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STD or Prostatitis
I will try to be as quick as possible with this. 13 weeks ago I received unprotected oral sex from a CSW (female). Major mistake - feelings of guilt and anxiety kicked in shortly after. I am sure these feelings did contribute to my symptoms for a short while. However symptoms have continued to linger even after all negative tests.
Time Line:
Day 10 post exposure - I had urines taken for Ghon, Chlam, NSU - All negative
Almost 2/3 weeks post exposure - I developed symptoms such as frequent urinating, slight stinging sensations, occasional tenderness or irritation at tip of penis, dripping urine in small volumes after voiding. Aching testicles and hot sensations in testicles. Took Azythromycin 1G (OTC). I followed up with a visit to the doctors who prescribed 8days Doxcy twice a day and advised that I had an ultrasound of testes - this showed no signs of a vericosle or epyditimis. Completed Doxcy course.
4 weeks - HIV Duo, Syphilis, Hep B, Ghon, Chlam, Gardenella, Trichoma, NSU, HSV Urine PCR - All negative
Between 4 and 9 weeks post exposure my symptoms waxed and waned and now developed more lower back aches and discomfort in thighs and groin area. Ocassionally I have noticed a small amount of clear sticky discharge after urinating and mostly after passing stools.
9 weeks - Returned to docs and had a mid-stream urine test for UTI and urethal swab - All came back negative.
11.5 weeks - HSV 2 blood antibodies type specific test with Urine PCR/ also repeated the syphilis test - All Negative (just wanted to be sure)
Symptoms such as groin discomfort, very occasional sting inside penis, occasional clear sticky discharge only after urinating, small amounts of dripping urine after voiding and also dripping semen after ejaculation. All of which I am sure I did not experience before this exposure.
Could I have some sort of chronic bacterial prostatitis? Could this be caused by any of the STD's mentioned above which may not have been detected in any of my urine tests?
Time Line:
Day 10 post exposure - I had urines taken for Ghon, Chlam, NSU - All negative
Almost 2/3 weeks post exposure - I developed symptoms such as frequent urinating, slight stinging sensations, occasional tenderness or irritation at tip of penis, dripping urine in small volumes after voiding. Aching testicles and hot sensations in testicles. Took Azythromycin 1G (OTC). I followed up with a visit to the doctors who prescribed 8days Doxcy twice a day and advised that I had an ultrasound of testes - this showed no signs of a vericosle or epyditimis. Completed Doxcy course.
4 weeks - HIV Duo, Syphilis, Hep B, Ghon, Chlam, Gardenella, Trichoma, NSU, HSV Urine PCR - All negative
Between 4 and 9 weeks post exposure my symptoms waxed and waned and now developed more lower back aches and discomfort in thighs and groin area. Ocassionally I have noticed a small amount of clear sticky discharge after urinating and mostly after passing stools.
9 weeks - Returned to docs and had a mid-stream urine test for UTI and urethal swab - All came back negative.
11.5 weeks - HSV 2 blood antibodies type specific test with Urine PCR/ also repeated the syphilis test - All Negative (just wanted to be sure)
Symptoms such as groin discomfort, very occasional sting inside penis, occasional clear sticky discharge only after urinating, small amounts of dripping urine after voiding and also dripping semen after ejaculation. All of which I am sure I did not experience before this exposure.
Could I have some sort of chronic bacterial prostatitis? Could this be caused by any of the STD's mentioned above which may not have been detected in any of my urine tests?
MEDICAL PROFESSIONAL
Welcome to the STD forum. I'll try to help.
I doubt you have (or had) either an STD or prostatitis. The most common explanation for symptoms like yours, especially when they persiste despite azithromycin and doxycycline, is genitally focused anxiety. If that is the explanation, there could still be a prostate link. The chronic pelvic pain syndrome in men used to be classified as a form of non-bacterial prostatitis -- however, the prostate may not be involved at all, and one theory about CPPS is that it is largely if not entirely an anxiety phenomenon, related to tension in the pelvic muscles. I encourage you to google CPPS (spell it out) and start your reading with the excellent Wikipedia article and information from the Stanford Univ dept of urology, both of which will be near the top of the google hit list. You will find a lot of parallels between your symptoms and those of CPPS.
Besides your symptoms etc, you had an exposure that was very low risk for all STDs. Not completely risk free, but oral sex is generally considered safe sex because of the zero or near-zero chance for some STDs (HIV, hepatitis, chlamydia, HPV) and low risk for others (gonorrhea, herpes, syphilis, nongonococcal urethritis [NGU]). And none of those causes the symptoms you describe anyway. The one that comes closest is NGU, can be easily confused with prostatitis -- but not in cases that don't respond to doxy or azithromycin.
As for clear or semen-like urethral discharge with bowel movements, that's not abnormal. See this thread, as well as the others it links to: http://www.medhelp.org/posts/STDs/Discharge-and-Bowell-Movement-and-Concern/show/859854
So my belief is that your symptoms are not due to any infection from the oral sex event. If they are related to that experience, it is probably connected with your self-diagnosed anxiety about the event.
Perhaps most important, you can be certain you have nothing harmful. Even if you actually have NGU or a prostate gland problem, these are believed to be entirely harmless when the standard STDs have been excluded. There are few if any long term complications or health problems of any kind, either for affected men or their sex partners. Many men with such symptoms find them quite easy to live with, once they are confident they are an inconvenience only, not an important health threat.
So my advice is to stop testing for STDs; read up on CPPS; then consider visiting a urologist, if you haven't done so, to confirm the diagnosis and get personalized advice about it. But in the meantime, you really should not be worried.
I hope this helps. Best wishes-- HHH, MD
I doubt you have (or had) either an STD or prostatitis. The most common explanation for symptoms like yours, especially when they persiste despite azithromycin and doxycycline, is genitally focused anxiety. If that is the explanation, there could still be a prostate link. The chronic pelvic pain syndrome in men used to be classified as a form of non-bacterial prostatitis -- however, the prostate may not be involved at all, and one theory about CPPS is that it is largely if not entirely an anxiety phenomenon, related to tension in the pelvic muscles. I encourage you to google CPPS (spell it out) and start your reading with the excellent Wikipedia article and information from the Stanford Univ dept of urology, both of which will be near the top of the google hit list. You will find a lot of parallels between your symptoms and those of CPPS.
Besides your symptoms etc, you had an exposure that was very low risk for all STDs. Not completely risk free, but oral sex is generally considered safe sex because of the zero or near-zero chance for some STDs (HIV, hepatitis, chlamydia, HPV) and low risk for others (gonorrhea, herpes, syphilis, nongonococcal urethritis [NGU]). And none of those causes the symptoms you describe anyway. The one that comes closest is NGU, can be easily confused with prostatitis -- but not in cases that don't respond to doxy or azithromycin.
As for clear or semen-like urethral discharge with bowel movements, that's not abnormal. See this thread, as well as the others it links to: http://www.medhelp.org/posts/STDs/Discharge-and-Bowell-Movement-and-Concern/show/859854
So my belief is that your symptoms are not due to any infection from the oral sex event. If they are related to that experience, it is probably connected with your self-diagnosed anxiety about the event.
Perhaps most important, you can be certain you have nothing harmful. Even if you actually have NGU or a prostate gland problem, these are believed to be entirely harmless when the standard STDs have been excluded. There are few if any long term complications or health problems of any kind, either for affected men or their sex partners. Many men with such symptoms find them quite easy to live with, once they are confident they are an inconvenience only, not an important health threat.
So my advice is to stop testing for STDs; read up on CPPS; then consider visiting a urologist, if you haven't done so, to confirm the diagnosis and get personalized advice about it. But in the meantime, you really should not be worried.
I hope this helps. Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
Yes, it is true that NGU is excluded if there is neither discharge nor elevated WBC in the urethra. Without those findings, antibiotics generally have no effect.
Most STD clinic patients who may have it are referred to our urology colleagues; therefore, I do not treat CPPS and have no experience or knowledge of tamsulosin as a treatment. But I believe you would do well to trust your urologist and follow his or her advice.
I think my advice here has gone as far as it can; let's end this thread. Good luck.
Most STD clinic patients who may have it are referred to our urology colleagues; therefore, I do not treat CPPS and have no experience or knowledge of tamsulosin as a treatment. But I believe you would do well to trust your urologist and follow his or her advice.
I think my advice here has gone as far as it can; let's end this thread. Good luck.
Sorry doc was slightly confused by the beginning of you answer. Just to confirms, No abnormal discharge and WBC count always below 1 confirms no NGU? Want to eliminate from my possibilities.
Also a question you may have missed from above: My private GP has prescribed me a 4 week course of Tamsulosin (Flomax) thats when I discovered CPPS on the net. I havnt started taking the course yet. What is your opinion on this medication and is this prescribed for CPPS sufferers?
Also a question you may have missed from above: My private GP has prescribed me a 4 week course of Tamsulosin (Flomax) thats when I discovered CPPS on the net. I havnt started taking the course yet. What is your opinion on this medication and is this prescribed for CPPS sufferers?
MEDICAL PROFESSIONAL
FYI, you can disregard the UTI comment. There was a question today from someone concerned about recurrent "UTI". I mistakenly had that in mind when I started today's comment.
MEDICAL PROFESSIONAL
As I suspected, you probably have had recurrent or persistent NGU, prostatitis, or CPPS -- not UTI.
The known and possible causes of NGU account for only around 60-70% of cases. Even after taking into account Mycoplasma genitalium and Ureaplasma (whose role is controversial), the cause of 30-40% of cases remains unknown. The diagnosis of NGU is entirely independent of tests for any and all possible causes. If you have documented urethritis (abnormal discharge and/or documented elevated white blood cells in the urethra), then you have NGU -- or at least a urethritis component to your problem. If not, then CPPS or prostatitis is the best bet.
After antibiotic therapy, recurrent or persistent NGU, as well as CPPS and non-infectious prostatitis, should be viewed as inconveniences, not serious health risks. There are no know serious consequences either for affected men or their sex partners.
Here is a link to information from Stanford, but not on their own website. I found it (and others) by adding "Stanford" to CPPS (spelled out) in my google search; I'm sure you can find others. Interesting, however, that the previous link to the Stanford dept of Urology, no longer shows up near the top of a CPPS search. I guess I'll have to modify that advice in the future. http://emedicine.medscape.com/article/437745-treatment
Thanks for the thanks. Glad to have been of help.
The known and possible causes of NGU account for only around 60-70% of cases. Even after taking into account Mycoplasma genitalium and Ureaplasma (whose role is controversial), the cause of 30-40% of cases remains unknown. The diagnosis of NGU is entirely independent of tests for any and all possible causes. If you have documented urethritis (abnormal discharge and/or documented elevated white blood cells in the urethra), then you have NGU -- or at least a urethritis component to your problem. If not, then CPPS or prostatitis is the best bet.
After antibiotic therapy, recurrent or persistent NGU, as well as CPPS and non-infectious prostatitis, should be viewed as inconveniences, not serious health risks. There are no know serious consequences either for affected men or their sex partners.
Here is a link to information from Stanford, but not on their own website. I found it (and others) by adding "Stanford" to CPPS (spelled out) in my google search; I'm sure you can find others. Interesting, however, that the previous link to the Stanford dept of Urology, no longer shows up near the top of a CPPS search. I guess I'll have to modify that advice in the future. http://emedicine.medscape.com/article/437745-treatment
Thanks for the thanks. Glad to have been of help.
Thanks so much for your answer.
With regards to the NGU my urine tests did test for Mycroplasma and Uriplasma etc...which was negative and WBC count was below one. Does this eliminate NGU (NSU) or can other undetectable organisms cause NGU and return totally normal urine tests? if this is the case then do I need any more antibiotics or will this clear up itself?
My private GP has prescribed me a 4 week course of Tamsulosin (Flomax) thats when I discovered CPPS on the net. I havnt started taking the course yet. What is your opinion on this medication and is this prescribed for CPPS sufferers?
I could not find the CPPS information from Stanford Univ dept of urology. Could you please paste me a link?
Thanks again Doctor, this forum has been a great help and it is an absolute privilige to be able to gain access to experts like yourself.
N
With regards to the NGU my urine tests did test for Mycroplasma and Uriplasma etc...which was negative and WBC count was below one. Does this eliminate NGU (NSU) or can other undetectable organisms cause NGU and return totally normal urine tests? if this is the case then do I need any more antibiotics or will this clear up itself?
My private GP has prescribed me a 4 week course of Tamsulosin (Flomax) thats when I discovered CPPS on the net. I havnt started taking the course yet. What is your opinion on this medication and is this prescribed for CPPS sufferers?
I could not find the CPPS information from Stanford Univ dept of urology. Could you please paste me a link?
Thanks again Doctor, this forum has been a great help and it is an absolute privilige to be able to gain access to experts like yourself.
N
You are reading content posted in the STDs Forum
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Syphilis is an STD that is transmitted by oral, genital and anal sex.
