Long term infectin

[dannz]

Hi,
I'm a 20 year old male, in good general health..

I have been going out with a girl since Nov 2006. In Oct 2006, I was a bit naughty, and had unprotected sex with someone else. .

Here is a timeline of what followed:

October 2007: Burning on urinating, frequent uriniating, leading to severe epididymitis. Got treatment for the epididymitis of 200mg doxycyycline on day one, folowed by 100mg a day for 6 days. I.e 1 week total. Epididymitis went away, but still had burning sensation on urinating and now a little discharge, not much though. -ve for chalmydia.
My girlfiend had tests, swabs taken showed -ve for chlamydia, plus a high vaginal swab taken which revealed no infection. Had another course of antibiotics, doxycycline again, 200mg a day for a week, then another of cipro for 5 days. Finall was clear of any symptoms by begining of november 2007.

November 2007:starteed to burn again on peeing, urine would drip out of me when I finished peeing.

December 2007, After masturbating, I noticed my semen was extremely sticky. Like mucus. I would also have a lot of clear sticky fluid dripping out of him afterwards. So I saw the doctor again. He checked my prostate, and said it was inflamed, but looked at my urine in a microscope, no wbcs, rbcs or bactera. He gave me doxy again 200mg day one followed by 100mg for 6 days, And also cernilton capsules which I have had to take for 30 days, 4 a day. After taking the doxycycline, I had an increase in this discharge, and frequency, although I think this might have been pyschologic.

January 2008: Symptoms not relieved so I went back and they cultured my urine, no infection present. problem is, It still sometimes burns when I pee and have lots of discharge after ejaculation.

Could this all be from gonnorhea, or can I rule this out cos the urine culture was negative?

Could I have anything I could pass on to my girlfriend?

Are my symptoms consistent with non bacterial prostatitis?

Thanks a lot.

Jeff

[Edward W Hook, MD]

Depends on the test.  If the swabs were used in a PCR type test, they would be find.  If it was culture, the cervical specimen is preferred.  EWH

[dannz]

Ok thanks for clearing all this up. Jus one last thing which is still bugging me, if she had the High vagina swabs taken and cultured, these will show gonorrhea? or would she need to have a swab taken from the cervix?

Thanks

[Edward W Hook, MD]

None of the additional information you have provided changes my feeling that what you are dealing with is not an STD.  Gonorrhea is almost never a cause of prostatitis (people used to believe this but we now know this is no longer the case).  You and our GF were both treated and STD is not contributing to your current problem.  you are not infected with chlamydia or gonorrhea..  

BTW, high vaginal swabs are a location not a test.  

Finally, trying to link all these circumstances may not be appropriate.  Work with your doctor to get this sorted out and dealt with.  EWH

[Edward W Hook, MD]

None of the additional information you have provided changes my feeling that what you are dealing with is not an STD.  Gonorrhea is almost never a cause of prostatitis (people used to believe this but we now know this is no longer the case).  You and our GF were both treated and STD is not contributing to your current problem.  you are not infected with chlamydia or gonorrhea..  

BTW, high vaginal swabs are a location not a test.  

Finally, trying to link all these circumstances may not be appropriate.  Work with your doctor to get this sorted out and dealt with.  EWH

[dannz]

Thanks for the reply.

Maybe should have made it clearer. The doctor looked at my urine in the microscope the first time, and said there were bacteria and wbcs in it.

I think my doctor only tested chlamydia, because on the results paper I got it just said: chlamydia, negative. My girlfriend got tested when I first told her about my epididymitis. She went to a womans clinic, and the doctor did a high vaginal swab and cultured from it, came back saying there was no infection. She had mild bleeding between periods and brown discharge just after Christmas and went back again. The doctor did another HVS test to check to see it wasn't caused by any bacteria, I assume to rule out PID. It was then that she looked at her pill packet and realise she had forgot to take it for 4 days.

I thought the HVS just tests for any bcteria present, not a specific one, so is it then safe to assume no gonnorhea from these results? She was given 1g azinthromycin to be on the safe side the first time. We've used condoms since October, apart from once last week.

I was more thinking maybe the gonnorhea bacteria moved up to my prostate and is now causing my mucus-like semen, and the subsequent discharge after ejaculation. Is it much more likely my initial infection was caused by another bacteria like e.coli whch then moved to the epididymus then on to the prostate? From what I've been reading, it seems this could be just as likely, but you know how it is, get the worst case in your head and that's what it has to be, no matter how illogical.

As for the symptoms, like you said, main one is burning. I have had a few days where I have needd to go about 8 times, but nothing to abnormal there, and I did have a very small amount of clear discharge a few times, but not for ages, that was back in october.

So do you think given the amount of antibiotics I've aken and my girlfiend's negative cultures, I can assume neither of us are infected with anything?

Thanks again

[Edward W Hook, MD]

As I read your post, one thing I note is that there has never been a positive culture or test fro any bacteria.  At this time, unless this is an oversimplification,  your symptoms can be summarized primarily as continued burning on urination and unusual characteristics to your ejaculate, sometimes in terms of viscosity and most recently in terms of volume.  

First your questions, then some additional thoughts.

Regarding could this be gonorrhea.  VERY unlikely.  Your symptoms don't fit and at this time when a person is tested for chlamydia, they are also typically tested for gonorrhea as well, Finally, between all of the doxycycline and the ciprofloxacin you've taken, those antibiotics would have taken care of most gonorrhea as well.

Regarding your girlfriend's risk. It was not clear from reading your post if she has been treated or not.  It is important t he you both were treated at the same time, without having sex until you were both finished your antibiotics, at least once.  If you have done that, she should not be at risk.

Finally, some thoughts. First, following STDs some patients do have persistent burning on urination.  This usually passes with time.  Secondly, there is no STD that typically changes the quantity or quality of ejaculate.  Putting all of this together, my guess is that you do not have an STD unless there is some part of the history that I've gotten wrong.  I think you need to work with your urologist to get this sorted out but STDs do not have to be part of the consideration.  EWH