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Persistent NGU

About 6 months ago I had a brief kissing and "oral" encounter with a stripper in Mexico. By 'oral', she mostly performed hand stimulation on my penis using her saliva as lubricant. No insertive oral sex occured but she did touch her tongue to the opening of the urethra for a few seconds. I did not notice any lesions or blisters on her face, but the place was dark. The next day I felt a tingling at the opening of the urethra and the 2nd day I had hard pain with clear muscus-like discharge. No visible signs of blisters or any other skin conditions. The hotel doctor ran a dipstick through my urine and said I had a bad infection and gave me cipro. I have not experienced any discharge since then but the pain has been close to non-stop. 1 week after this incident I also had the worst sore throat of my life (no blisters). 6 months later, I am still in the same condition. Sometimes the pain would subside for a week but then fully return. Sometimes I can feel pain inside towards the base of the penis and even the testicles but mostly at meatus which became red and puffy about 2 months into this. I also swore I got a cold-sore on my lip approximately 2.5 months into this (didn't have the opportunity to get it cultured), but my blood remains negative. The following tests and treatments were done:

Gonorrhea, chlamydia, ureaplasma, and mycoplasma: negative by urine and urethral swab
syphilis: negative by blood at 6.5 weeks
HSV-1 and HSV-2: negative urethral swab and IGG blood (Quest HerpeSelect) for both -1 and -2 (<0.3 for both) at 15 and 22.5 weeks.
Semen culture: negative for HSV and bacteria
HIV: negative at 17 weeks.

4 weeks levaquin, 3 weeks doxy, 1 rocephin shot, 3 weeks of a different cephalosporin (forgot the name), 10 weeks of Valtrex.

Do you have any suggestions about what to do? The doctors have run out of ideas and my condition is not getting noticably better with time. Any thoughts about a Western Blot test for atypical HSV1 condition?
3 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum. Unfortuantely, we can't help much.  You had accurate responses to the same problem/questions on the STD community forum several weeks ago.  Most likely you never had any STD; but even if the initial problem was sexually acquired NGU, that problem is now long gone.  Herpes is absolutely not a possible explanation.  Tingling of the penis, without visible discharge of pus or mucus from the penis, is not a symptom of NGU; and any infection that could possibly cause that symptom would have been been cured with all the anti-infective treatments you have had.  In other words, persistence of the symptom despite those treatments prove that something other than an infection is responsible.

Probably your doctors have "run out of ideas" simply because nothing is wrong.  Symptoms alone do not indicate a disease process, and lots of people live indefinitely with unexplained symptoms, especially once they know nothing serious is the cause.  Millions of people live with chronic back pain, intermittent unexplained headaches or abdominal pain, or painful ankle that persist long after the injury has healed.  Same for the genitals.  It is clear you have nothing that will ever harm you or a sex partner.

So most likely you're just going to have to learn with this symptom, which obviously is nagging but not actually all that painful.  Often simply knowing it's nothing serious is the first step in tolerating an unexplained symptom.  Probably it's time to just suck it up and move on.  I see no point in additional HSV testing or in any further tests of any kind.

Good luck--  HHH, MD
Helpful - 1
239123 tn?1267647614
MEDICAL PROFESSIONAL
Yes, CPPS certainly is a possibility.  I have no suggestsions for any particular additonal tests, treatment, etc.  CPPS and prostatitis are outside my specialty and, except for suggesting them as a possibilities, beyond the scope of this forum -- since it's not an STD.  You'll have to seek any additional advice somewhere else.  I will have no further comments.
Helpful - 0
Avatar universal
Thanks for the reply. Unfortunately, for let's say 1 week of a month, the pain actually is quite unbearable and effects not just my social life but also my professional life since I can't concentrate. This is why I have been so persistent with doctors. Thankfully, for the remaining days of the month I just have the "nagging" pain which "is" tolerable. I will admit that I have become a little obsessed with the possibility of HSV because of the quick onset of symptoms, the lack of response to antibiotics, and the unexplain sore on my lips (I know it was not a pimple); but the evidence against HSV is also rather overwhelming (negative blood and swab tests, no blisters on genitals, no real response to Valtrex).

Based upon what you said earlier, I guess it is possible for an initial infection to cause prolonged symptoms (pain cycle) long after the infection has been eliminated? My doctors told me that they would have expected me to recover by now. Do you think a cystoscopy may be worth a try to see if there is an physcial/mechanical problem? Do you think non-bacterial prostatitis or CPPS is a possibility? If so is there anything that can really be done or do you know any doctors, medical groups or universities that cover cases such as this? Thanks again, I know I may seem pushy or obsessed but 6 months of this condition begins to wear on a person, especially since I have always been completely healthy up to this point.
Helpful - 0

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