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Prostate or HSV2 or HPV
Hello Doctors.
Sexual History:
-straight 32yo male
-celibate for the last 3 years
-4 years ago had female partner with genital HSV2 and HPV (LEEP performed 6months before I knew her). We had mostly oral sex (both ways) and masturbated eachother for the year we were together and had condom protected intercourse 3-5 times. She was not on suppressive therapy, although hopefully we avoided obvious outbreaks.
Out of the blue, after no sexual contact of any kind in the last couple years, a couple months ago I had what seemed like a UTI or prostatitis. Severe semen like discharge (slightly yellow when wiped onto toliet paper) that didnt stop, urethral and some pelvic pain, and after a day or so even led to watery anal leakage/discharge. I had no problems with defecating, but I certainly had significant urinary voiding problems. Urgency, incomplete voiding, some pain with stream. Notice no external lesions at the time (I've had a couple PCR tests in the past when I would see something worrisome on my penis, but never anything classical and was always negative).
I saw my GP and a urologist.The GP did a urinalysis:
Blood: +++ 50
Ketone: 50
Protein: 100
Nitrites: Positive
Ph: 5
SGravi: 1.025
Leuko: 500
Found Greater than 100,000 FU/ml of Ecoli
Everything else negative including Gono PCR on discharge. STD PCR urine test for chlamydia, trich, mycop, neisseria gono, ureaplas all neg. No tests done for HSV at the time
GP suggested UTI from E coli or perhaps Prostatitis. I took Cipro and the discharge stopped and pain went away with 48 hours. I still had some fear it could be herpes related.
I still have lingering Prostatitis like symptoms two months later. Some very very minor discomfort urinating, varying level of pain in tip of penis, urethral and prostatic? ache. Urine tests since and cyscoptomy were normal. HPV or HSV the cause? Urologist is at a loss.. Nerve problems from herpes?.
Sexual History:
-straight 32yo male
-celibate for the last 3 years
-4 years ago had female partner with genital HSV2 and HPV (LEEP performed 6months before I knew her). We had mostly oral sex (both ways) and masturbated eachother for the year we were together and had condom protected intercourse 3-5 times. She was not on suppressive therapy, although hopefully we avoided obvious outbreaks.
Out of the blue, after no sexual contact of any kind in the last couple years, a couple months ago I had what seemed like a UTI or prostatitis. Severe semen like discharge (slightly yellow when wiped onto toliet paper) that didnt stop, urethral and some pelvic pain, and after a day or so even led to watery anal leakage/discharge. I had no problems with defecating, but I certainly had significant urinary voiding problems. Urgency, incomplete voiding, some pain with stream. Notice no external lesions at the time (I've had a couple PCR tests in the past when I would see something worrisome on my penis, but never anything classical and was always negative).
I saw my GP and a urologist.The GP did a urinalysis:
Blood: +++ 50
Ketone: 50
Protein: 100
Nitrites: Positive
Ph: 5
SGravi: 1.025
Leuko: 500
Found Greater than 100,000 FU/ml of Ecoli
Everything else negative including Gono PCR on discharge. STD PCR urine test for chlamydia, trich, mycop, neisseria gono, ureaplas all neg. No tests done for HSV at the time
GP suggested UTI from E coli or perhaps Prostatitis. I took Cipro and the discharge stopped and pain went away with 48 hours. I still had some fear it could be herpes related.
I still have lingering Prostatitis like symptoms two months later. Some very very minor discomfort urinating, varying level of pain in tip of penis, urethral and prostatic? ache. Urine tests since and cyscoptomy were normal. HPV or HSV the cause? Urologist is at a loss.. Nerve problems from herpes?.
MEDICAL PROFESSIONAL
Sorry that I misundertood the timing. You are correct that this is outside the scope of this forum. That said, I would wonder whether you have a fistula (an abnormal open connection) between your rectum and your urinary tract, such as the urethra or bladder. Fistulas can result when infection burrows between adjacent hollow organs. In this part of the body, most fisutlas result from inflammation or infection that starts in the GI tract, e.g. with inflammation in the rectum or lower intestine, especially in people with inflammatory bowel disease (ulcerative colitis or Crohn's disease). Have you ever had such a diagnosis? Or recurrent low abdominal pain, blood in stools, etc?
This is only a guess, but you might raise it with the urologist. Most likely it won't pan out, but better safe than sorry.
This is only a guess, but you might raise it with the urologist. Most likely it won't pan out, but better safe than sorry.
I don't want to take up too much time on the forum, as I appreciate the help and advice. However, specifically on the anal discharge... it actually occurred before I took any medication or saw any doctor. The urinary symptoms started and then the next morning I had penile discharge, and then several hours later I had the anal (watery) discharge. The cipro was effective at knocking out the discharge both from my penis and anus within 24-48 hours. Could I have had some kind e coli infection spread throughout my digestive tract? I had no stomach problems or problems defecating. I know this out of the scope of the forum, but any suggestion from wise Dr. HHH is appreciated.
MEDICAL PROFESSIONAL
Correct about NGU and HSV.
Your anal discharge could have been a side effect of ciprofloxacin upsetting your normal rectal and colonic bacteria. In any case, no STD can cause anal symptoms unless there was recent sexual penetration of the anus.
Your anal discharge could have been a side effect of ciprofloxacin upsetting your normal rectal and colonic bacteria. In any case, no STD can cause anal symptoms unless there was recent sexual penetration of the anus.
Also no ultrasound has been done yet, only cystocopy
Thank you for the near immediate response Dr. HHH. I guess I was lucky with my timing. I will bring this response to my next appointment. Do you have any opinions on the anal discharge that occurred? My Urologist didn't seem to have a response for that either.
Also, I realize I forgot to list I did actually have a WB done a year ago that was negative for HSV2 but positive for HSV1. (I believe that is an oral infection from when I was a boy, but I'm not certain.)
Also I read that NGU or urethritis can be caused by HSV, but it's generally with an initial infection, right? Not something that would show up years later?
Also, I realize I forgot to list I did actually have a WB done a year ago that was negative for HSV2 but positive for HSV1. (I believe that is an oral infection from when I was a boy, but I'm not certain.)
Also I read that NGU or urethritis can be caused by HSV, but it's generally with an initial infection, right? Not something that would show up years later?
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
This actually sounds very straightforward: you have (or have had) bacterial prostatitis and UTI due to E. coli. While not the usual cause of prostatitis, especially in men under 40 years old, clearly that is what you have had. Regardless of the initial cause, prostatitis symptoms can persist after the acute infection has resolved. Also, even with potent antibiotic therapy -- like ciprofloxacin versus E. coli -- it can be difficult to entirely eradicate prostate gland infections. Alternatively, damage from the E. coli infection may have left you with chronic, non-infective prostatitis. In any case, if I were your urologist, I would recommend a 3-glass urinalysis and culture, and perhaps repeat ultrasound -- and if these don't show anything, I would repeat the same things again in a few weeks.
This clearly is not an STD. Neither herpes nor HPV ever behaves this way. The only STDs that might predispose you to bacterial prostatitis are chlamydia and gonorrhea, and these are pretty much impossible in someone who hasn't been sexually active for so long; they would have cleared on their own within a few months, tops. This problem is entirely unrelated to your past sexual partners or relationships.
So my advice is that you continue to work with your urologist. You print out this thread as a framework for discussion -- I suspect s/he will agree with most of what I have said.
I hope this has been helpful. Best wishes-- HHH, MD
This actually sounds very straightforward: you have (or have had) bacterial prostatitis and UTI due to E. coli. While not the usual cause of prostatitis, especially in men under 40 years old, clearly that is what you have had. Regardless of the initial cause, prostatitis symptoms can persist after the acute infection has resolved. Also, even with potent antibiotic therapy -- like ciprofloxacin versus E. coli -- it can be difficult to entirely eradicate prostate gland infections. Alternatively, damage from the E. coli infection may have left you with chronic, non-infective prostatitis. In any case, if I were your urologist, I would recommend a 3-glass urinalysis and culture, and perhaps repeat ultrasound -- and if these don't show anything, I would repeat the same things again in a few weeks.
This clearly is not an STD. Neither herpes nor HPV ever behaves this way. The only STDs that might predispose you to bacterial prostatitis are chlamydia and gonorrhea, and these are pretty much impossible in someone who hasn't been sexually active for so long; they would have cleared on their own within a few months, tops. This problem is entirely unrelated to your past sexual partners or relationships.
So my advice is that you continue to work with your urologist. You print out this thread as a framework for discussion -- I suspect s/he will agree with most of what I have said.
I hope this has been helpful. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
