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Persistent NGU/Chlamydia?

I need help.  I'm 28 and began having prostatitis issues when I was about 18.  The prostatitis occurred on and off over the years and I recall being pretty good for a few years around 24-27.  Last year I received oral sex and about a week later had a slight discharge and burning.  

Doctor did not test anything but prescribed usual meds for Chlamydia and Gonorrhea (Suprax and 10 days of doxycyclene).  Before this, had taken multiple rounds of various antibiotics over the years, but the only one I'd taken in the previous months was doxycyclene (as anti-malarial while traveling abroad, for one two months). Symptoms occurred a couple of months after ceasing the doxy.

Came back after treatment and was tested... came back positive for Chlamydia.  Took more doxy, restested a couple of weeks later, and it said negative.  

Since then, have had recurring and seemingly very stubborn prostatitis for about ten months now, but different than the usual dull ache; it is more of a burning feeling, both in the prostate (and perineum) and in the urethra.  Feels like a very mild burning from the tip of the penis up to about 1-2 inches in.  It comes and goes.  

Went to a doctor about eight months ago and he did a culture to prostatic fluid.  Treated for 1-2 months with Bactrim.  Symptoms got better, but then came back.  

Finally, a month and a half ago, went to a different urologist; explained my story.  He assumed I had persistent chlamydia in the prostate, but no test.  Prescribed doxycyclene 3 times daily for a month, and after a month, said to stay on 1 doxycyclene per day for a month.  After a month, symptoms were better, but after 2 weeks of 1/day, symptoms are returning, urethra is quite red and inflamed, testicles sore, etc.  

No sex to date since the initial symptoms started.

Nobody seems to have a clue how to help me and I am now getting well into a serious relationship with the girl I am probably going to marry.  Any help you can provide would be much appreciated.
3 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
1.   While trich could be causing your urethral inflammation, it does not explain your other symptoms such as testicular ache.  

2.  Finding a doctor who you can connect with is sometimes difficult and, unfortunately, involves a certain amount of trial and error.  Your question was articulately presented here. I would hope that you could find a urologist who will listen and then outline a logical plan to address your difficulties.  Don't expect them to have all the answers, or to be able to answer the "what ifs", rather you are looking for someone who will commit to working with you to get this taken care of and to explain to you why he (or she) is doing what they are doing.

Hope this helps.  EWH
Helpful - 0
Avatar universal
Thanks for your reply.

Just a few questions, if you wouldn't mind:

Do you think trich could be a possibility here?  Or some other type of problem that isn't cured with these drugs (but perhaps improved due to their anti-inflammatory properties)?

How does one really find a good urologist who can do more than prescribe doxycyclene?  Should I be insisting on chlamydia and other types of tests/cultures/etc?  Are there certain times one must wait for tests to be accurate?  I'm just wondering why these have never been done on me... Seems like my prescriptions have been based on guesses.

Is it possible that this is something that will be a problem for the rest of my life?  Is it possible that whatever is causing this is contagious (to a female via oral/vaginal sex)?

Thanks again.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to the STD Forum. Your problem is a difficult one, not because chlamydial infections are particularly hard to treat, they are not and I am confident that your chlamydial infection has been treated but because the activity seems to have stirred up your chronic prostatitis.  As you know through experience, chronic prostatitis is literally and figuratively a real pain.  It is rarely caused by STD agents and has a tendency to require repeated, prolonged treatment.  That you had improvement on both the Bactrim and the doxycycline is a good sign (incidentally, both of these medicines are active against chlamydia).  

My advice is that this is a problem that you need to work through with a good urologist who you have confidence in.  My guess is that, given your history, he/she may recommend prolonged therapy for up to 6 weeks.  As to which antibiotic, that you improved with both the doxy and the Bactrim suggests that these might work.  the alternative class of drugs which are active for treatment of chronic prostatitis are the quinolone antibiotics.  Of these, I would recommend that you not use ciprofloxacin ( a favorite for prostatitis therapy) but instead use a related drug such as levofloxacin which has better activity against chlamydia, just in case this is related to your recent chlamydial infection (I doubt that it is but if we can cover both bases, why not).  Furthermore, given your history, it is possible that you may need to be treated more than once to resolve this problem.

Further, as I suspect this is no longer an STD problem but something that has come up coincidentally, you might also wish to ask this same question at the MedHelp Prostatitis Expert Forum.  I have little personal experience with the site but it would be worth trying.  

I hope these comments are helpful to you.  Please let me know what the urologist says.  EWH
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