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Urology (Expert Forum)
Reoccuring Urethritis
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Reoccuring Urethritis
by suchapain, Jan 11, 2005 12:00AM
In Jan 04 I had unprotected sex with a short-term girlfriend. Approximately 10 days later I experienced yellowish puslike discharge from my penis and a strange discomfort in the pubic region and testes.
Upon researching various medical sites I came to my non-medical opinion that I had Ghonnorhea or Clamadia. I went to my doctor and was examined by the onsite nurse who incorrectly stated that I must have one or both of the aforemetioned STD's. I was perscribed an antibiotic and sent on my way.
The meds worked until I stopped taking them and the symptoms returned. I then went to the local ER, was examined, given a shot in the hip and more antibiotics (sorry, don't recall what) which finally ended all symptoms around Feb 04.
Fast forward to Sep 04 and I have unprotected sex with my fiancee. Approximately 10 days later I show the same signs as mentioned above. This time I go to the ER and have a culture done which tests negative for Ghonnorhea or Clamadia. I recieve a shot, antibiotics - it's gone. My fiancee also gets tested for the same with no positive result. The only observation my fiancee's doctor noted was a rough vaginal wall (like bacterial vaginosis?) and thush she was given an antibiotic.
Now to Christmas holidays, my fiancee and I again have unprotected sex - assuming we have been cured of any bacterial nusiance. Before any symptoms show up (I had a sneaking suspicion they would) I consulted with my MD, who referred me to an infectious disease specialist. The specialist heard my story and highlighted ureaplasma or mycoplasma as possible culprits and asked me to return if I start to show symptoms.
10 days later, very similar symptoms (discharge is not as yellow-like, more clear) appeared. The specialist gave me an antibiotic (two large diamond shaped pills only) took a culture, and had blood drawn for herpes.
I just recieved the results of the culture -- negative for ghonorrhea and clamadia?? This is an issue to work out with the specialist - why I was tested for that again if NGU's were suspect!
At any rate here's what I need some help/assurances on:
1. Is a specialized test/culture required to detect NGU's such as ureaplasma?
2. If my symptoms are gone with most antibiotic treatment, how could herpes (a virus) be the cause?
3. Symptoms only occur after sexual contact - it is assumed that it is sexually transmitted and my fiancee is infected.
4. Could she have a non-threating vaginal / oral bacteria which I am being infected by due to different body chimestry?
5. Could this bacteria remain in my fiancee, non symptomatic, and potentially impact her fertility?
6. Now that my symptoms are gone and the bacteria is destroyed, will I not know what this is until I can be cultured again? (hence, showing symptoms) Is there a specific test that my fiancee should get?
I am most concerned about my fiancee and her health but want to know what this is before sending her to be tested again.
Upon researching various medical sites I came to my non-medical opinion that I had Ghonnorhea or Clamadia. I went to my doctor and was examined by the onsite nurse who incorrectly stated that I must have one or both of the aforemetioned STD's. I was perscribed an antibiotic and sent on my way.
The meds worked until I stopped taking them and the symptoms returned. I then went to the local ER, was examined, given a shot in the hip and more antibiotics (sorry, don't recall what) which finally ended all symptoms around Feb 04.
Fast forward to Sep 04 and I have unprotected sex with my fiancee. Approximately 10 days later I show the same signs as mentioned above. This time I go to the ER and have a culture done which tests negative for Ghonnorhea or Clamadia. I recieve a shot, antibiotics - it's gone. My fiancee also gets tested for the same with no positive result. The only observation my fiancee's doctor noted was a rough vaginal wall (like bacterial vaginosis?) and thush she was given an antibiotic.
Now to Christmas holidays, my fiancee and I again have unprotected sex - assuming we have been cured of any bacterial nusiance. Before any symptoms show up (I had a sneaking suspicion they would) I consulted with my MD, who referred me to an infectious disease specialist. The specialist heard my story and highlighted ureaplasma or mycoplasma as possible culprits and asked me to return if I start to show symptoms.
10 days later, very similar symptoms (discharge is not as yellow-like, more clear) appeared. The specialist gave me an antibiotic (two large diamond shaped pills only) took a culture, and had blood drawn for herpes.
I just recieved the results of the culture -- negative for ghonorrhea and clamadia?? This is an issue to work out with the specialist - why I was tested for that again if NGU's were suspect!
At any rate here's what I need some help/assurances on:
1. Is a specialized test/culture required to detect NGU's such as ureaplasma?
2. If my symptoms are gone with most antibiotic treatment, how could herpes (a virus) be the cause?
3. Symptoms only occur after sexual contact - it is assumed that it is sexually transmitted and my fiancee is infected.
4. Could she have a non-threating vaginal / oral bacteria which I am being infected by due to different body chimestry?
5. Could this bacteria remain in my fiancee, non symptomatic, and potentially impact her fertility?
6. Now that my symptoms are gone and the bacteria is destroyed, will I not know what this is until I can be cultured again? (hence, showing symptoms) Is there a specific test that my fiancee should get?
I am most concerned about my fiancee and her health but want to know what this is before sending her to be tested again.
Doctor's Answer
by Kevin Pho, MD, Jan 12, 2005 12:00AM
, Jan 12, 2005 12:00AM
To answer your questions:
1) You can consider more specialized testing for ureaplasma and mycoplasma - which can be done via culture or nucleic acid amplification tests.
2) Antibiotics typically won't cover herpes - antivirals would be needed. A viral culture or blood tests for herpes can be considered.
3) Your fiancee certainly would be at higher risk - the only way to be sure is for her to be tested.
4) I'm not sure what "non-threatening bacteria" is - but it may be possible that she can pass on any bacteria to you without protection.
5) Depends on the organism. Things like chronic pelvic inflammatory disease can lead to infertility.
6) If the bacteria is gone, it would be difficult to say what exactly caused your symptoms.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
1) You can consider more specialized testing for ureaplasma and mycoplasma - which can be done via culture or nucleic acid amplification tests.
2) Antibiotics typically won't cover herpes - antivirals would be needed. A viral culture or blood tests for herpes can be considered.
3) Your fiancee certainly would be at higher risk - the only way to be sure is for her to be tested.
4) I'm not sure what "non-threatening bacteria" is - but it may be possible that she can pass on any bacteria to you without protection.
5) Depends on the organism. Things like chronic pelvic inflammatory disease can lead to infertility.
6) If the bacteria is gone, it would be difficult to say what exactly caused your symptoms.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Member Comments (1)
by suchapain, Jan 11, 2005 12:00AM
To: Urinary Tract Infections
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