elevated WBC in semen caused by gonorrhea?

[MarkS12345]

Hello Drs., thanks in advance for your answer to my question.  39 year old married male here, and like many other posters on here I screwed up and I'm pretty worried about it...about 4 months ago I received unprotected oral sex from another man.  I understand that the chance of catching something is pretty low, but the most likely culprit would be gonorrhea.  I didn't have any discharge, painful urination, etc, after the encounter, and I never got tested.  About 6 weeks ago I had a semen analysis because my wife and I are trying to get pregnant.  The sperm count was a little low (my testosterone level was also a little low), and the WBC count was about 700,000.  My urologist had me take sulfameth for a month and repeat the semen analysis.  The sperm count improved (testosterone is up also), but the WBC was still around 600,000.  I'm currently taking cipro for a a month.  The only other symptom that might be related is frequent urination, but I've had that for years, and it seems to have gotten better after taking the sulfameth.  My question is, do you think that gonorrhea or another STD is causing my elevated WBC count?

[Edward W Hook, MD]

Prostate cancer is not related to prostate infection.  Prostate infections are caused by a wide variety of microbes, most of which originate from the urinary tract.  In some cases even though there is no obvious causative organism, prostate inflammation can be treated with antibiotics.  In addition chronic prosate inflammation is related to the the so-called chronic pelvic pain syndrome for some men (I hate the term).  You could learn more abou this perplexing problem with a Google search.  Look at the explanation on Wikepedia first- it's quite good.  EWH

[MarkS12345]

Thanks for your answer.  If you'll permit a follow up question, which I hope isn't outside  the scope of this forum...what causes prostate inflammation?  I have a family history of prostate cancer (dad, his brother, and their father), but my psa level is normal.

[Edward W Hook, MD]

Welcome to our Forum.  Given the symptoms that you do have (a bit or urinary frequency) I suspect that you may have a bit of prostate inflammation rather than any STD. As you already know, the risk for STDs from receipt of oral sex is rather low and the fact that you had the minor symptoms that you do have preceded you exposure (I believe) are strong evidence that this is not an STD.  Prostate inflammation, manifest as increased numbers of white blood cells in ejaculate is relatively common and cipro and sulfamethoxazole are the first drugs I would use in this situation.  I would not worry about STDs as a contributor.  EWH