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Post NGU Complications
Dear Doctors,
First, let me thank you for the invaluable resource you provide here. Your advice helps more people than you know.
Ten weeks ago, I received unprotected oral sex and had protected vaginal sex. After experiencing some burning with urination and an increase in the need to urinate, I visited an STD clinic. I tested negative for gonorrhea and chlamydia but was diagnosed with NGU. I was treated with 1 gram of azithromycin and one week of Cipro. I returned to the clinic two weeks later and, after a swab test, was told that the NGU was gone.
Six weeks ago, I felt some pain in my testicles. Concerned that my NGU had led to epididymitis, I returned to the clinic and was given two weeks of doxycycline and a shot of some other antibiotic in the arm (I don't remember the name). I experienced no symptoms during the two weeks on doxycycline.
For the past three weeks, I have had periods of mild to painful sensitivity in my urethra. Some days, things feel fine. Other days, I have hours where it feels a little like sandpaper on my boxer shorts. Over the last week, the sensitivity has declined somewhat but the opening of my urethra has been noticably red at times (without any noticeable swelling). I have not had sex since the original encounter so I am fairly sure these more recent symptoms are not a new infection.
I am reluctant to return to the STD clinic for this but am worried. Could my current symptoms be the after effects of the trauma of the NGU? Could it be a side effect of taking so many antibiotics? Should I expect the symptoms to clear up on their own? If so, what time frame is reasonable? If not, do I need to see a urologist? Do you think that anxiety may be the culprit? I would love to be able to forget this and move on with my life but do not want to risk future partners or my own health.
I'm deeply grateful for any help you can give me.
First, let me thank you for the invaluable resource you provide here. Your advice helps more people than you know.
Ten weeks ago, I received unprotected oral sex and had protected vaginal sex. After experiencing some burning with urination and an increase in the need to urinate, I visited an STD clinic. I tested negative for gonorrhea and chlamydia but was diagnosed with NGU. I was treated with 1 gram of azithromycin and one week of Cipro. I returned to the clinic two weeks later and, after a swab test, was told that the NGU was gone.
Six weeks ago, I felt some pain in my testicles. Concerned that my NGU had led to epididymitis, I returned to the clinic and was given two weeks of doxycycline and a shot of some other antibiotic in the arm (I don't remember the name). I experienced no symptoms during the two weeks on doxycycline.
For the past three weeks, I have had periods of mild to painful sensitivity in my urethra. Some days, things feel fine. Other days, I have hours where it feels a little like sandpaper on my boxer shorts. Over the last week, the sensitivity has declined somewhat but the opening of my urethra has been noticably red at times (without any noticeable swelling). I have not had sex since the original encounter so I am fairly sure these more recent symptoms are not a new infection.
I am reluctant to return to the STD clinic for this but am worried. Could my current symptoms be the after effects of the trauma of the NGU? Could it be a side effect of taking so many antibiotics? Should I expect the symptoms to clear up on their own? If so, what time frame is reasonable? If not, do I need to see a urologist? Do you think that anxiety may be the culprit? I would love to be able to forget this and move on with my life but do not want to risk future partners or my own health.
I'm deeply grateful for any help you can give me.
MEDICAL PROFESSIONAL
Thanks for the follow-up. Unfortunately, there isn't much more I can suggest. Many patients with such symptoms do see urologists for evaluation of the prostate gland or other causes, but in my experience in most cases nothing useful comes out of the evaluation. As I tried to make clear in my primary reply, an important take-home message is that persistent symptoms of this sort probably never indicate any kind of serious problem. With no documented urethritis following the evaluation in the STD clinic -- which sounds like exactly what we would do in my own clinic, and probably highly expert -- the best thing probably is to sit tight, with the expectation the discomfort will fade with time. You can be sure you have nothing that will ever harm you or any current or future sex partner(s).
Sorry I can't be more helpful. Good luck with it. And try not to worry about it; most people can learn to live with minor discomforts (including genital ones) once they are confident there is no serious health problem.
Sorry I can't be more helpful. Good luck with it. And try not to worry about it; most people can learn to live with minor discomforts (including genital ones) once they are confident there is no serious health problem.
MEDICAL PROFESSIONAL
Welcome to the STD forum. Thanks for your kind comments about it.
One of the most vexing problems in STD management -- for both providers and affected patients -- is persistent or recurrent symptoms of NGU. Often the problem is never solved. But here is the good news: persistent or recurrent NGU (or of symptoms when actual urethritis cannot be documented) appears to be harmless. There appear to be no complications and no long term health impacts for either affected men or their sex partners. Evem acute, untreated NGU appears to be harmless when not caused by chlamydia, and no complications have been reported from NGU acquired during oral sex. So even if neither I nor your STD clinic can provide clear answers, you really shouldn't worry too much about this.
As to your specific situation, I see two somewhat separate issues here. The first is whether you had NGU to start. The STD clinic diagnosis has to be taken seriously, but frequent urination or urinary urgency are not common NGU symptoms, and usually abnormal discharge is the main symptom.
Whether or not you had NGU, the second issue is the cause of your current symptoms. They are not typical for recurrent or persistent NGU; again, discharge usually is the main symptom. Any time any body part is injured (including injury by infeciton, not only trauma), symptoms of irritation can continue long after the problem has healed. Think of the sprained ankle that still aches weeks or months later, the cough that continues for several weeks after a cold clears up, and so on. The genitals are not immune to this sort of thing.
That said, it is still possible you have a persisting infection of some sort. Yeast overgrowth due to antibiotics is a slight possibility. Trichomonas causes a few cases of NGU, although it isn't acquired by oral sex, so that's a long shot.
Epididymitis is not known to result from nonchlamydial NGU, or from NGU acquired by oral sex -- and that causes not just testicular discomfort, but overt pain, swelling, and marked tenderness, usually of only one testicle. I have to believe the clinic was being hyper cautious, not that they actually diagnosed epididymitis.
As for anxiety, whenver a person suggests that as a cause for his or her own symptoms, usually s/he is right -- so that's certainly a possibility for some if not all your symptoms. (I'm not much of a believer in anxiety creating such symptoms on its own. But for sure anxiety can magnify minor aches and pains that otherwise wouldn't be noticed, or can make normal body sensations perceived as uncomfortable or painful.)
Because there are no known complications etc, it is safe to just sit tight for at least a couple of weeks. Most likely your symptoms will gradually fade. If they persist beyond 2-3 weeks, or if they get worse at any time or you start having a discharge, get professionally evaluated Returning to the STD clinic should be fine; I'm not sure this warrants seeing a urologist.
In the meantime, try not to worry. The best bet is simply persisting irritative symptoms along the lines I suggested above, not any continuing infection or anything else likely to cause harm.
I hope this helps. Good luck-- HHH, MD
One of the most vexing problems in STD management -- for both providers and affected patients -- is persistent or recurrent symptoms of NGU. Often the problem is never solved. But here is the good news: persistent or recurrent NGU (or of symptoms when actual urethritis cannot be documented) appears to be harmless. There appear to be no complications and no long term health impacts for either affected men or their sex partners. Evem acute, untreated NGU appears to be harmless when not caused by chlamydia, and no complications have been reported from NGU acquired during oral sex. So even if neither I nor your STD clinic can provide clear answers, you really shouldn't worry too much about this.
As to your specific situation, I see two somewhat separate issues here. The first is whether you had NGU to start. The STD clinic diagnosis has to be taken seriously, but frequent urination or urinary urgency are not common NGU symptoms, and usually abnormal discharge is the main symptom.
Whether or not you had NGU, the second issue is the cause of your current symptoms. They are not typical for recurrent or persistent NGU; again, discharge usually is the main symptom. Any time any body part is injured (including injury by infeciton, not only trauma), symptoms of irritation can continue long after the problem has healed. Think of the sprained ankle that still aches weeks or months later, the cough that continues for several weeks after a cold clears up, and so on. The genitals are not immune to this sort of thing.
That said, it is still possible you have a persisting infection of some sort. Yeast overgrowth due to antibiotics is a slight possibility. Trichomonas causes a few cases of NGU, although it isn't acquired by oral sex, so that's a long shot.
Epididymitis is not known to result from nonchlamydial NGU, or from NGU acquired by oral sex -- and that causes not just testicular discomfort, but overt pain, swelling, and marked tenderness, usually of only one testicle. I have to believe the clinic was being hyper cautious, not that they actually diagnosed epididymitis.
As for anxiety, whenver a person suggests that as a cause for his or her own symptoms, usually s/he is right -- so that's certainly a possibility for some if not all your symptoms. (I'm not much of a believer in anxiety creating such symptoms on its own. But for sure anxiety can magnify minor aches and pains that otherwise wouldn't be noticed, or can make normal body sensations perceived as uncomfortable or painful.)
Because there are no known complications etc, it is safe to just sit tight for at least a couple of weeks. Most likely your symptoms will gradually fade. If they persist beyond 2-3 weeks, or if they get worse at any time or you start having a discharge, get professionally evaluated Returning to the STD clinic should be fine; I'm not sure this warrants seeing a urologist.
In the meantime, try not to worry. The best bet is simply persisting irritative symptoms along the lines I suggested above, not any continuing infection or anything else likely to cause harm.
I hope this helps. Good luck-- HHH, MD
MEDICAL PROFESSIONAL
Thanks for the thanks. Take care.
Once again, thank you. I am extremely grateful for your advice. This gives me a great deal of peace of mind which I sorely needed. I will be able to relax a little now and stop endlessly searching (to no avail) the Internet in search of answers.
In case you do not hear it enough, your expertise and thoughtful replies provide a huge service to many people out there. Without the information found here, many people would be left to drive themselves crazy with the rumors and speculation found on other sites. Thanks again.
In case you do not hear it enough, your expertise and thoughtful replies provide a huge service to many people out there. Without the information found here, many people would be left to drive themselves crazy with the rumors and speculation found on other sites. Thanks again.
Thank you once again for your earlier reply, Doctor. I wanted to follow up with an update on my condition. Following your advice, I returned to the STD clinic after the sensitivity around my urethra continued for three weeks. I was checked again for NGU, gonorrhea and chlamydia (a urine test as well as a swab). All tests were negative. The doctor felt my prostate and thought everything was fine. He did not recommend a herpes test (I have never had any visible sores or red spots on my penis). He said he was "not worried" about the sensitivity I was experiencing around the head of my penis.
Since the last visit to the clinic, I have continued to have some minor sensitivity on the tip of my penis (it is very difficult to tell whether it is from the urethra or from the skin surrounding the head). It feels like a little scratchiness on the tip of my penis. The irritation is not severe - I would rate it only about a 3 on a 10 point scale - and I only feel it when I am walking or running. It is, however, very disconcerting and is really beginning to depress me. The irritation seems to come and go for no good reason. Overall, I have had these same symptoms for two months in a row with no noticeable improvement (but things have not gotten worse either).
I am really lost. Is there some other STD that may cause this? Urethral HPV? Does this sound like prostatitis? Is there some non-STD disease that could be driving this? Is it possibly a fungus or a yeast infection (I have only very, very subtle redness around my urethra from time to time). Do I need to see a specialist (I have no health insurance and have no job at the moment)? If so, which one?
I hope that you can provide some guidance. Your posts to other members are incredibly valuable. Once again, I am extremely grateful for your response not only to me, but to every other member of the community.
Since the last visit to the clinic, I have continued to have some minor sensitivity on the tip of my penis (it is very difficult to tell whether it is from the urethra or from the skin surrounding the head). It feels like a little scratchiness on the tip of my penis. The irritation is not severe - I would rate it only about a 3 on a 10 point scale - and I only feel it when I am walking or running. It is, however, very disconcerting and is really beginning to depress me. The irritation seems to come and go for no good reason. Overall, I have had these same symptoms for two months in a row with no noticeable improvement (but things have not gotten worse either).
I am really lost. Is there some other STD that may cause this? Urethral HPV? Does this sound like prostatitis? Is there some non-STD disease that could be driving this? Is it possibly a fungus or a yeast infection (I have only very, very subtle redness around my urethra from time to time). Do I need to see a specialist (I have no health insurance and have no job at the moment)? If so, which one?
I hope that you can provide some guidance. Your posts to other members are incredibly valuable. Once again, I am extremely grateful for your response not only to me, but to every other member of the community.
Thank you for your detailed and thoughtful reply. It helps ease my mind considerably. I will give it some time and post and update in a week or two. Once again, thank you.
You are reading content posted in the STDs Forum
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