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penis/urethra irritation
Hi DR,
Im 29, male, and in a bind. Like many who come here, I am anxious:
on DEC26, I had an oral (unprotected give/receive) with another male (transexual).
3-4 days later, i feel general anxiety over this, and start to freak out, but since ive been over this before, i assume the "symptoms" if anything, will actually show up soon. Ive been anxious
25 days after possible exposure i got tested for syphilis, chlamydia, gonorrhea urine/throat). all negatives. no HIV testing done. (if I test negative for these big ones, what else can i pick up out there? HSV-1/2 and...?)
today (since a week or so ago), my "symptoms" include the feeling of irritation at the opening of the penis/urethra, but when i check under a light, i see a small red spot on one side (dont know, but I feel this might be 'normal'), but only if i open up the head quite a bit. i have avoided touching it, so as not to get anxious about this and see things which always been there. If I stand up, the symptom goes away. I can touch the penis, squeeze it, no pain, no discomfort. I do feel like i gotta pee but if i do, i do it, no pain/burning while urinating. i believe i have complained in the past about this, and got chastised by nurses poking me with penicillin and giving me 10 days of antibio pills. tests came neg.
i masturbate a LOT for long periods of time. today i stopped all penis contact in case is just me roughening it up. If i masturbate, the "ring" around the urethra feels irritated more.
I have an appnt with my doc two days from now for a physical, and will bring this to her attention, and to ask for a full sexual health test as part of my physical.
i do not intend to place myself in similar situations in the future, and would like to engage in sex with a particular lady, but i want to KNOW as close to 100% that I am clean (or not), and will not give her *anything* that has a stigma of being sexually transmitted. I want to show her my test results for everything possible.
concern is STD.
Im 29, male, and in a bind. Like many who come here, I am anxious:
on DEC26, I had an oral (unprotected give/receive) with another male (transexual).
3-4 days later, i feel general anxiety over this, and start to freak out, but since ive been over this before, i assume the "symptoms" if anything, will actually show up soon. Ive been anxious
25 days after possible exposure i got tested for syphilis, chlamydia, gonorrhea urine/throat). all negatives. no HIV testing done. (if I test negative for these big ones, what else can i pick up out there? HSV-1/2 and...?)
today (since a week or so ago), my "symptoms" include the feeling of irritation at the opening of the penis/urethra, but when i check under a light, i see a small red spot on one side (dont know, but I feel this might be 'normal'), but only if i open up the head quite a bit. i have avoided touching it, so as not to get anxious about this and see things which always been there. If I stand up, the symptom goes away. I can touch the penis, squeeze it, no pain, no discomfort. I do feel like i gotta pee but if i do, i do it, no pain/burning while urinating. i believe i have complained in the past about this, and got chastised by nurses poking me with penicillin and giving me 10 days of antibio pills. tests came neg.
i masturbate a LOT for long periods of time. today i stopped all penis contact in case is just me roughening it up. If i masturbate, the "ring" around the urethra feels irritated more.
I have an appnt with my doc two days from now for a physical, and will bring this to her attention, and to ask for a full sexual health test as part of my physical.
i do not intend to place myself in similar situations in the future, and would like to engage in sex with a particular lady, but i want to KNOW as close to 100% that I am clean (or not), and will not give her *anything* that has a stigma of being sexually transmitted. I want to show her my test results for everything possible.
concern is STD.
MEDICAL PROFESSIONAL
Your symptoms almost certainly are not due to NGU. But you ask a good question, and it has been some time since Dr. Hook or I summarized the basic knowledge about it. So here goes.
Nongonococal urethritis is exactly what the name itself means: urethritis (inflammation of the urine passage) not due to gonorrhea (the gonococcus). There are many causes; chlamydia is the most commoon but accounts for only about one third of cases; Mycoplasma genitalium causes 10-20%; trichomonas, herpes, and adenovirus account for 1-5%; and there is controversy about the possible role of Ureaplasma. With currently available technologies, the cause cannot be determined in 30-40%, even with sophisticated, research lab testing. Some cases may be due to entirely normal bacteria from a partner's mouth or genital tract, and some might not be due to infection at all -- e.g., an unexplained immunologic reaction in the urethra. In other words, NGU generally is an STD. However, because of the possibility of normal bacteria or a non-infectious cause, NGU sometimes appears in men not otherwise at risk for STD, e.g. in a mutually monogamous relationship.
Testing usually is not available for any of the known causes except chlamydia (and gonorrhea to make sure urethritis is NGU and not gonorrhea). Because the cause is varied and usually unknown, the diagnosis of NGU depends on physical examination plus tests to look for inflammation in the urethra, such as urinalysis to find abnormal levels of white blood cells.
Another important aspect is that except for cases caused by chlamydia or perhaps M. genitalium, NGU appears to be a harmless condition. It is not known to be associated with any long term serious outcomes -- no urethral stricture, no infertility, no epididymitis, no health problem in sex partners. And most cases probably clear up on their own without treatment. So it definitely isn't anything to worry about. It should generally be looked on as an inconvenience -- if the chlamydia test is negative, NGU is not nearly as big a deal as most other STDs.
NGU rarely causes the sort of symptom you describe. The primary symptom is discharge, not discomfort or pain without discharge. If you aren't seeing abnormal dripping of pus or mucus from the penis (sometimes most obvious early in the morning, before urinating), it's pretty sure you don't have it. If the health care provider you saw for your STD testing did not observe abnormal discharge, and especially if s/he did a test for inflammation (like a urinalysis) and it was normal, then NGU isn't an issue. If you haven't had such an examination, that's what's needed to rule it out.
In summary, do not get your hopes up for a physcial explanation of your symptoms. My reply above (the next to last paragraph) still applies. You might also search online about "chronic pelvic pain syndrome"; the Wikipedia article is especially good. It's a largely anxiety-driven condition that once was considered a form of prostatitis. You might find the description is consistent with many of your symptoms.
That will have to end this thread. Don't worry about this; almost certainly there is nothing that has any chance of ever harming you or a partner.
Nongonococal urethritis is exactly what the name itself means: urethritis (inflammation of the urine passage) not due to gonorrhea (the gonococcus). There are many causes; chlamydia is the most commoon but accounts for only about one third of cases; Mycoplasma genitalium causes 10-20%; trichomonas, herpes, and adenovirus account for 1-5%; and there is controversy about the possible role of Ureaplasma. With currently available technologies, the cause cannot be determined in 30-40%, even with sophisticated, research lab testing. Some cases may be due to entirely normal bacteria from a partner's mouth or genital tract, and some might not be due to infection at all -- e.g., an unexplained immunologic reaction in the urethra. In other words, NGU generally is an STD. However, because of the possibility of normal bacteria or a non-infectious cause, NGU sometimes appears in men not otherwise at risk for STD, e.g. in a mutually monogamous relationship.
Testing usually is not available for any of the known causes except chlamydia (and gonorrhea to make sure urethritis is NGU and not gonorrhea). Because the cause is varied and usually unknown, the diagnosis of NGU depends on physical examination plus tests to look for inflammation in the urethra, such as urinalysis to find abnormal levels of white blood cells.
Another important aspect is that except for cases caused by chlamydia or perhaps M. genitalium, NGU appears to be a harmless condition. It is not known to be associated with any long term serious outcomes -- no urethral stricture, no infertility, no epididymitis, no health problem in sex partners. And most cases probably clear up on their own without treatment. So it definitely isn't anything to worry about. It should generally be looked on as an inconvenience -- if the chlamydia test is negative, NGU is not nearly as big a deal as most other STDs.
NGU rarely causes the sort of symptom you describe. The primary symptom is discharge, not discomfort or pain without discharge. If you aren't seeing abnormal dripping of pus or mucus from the penis (sometimes most obvious early in the morning, before urinating), it's pretty sure you don't have it. If the health care provider you saw for your STD testing did not observe abnormal discharge, and especially if s/he did a test for inflammation (like a urinalysis) and it was normal, then NGU isn't an issue. If you haven't had such an examination, that's what's needed to rule it out.
In summary, do not get your hopes up for a physcial explanation of your symptoms. My reply above (the next to last paragraph) still applies. You might also search online about "chronic pelvic pain syndrome"; the Wikipedia article is especially good. It's a largely anxiety-driven condition that once was considered a form of prostatitis. You might find the description is consistent with many of your symptoms.
That will have to end this thread. Don't worry about this; almost certainly there is nothing that has any chance of ever harming you or a partner.
Thanks. I just got my results back. They were negative. I do have a concern that I have something there. If not from now, from the past, though a girl I dated has never had anything bothering her as a result of me. What is NGU? I think is about the only thing I have not gotten tested for. Is this worthwhile to persue? would a "urine amplified probe technique" pick it up? As of now, I am neg for syphillis, chlamydia, gonorrhea, and very much likely HIV (I got a verbal negative from the doc). Is there any STD i am not paying attention or not getting tested for? I am about 99% sure is not herpes because it persists and is annoying. I am lost as to what should I do from now on. Is it possible that I am ignoring it too much to the point that I am not seeing another symptom (for example, too little discharge, too tight pants make me pee often, etc.. etc..) I want to rule out all STDs... that is my goal.
MEDICAL PROFESSIONAL
I have no way of judging the likelihood that your transsexual partner had an STD, in particular an oral infection that could contribute to your penile symtoms. However, In general oral sex is safe sex; not perfectly so, but much less likely that vaginal or anal sex to result in STD transmission. The risk is especially low for the penile partner exposed to another person's mouth.
Your symptoms are not typical for any STD. As you seem to understand, I'm not sure they are abnormal at all -- your obvious anxiety and stress might just be making you more aware of normal body sensations. Your self-described irritation from vigorous masturbation probably is contributing as well.
In any case, the negative STDS test results are reliable for some infections (gonorrhea, chlamydia) and probably so for others (it was a little early for syphilis but that is extremely unlikely. Based on the nature of your exposure and your symptoms, I do not recommend testing for herpes or any other STD. But HIV testing makes sense -- not because of this exposure, but because every non-monogamous sexually active person should have an HIV test from time to time, like once a year.
I hope this helps. Best wishes--- HHH, MD
Your symptoms are not typical for any STD. As you seem to understand, I'm not sure they are abnormal at all -- your obvious anxiety and stress might just be making you more aware of normal body sensations. Your self-described irritation from vigorous masturbation probably is contributing as well.
In any case, the negative STDS test results are reliable for some infections (gonorrhea, chlamydia) and probably so for others (it was a little early for syphilis but that is extremely unlikely. Based on the nature of your exposure and your symptoms, I do not recommend testing for herpes or any other STD. But HIV testing makes sense -- not because of this exposure, but because every non-monogamous sexually active person should have an HIV test from time to time, like once a year.
I hope this helps. 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.
