Need Help Please

[Mystery007]

Good afternoon Dr. Handsfield,

I actually ran into your page by complete accident but when I saw how much good advice you were giving out, I signed up with hope that you could help me.

I'll start out by saying I'm 27 year old hetero male. I don't sleep around and only sleep with girlfriends (no girlfriend since Jan 2010). In October 2012 I received oral sex (only) from this girl I was dating. I would say within 2-3 weeks after that, I started noticing a burning sensation when I was urinating. The urologist prescribed doxy for 2 weeks or so (from what I remember) which didn't help. Then the next symptom I started to experience was a white/clear discharge and sometimes even though it was rare, white and clumpy (probably only a handful of times ever) coming out of the penis. The weirdest thing is that I only ever seem to have this discharge when I'm doing a bowel movement. I then started getting more symptoms over time which include: Redness/irritation at tip of penis, a jabbing pain inside the head of the penis (which ended up going away), left testicle pain, sideways or crooked spraying of urine while peeing and the symptom I find the most weird and no doctor has ever heard of is that my genitals, especially the testicles and head of the penis have an ongoing cold sensation like the feeling of a dog's wet nose. So being completely stumped, I continued to see more urologists and none of them could explain to me what's wrong. I've been on a lot of different antibiotics, none which have worked. I have no idea what to do and I've been going through this for 14 months with still no answers. This is my first comment on this site so hopefully this finds you and you can shed some light on my situation. Please help I'm in desperate need to find a cure to this mystery problem.

P.S. I also had all the STD testing done from which everything came back negative all 3 or 4 times I was tested. The doctors also said that the penis looks normal. Please help.

Thanks,
J

[Edward W Hook, MD]

You and I are going to disagree here.  This is not an STI but may be a coincidence.  Non STI problems of the prostate and male genital tract are common as urological and dermatological problems.  Autoimmune diseases can also appear with genital manifestations and as I have already mentioned anxiety can cause many somatic problems.  You might check the description of the CPPS (chronic pelvic pain syndrome) on Wikipedia as well, this may be what is troubling you- it is NOT an STI.  

I do not recommend any further antibiotics for you. The recommended treatment for NGU is either a single 1.0 gram dose of azithromycin or 7 days of doxycycline, 100 mg twice daily.  As I said, I do not recommend this for you at this time.

With this, it is time for this thread to end.  I wish you the best but will have no further comments and further questions will be deleted without comment.  

Take care.  EWH

[Mystery007]

But I wouldn't be doing the same thing, I'd be combining different antibiotics from which I haven't done before.. The other problem is that I have been to soo many doctors and none of them are willing to help further than 1 or 2 visits.. The redness and irritation is not to noticeable sometimes seeing how it comes and goes and the couple times the doctors saw it, they said it was normal, which I know is not true.. I just don't know what to do anymore.. What were you talking about when you said it could be from other things, the symptoms I'm having.. Like what? Could it be coincidence that I got these symptoms right after I had been with that girl? A buddy of mine has these same problems and it too was right after he was with a girl that's why I believe it's STI/STD related or even NGU. What are the best antibiotics for NGU?

[Edward W Hook, MD]

I don't discount that you are expereincing the symptoms you describe and agree with you that the symptoms you describe are sometimes associated with STIs but that does not assure you that they are due to STI.  Numerous other, non-STI problems can cause such symptoms and, as I said before, the fact that you have apprently been treated on numerous occasions with antibiotics makes it unlikely that more antibiotics are going to address your problem.  It would seem to me the if you have redness and discharge that your doctors can see, then they should have a place to start with in evaluation of your difficulties.  Further, I do not know if you have intereacted with a physician who has worked with you going forward. There are numerous problems in medicine which must be observed going forward in order to sort them out.  My best advice is to find a doctor that you feel comfortable with and who does not discount your concerns and work with them, even if it required you to see him or her repeatedly over time.  The one thing I am confident of however is that to "throw" more antibiotics at this process without knowing what the problem is will not help. It was Einstein who said the "one definition of insantity is to do the same thing over and over again and expect a different result".  EWH

[Mystery007]

The symptoms from which I told you, redness/irritation, white/clear discharge and testicle pain are the main 3 symptoms, (besides the cold genitals) are all symptoms of a STD or STI.. I got all these symptoms only after I received oral from the girl which would obviously lead me to believe I contracted something from her, I don't think there would be another way I could've gotten all this?.. Yes I have seen multiple doctors over the year + and because I always test negative for all the things they normally test for, they say I'm fine and brush me away.. I don't feel fine and that's why I'm still pursuing this issue.. I haven't had any antibiotics in a few months and all of the urologists I've seen pretty much dismiss me because all of my tests are normal. I'm tired of doctors just giving up on me because there is no "seeable evidence" that I have something wrong with me so I would appreciate it if you could help me out in any way you can.. If you could advise me on any antibiotics I could take that I haven't already taken or combination antibiotics that you think would rid this problem so I could at least give it a shot, I've actually never combined any 2 antibiotics at the same time and from what I read, that is better than just taking 1. I didn't mean to sound so upset with you the other night but I just really REALLY need some help and seeing how no one wanted to help me in person, I tried seeking help online. Please.

Thanks,
J

[Edward W Hook, MD]

I do not deny your symptoms but they are not due to an STI.  Your expectations are unrealistic if you think that you can improve on multiple evaluations, courses of treatment and, I presume, tests with a brief on-line consultation, that is simply not the case.   Because we have worked together and have never disagreed on advice to a client, Dr. Handsfield and I do not comment on each other's replies.  As it happens, we were speaking about other issues today and guess what, he would have provided you with the same assessment.  Nothing you describe suggests any recognizable STI

Further, following multiple courses of antibiotics you can be confident that you symptoms do not represent an STI which poses a risk for you or for sexual partners.  At this time, if you are taking antibiotics for these problems, my advice would be to stop for several weeks and then seek evaluation by a knowledgable physician, probably a urologist.  EWH

[Mystery007]

The evidence is my pain and discomfort for the past 400+ days of my life.. Could you please ask Dr. Handsfield what his thoughts are on this situation.. Or at least give me more than what you've already written me? I feel like I just wasted my money for the same old response.

[Edward W Hook, MD]

NGU can manifest itself as burning on urination or discharge- you presented with burning on urination.  Your doctor decided to treat you for the logical and most likely cause.  Since then I will presume that you have not only been treated with multiple antibiotics but tested as well and the tests are negative.  From what you say, there is no evidence that these persisting symptoms are due to an STI.  Sorry for your frustration but there is nothing more to say or do in an online situation. EWH

[Mystery007]

I'm sorry to say but this was in no help to me at all. I also never had any discharge ever prior to all this happening and I am 100% certain on that. I really was hoping Dr. Handsfield would of responded seeing how I paid in the hopes he would write back. This whole problem started after oral sex.. Never had ANY of these symptoms before and it's now over a year that I continue to have them.. It's not in my head and it's a real problem that haunts me 24/7. I've taken doxy which didn't work and a lot of other antibiotics with no relief.. I need some sort of advice that could potentially lead me out of this garbage. Please

[Edward W Hook, MD]

Dr. Handsfield and I take questions without regard to requests for one of us or the other.  Our opinions and recommendations are always the same anyway.  This afternoon you happened to get me.  

I can comment of some of what has happened to you but cannot explain some of your more recent symptoms.   I suspect that the burning on urination you experienced following receipt of oral sex was a problem called non-gonococcal urethritis which is the most common STI to occur following receipt of oral sex.  This problem can be caused by a variety of bacteria and doxycycline (usually given for 7 days) is a recommended therapy.  Following an event such as the one you describe however, folks tend to pay more attention to their genitalia and may start to notice things that occurred but were not noticed before. This almost certainly is the case for the clumpy discharge you mention and may also account for some of your other symptoms.  I suspect that the clumpy discharge you noticed were normal secretions coming from your prostate gland. These secretions can be expressed from the gland and penis during bowel movements (particularly if the stool is firm/hard). This is normal but is often not noticed unless persons are looking for signs of discharge, etc.  

As for your cold sensation at the tip of the penis, intermittent testicular pain, or redness, I cannot offer an explanation but can say with confidence that they do not bring to mind any STI.

I hope these comments are at least in part helpful.  Take care. EWH