are looking for some help & advice in tough situations.
3 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to the Forum.  Your unfortunate situation is the all too common consequence of when well meaning clinicians are treated for STIs without full testing.  I suspect that right now both you and I wish you had been more fully evaluated.  Neither I nor you know for sure that you have urethritis.  The symptoms you describe, discomfort AFTER urination are not typical for STI related symptoms in any way.  Further, you have received recommended treatment both for NGU and for refractory NGU.  At this time I would suggest that you seek proper evaluation for NGU with a urethral swab specimen collected and stained at least an hour after you have last voided.  If that is positive, then perhaps consideration of possible pathogens such a M. Genitalium would be appropriate but the starting point for evaluation of your continuing concerns .  

Even if this is NGU, following the treatments you have had, there is little reason to worry about resuming unprotected sex with your wife.

Another possibility if there is not evidence of urethritis is that your own guilt and anxiety related to your misstep may be working to amplify normal sensations or sensations related to another problem unrelated to the exposure you have mentioned.

I hope this comment is helpful.  EWH
Helpful - 1
300980 tn?1194929400
MEDICAL PROFESSIONAL
The test for NGU involves taking a swab from the urethra and placing the material on a slide to look for increased numbers of white blood cells.  Many STI/GUM Clinics do these tests on site in just a few minutes.  Unfortunately, not all GPs do this simple and informative test.  EWH
Helpful - 0
Avatar universal
Thank you Dr. Hook.  Your comments have put me somewhat at ease. I will be following up with my GP for further evaluation as you suggest. With a swab test what should my Dr be looking for? Elevated WBC?  Is there a specific test I should ask for?  How long does it typically take for results? Just want to have as much info going in so that I get the appropriate care. Is an NGU test considered another STI screening?
Helpful - 0

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