prostatitis/std. worried

[recpr]

Hello Drs. Early May of this year I had unp oral to a Tran escort. He also teased his penis on my anal a.  1 week later I have sex w/ wife.  About 2.5 weeks after-redish testicles, warm and somewhat tender.  NO discharge, but discomfort AFTER urination, perenial itch, genitals smell, anal itch?.  
depressed anxious, lump in throat. Get freq urination for 2 days(anxiety?).  3 weeks from exposure- test @ STD clinic for G/C(urine NAAT), BUT I had started taking Amoxicilin for strep. Tests- Neg.   Go to Dr. the day after i'm done with amox, tested G/C..(Res=NEG) Get 1g of ceftriaxone IM and 1.5g zithromx 500mg/3days. sympt go away. @that point(6/4) wife(asymptomatic) gets same treatment.  
-5.5 weeks go by(no sex) feeling fine except anal feels weird. Around 7/14 finally have sex w/wife.
~ 3-3.5 weeks later,start feeling same testicular pain.  I thought exercise?(lots of dumbbell swings).  pain got worse, urethral discomfort AFTER urinat. Symptoms return gradually.  went to Dr. and this time w/out being on antibiotics NAAT tested for G/C,trich, HIV, syph (had herpes hsv2 from my wife).
Quick in-clinic urinalysis showed sterile urine, no WBC.  The Dr. doesn't think it's STD, thinks it's prostatitis. Thus, Levaquin 400mg/ 10 days.. nothing.
Reslts =NEG.  I then think mycop g, ureaplasma, etc.  So day after done w/Levaq, I go back, give urine sample and get tested for MP, UP, candida, MHom, etc.  all =NEG
From then to now I’ve been on Avelox(400mg/ for a total of 4 weeks) w/ only until now seeing min. improvement.  Urologist did DRE=soft and bit boggy.  Cystoscopy=inflamed prost. CATscan..ok
Wife took 10Avelox. Still have inflamed testes, general pain, very little discomfort after urination, yellowish semen, poking/itchy anus feeling, but no more lowr back pain. Standing aggravates and laying down/sitting eases pain.  Ur and Dr. said stop AB and both of us return 3wks for tests.
What could it be?

[Edward W Hook, MD]

There is no realistic possiblity that your wife's joint problems are DGI. Please address your own guilt directly.  STIs related to the concerns you have described are not relevant to your or your wife's difficulties.  EWH

[recpr]

Hello Doctors.
I wanted to reply as a follow-up.  Basically right after the last post I stopped taking Avelox, waited 3 weeks and got NAAT PCR tested for Gon, Chlam, Trich, Mycoplasmases, Ureas, Candidas, and even blood work for Hep A, B, C.  everything Negative.  I had also taken my wife to the dr. but he didn't want to test her because she didn't have symptoms.  Within the following weeks up until now I also got a testicular ultrasound that showed no evidence of orthrital-epiditimytis, but 3 small little cysts on the left epiditimis(the left epititimis is the one that would mainly hurt), of which my urologist said is common and nothing to be concerned about.  I also got a semen analysis and culture, of which all came back normal, no growth.  Only thing odd was a 60> min. liquefaction time for the semen.

All of that is fine, the pain has gone away extremely gradually.  However, my wife has still been experiencing knee discomfort(on both knees). More on the interior/exterior side of the knee. If I touch it, it hurts sometimes.  Not red/swollen and doesn't impede her movement.It hasn't gotten worse, but kind of lingers.  Some days she feels fine, some days it hurts some.
What really got me scared once more is that on Sep.30, she had gotten Bactrim for a possible throat infection, and 4 days into it she experienced itching on her face, back of scalp with no rash, AS well as a bad flare up of her knees that DID make it difficult for her to walk. It went away the next day or two.  Just about 2 weeks ago she started itching all over and got what she says were hives on her upper torso, legs(knee area included), and stomach area.  They went away but the itching continued, with no rash. It would flare up badly at night and keep her up. I noticed her forearms became slightly bumpy(so subtle I could only see it at an angle) and now smoothed out.  She's on Prednizone and has no itching, but I'm worried now for some reason about DGI.  In fact, just this weekend I experienced some mild migrating joint discomfort(hand, then rear ankle) and yesterday I felt sore throat and achyness(cold probably), but my right interior are of knee started hurting very midly, and if I apply mild pressure it kind of hurts a bit.  Please give me your thoughts.  After all this time, could DGI be a possibility for her?   I never had a rectal swab for Gon.(only unprotected penile teasing) and am worried infected pre-ejaculate got in??? Thank you.

[Edward W Hook, MD]

You need to discuss this with a urologist.  Prostatitis can be caused by a variety of bacteria. Virtually no are STIs however.  there is also a difference between a UTI and prostatitis. EWH

[recpr]

Sorry, so, could my prostatitis be bacterial(warmth, redness and pain in testicles that seems to alternate teste)? and if so, would I be infectious to my wife?
What kind of bacteria could it be?  Thank you.

[Edward W Hook, MD]

I hope my comments have helped. Take care. EWH

[recpr]

thank you very much for your assessment. it does ease my mind. I do want to be positive,  but hate uncertainty and like to know 100%. I have been completely emotionally destroyed by this and want it to end, and have my wife safe.  thank you.

[Edward W Hook, MD]

None of this additonal information change my assessment of advice.  If you had an STI there would have been positve tests at some point along the course.  You apparently do not want to believe your urologist or me- I can't  help that.  EWH

[recpr]

Thank you for the reply. I still have some questions though.  What about the validity of the first 2 std tests? I was on amoxicilin for the first one and had just finished 7days worth when I took the second test.

Also, the timing of sex and symptoms are just right. How could I have gone 5.5 weeks w/out any symptoms, and then 2.5 weeks after I resume sex w/ wife I feel symptoms?

Also, if, let's say, Gonorrhea, was in my prostate, would the latest urine NAAT test I got(off ABs) have detected it?

-What about the red-ish, warm and sometimes slight tenderness in the testicles(epiditimytis?), not to mention the yellow semen? does that not indicate STD infection?

My wife this whole time hasn't had any symptoms except some sudden lower back and knee pain/shocks of pain that went away. (reactive arthritis??) What is the best method for STD testing for women? are urine NAATs good enough to detect std for them? or should she have vaginal or endocervical swab?

-I fear my wife or I have a resistant Gonorrhea and she will never be cured.  I know from this site that it is believed G/C don't really infect prostate, but, what else could this be?

Before all of this, I went to Dr. because of bowel movement issue and PSA was normal, and food and other allergy tests were completely non-reactive.

I'm not sure if this is relevant, but, for the last few years now I've experienced a gradual issue having bowel movements.  I end up having to 'push' and strain alot because I feel i'm not done defecating.  I have to rock back and forth a bit, massage abdominal area, and flex the rectal muscles?  (Urologist told me that could affect prostate)  It's gotten worse and even noticed mucus-ish stool.  When straining I force my bladder too and it makes drips of urine come out.  

Once again, thank you SO much.

[Edward W Hook, MD]

Welcome to our Forum.  Thanks for shortening your post.  The symptoms you describe do not cause me any concern regarding the possibility of any STI.  Your symptoms- urinary frequency, discomfort after urination, etc.- are not suggestive of STI.  Similarly your tests for STI microorganisms have been negative and despite that the treatments you have had (ceftriaxone, azithromycin, levaquin and now moxifloxacin would have cured most bacterial STIs, you have not responded, thereby helping to establish that these are not due to an STI/.   Finally, what is described- both your symptoms and the boggy prostate that your doctor has noticed are consistent with prostatitis, not STI.  I agree with what you doctors have said.  If the treatment does not work, you may need a longer course of medication – sometimes it take a month or more of therapy to resolve prostatitis.  .

At this time I would urge you not to worry further about STI and to work with your doctors to address what may be prostatitis.  I hope this comment helps. EWH