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Avatar universal

Had unprotected oral, now experiencing itching and discharge, what is it??

I’m a 37 year old male and received unprotected oral sex from a female (escort) almost a week ago. 48 hours after contact I noticed itching/burning sensation when finishing urinating. That same night I noticed some white discharge (small amount). The next day (60 hours after encounter) I had urine tested at quest diagnostics for Gonorrhea and Chlamydia. It took a few days for results but both came back negative.

I’m now six days after the initial encounter and trying to figure out what to do next. Itching/burning has been consistent but discharge has been more clear than white the last couple days. Symptoms are mild but definitely something not right down there, and my only real concern is not passing anything on to my significant other.

Looking for any relevant advice but specifically would like to know 1. Was my test at T+ 60 hours long enough to give reliable results for Gonorrhea and Chlamydia, 2. Was there something else I should have been tested for and 3. What is my next step?
19 Responses
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Avatar universal
Jbob, any updates? Your symptoms are very similar to mine. Hope you're alright!
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Avatar universal
Thanks for all the recent responses.

The Urologist I saw the other day declined a prostate exam because he said prostatis is very rare and highly unlikely at my age, so I guess that’s that.

He did do a swab test for mycoplasma genitalium (at my request) which of course came back negative.

So I’m Week 1 I had a noticeable discharge and high WBC in my urine, but 10 weeks later I no longer seem to have any abnormalities that can be measured on standard testing, so I basically feel I’m at a dead-end medically.

My next step was going to be to try and find a better rated urologist to book an appointment, but after seeing a total of 5 doctors I’m probably just wasting money and time going to a sixth.

So at this point I’m basically left with this lingering lower pelvic pressure which is tough to localize (but has admittedly gotten a little better in the past week), plus the intermittent discomfort in my urethra/penis, which depending on the time of day takes the form of either scratchy-ness (like there’s sand or something in there), and/or not feeling completely empty after urination, and/or just general pressure or mild soreness.

The only positive I can say is that my symptoms are milder today than they were 5 weeks ago, and my symptoms 5 weeks ago were milder than they were 10 weeks ago, so the trend seems to be getting better, just on a very long timeframe. So I think my best course of action at this point is to just wait it out and hope it eventually resolves fully in another month or two (anyone who’s had these type of symptoms clear up on their own after a few months please let me know since it would make me feel better).

This is probably my last post here unless something significant changes - part of my reason for the public posting was to try to help others find a resolution, but I’m left with no more answers than when this all started...
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Avatar universal
I should also add the after ejeculation, which they say to do to help cure prostatitis I experienced quite a bit of anal area pain
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Avatar universal
Having had Prostaitits personally my symptoms were frequent urination, anal discomfort when passing stools. Pain between the scrotum and anus lasting hours after passing stools, and a notable dribble after completing urination and a feeling of never being fully empty after urination. I also had WBC in my urine.  I never really experienced any abdominal pain. But my penis was sore but I was also battling balantis from all the antibiotics I took to cure the prostate infection. Could you also be having focused anezoty that’s causing you issues?
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207091 tn?1337709493
COMMUNITY LEADER
I was thinking prostatitis the whole time I was reading your post. Ask your doctor for a prostate exam. Also ask about an anal fissure, though it sounds more like prostatitis.

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Avatar universal
Hmm it is a rather complicated case right here.

A DRE should be conducted to check for prostatitis.

Perhaps consider a culture of prostatic fluid

I am sure u have ruled out bacteria causes : Chlamydia, Gonorrhea, NSU organisms such as Ureaplasma and Mycoplasma.

Urinary Tract Infections (UTIs) such as E. Coli, Klebsiella can also cause Prostatitis.

Tuberculosis is a rare cause of Prostatitis.

Non-Infectious causes of Prostatitis include Chronic Prostatic Pain Syndrome and Abacterial Prostatitis.

What u need to do now is determine whether u have prostatitis first. Then move on from there.
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Avatar universal
Still no answers for me here, I’ve been dealing with symptoms for about 10 weeks now...

The urge to urinate frequently has almost completely subsided in the past 1-2 weeks which I guess is a good thing, but the itchy/soreness in urethra post-urination is still there, though not as bad as it’s been in the past

The new big symptom that’s developed for me is a near constant soreness/pressure in my lower abdomen and near base of penis...it feels exactly like intestinal pain only it’s lasted for over a week. It seems to maybe get worse after urinating but I can’t say for sure. But it definitely seems to get worse for about 12-24 after ejaculating, which I tried twice in the past week.

So anyway, I did a urine culture the other day through Request a test (Quest Diagnostics) which came back negative for anything. My last test at a doctor showed no white blood cells so whatever it is no longer seems to be testable via urine.

I have an appointment with another Urologist tomorrow, any suggestions on what to ask or where to try and steer the conversation?

Would I be correct that Prostatis is a likely explanation at this point? I think I read somewhere that it can be triggered by a bacterial infection, even if the bacteria is gone.

For that matter, was the negative urine culture even conclusive that there is no bacteria, or could the bacteria be hiding somewhere?

I feel as though I’m never going to get rid of this if I can’t figure out what it is. Any suggestions would be appreciated...
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Avatar universal
Posting another update...I’m kinda past the point of expecting any actionable advice from anyone but still curious to hear any thoughts, if nothing else than for moral support.

I went to see new primary care provider today. Urine dip was completely negative, even for elevated WBC. Additional culture was not recommended because lack of WBC means there would be nothing to culture. I’m being referred to a(nother) urologist.

I’m exactly 8 weeks from point of infection, 7 weeks from start of treatment and now 2 weeks since the last time I took antiobiotics. I feel as though I’m having fewer days per week with “bad” symptoms than I was say 5 weeks ago, but on any given day I’m still feeling heightened awareness of need to urinate, and mild burning/soreness/itchiness after urinating. On “bad” days I feel a constant need to urinate that can last 6-8 hours and is not relieved even after going. Maybe a few more symptoms down there as well (lower abdomen soreness, for example) but that’s so vague that it’s hard to attribute to anything.

I’m sure this is a medically naive statement but it feels like the 34 days of straight antibiotics partially killed this, but didn’t completely kill it.

As anyone knows who’s dealt with this, the symptoms themselves are really quite mild in the grand scheme of things (a paper cut “hurts” more in an absolute way). But the stress and frustration of not knowing what this is, and not being able to carry on normal relationships out of fear of spreading something is really what makes this so bad.

The high WBC count during my first exam in week one (and again in week two) is the only test result I’ve had that shows anything abnormal at all, so on top of everything now I’m reaching a point where providers might be thinking this is in my head...
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2 Comments
Hey just reading your update, this is my suggestion. And I only say this because I feel your frustration. Take one more MG test, but you HAVE to be off of antibiotics for at least 3 weeks, if no doctor will take you seriously do what I did and take the mylabbox test for it. It’s pretty cheap considering it’s your health, and if it’s false after bing off of antibiotics then I would trust it otherwise my vote is still for MG. What you describe sounds like my symptoms.
Doctors will tell you “MG can’t be passed on orally” and then the same doctors will also tell you that they don’t have much research on it. So maybe it can and they just don’t actually have a clue.
All of this is just my two cents take it for what it’s worth bro and good luck
Thanks for the feedback, and yeah that’s something I was considering doing myself, I’ll probably try that in a week or so.
Avatar universal
Thanks, my visit to the Urologist yesterday was essentially worthless, he told me we should just monitor it and see what happens since antibiotics aren’t working. I talked him into giving me Levofloxican to see if that might help, since I’ve read here that worked for others.

I purchased an online test for M Genitalium (urine test) and will be going to Labcorp this afternoon to have that done, we’ll see what it comes back with I guess.

I’d be curious to hear what “type” of doctors people here have had success with. In my experience so far the clinics seem to be way more knowledgeable than the specialty doctor I saw (he claimed M Genitalium is untestable which is contradicted by a simple Google search).

So I guess my next steps are M.P. test today, start Levofloxican after that, see where I am in another week.  So frustrating...

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2 Comments
Hey, just curious how this whole thing is going? I am also going through a similar ordeal ( I have 2 confirmed tests of mycoplasma genitalium though. I've taken all available drugs in the US so far to no avail. I'm actually currently doing another longer treatment with tetracyclines to see if that works. I agree with Khal about the Mycoplasma Genitalium testing you definitely need to see if that is what it is. A word of caution, it can be a tricky ******* to find, if you've taken any antibiotics I suggest being off of them for at least 2 weeks because false negatives are all too common (trust me I had 2 negatives one while on antibiotics) MY other suggestion and Im sure any doctor you go to would suggest the same is to make sure its a first void urine sample (so first thing in the morning).
Really hope you're getting your issues resolved! Good luck, you can always DM if you need anyone to talk to about it! Good luck.
Thanks for the reply. Your message is timely...the short answer is I’m not much further along, they did a urine culture last week that came back negative, but I had only been off of antibiotics for 4 days at the time.  Having another one this Friday which will be about 2 weeks post-antibiotics, so we’ll see how that goes.

I’ve had symptoms now for about 6 weeks, though I’d say the past 2 weeks have been somewhat less in intensity, frequency, duration, etc. I’m not sure if that means the antibiotics worked partially. So I guess another few days before any new updates...
Avatar universal
Hi JBob, I understand your pain. After reading your story It reminds of me when i was going from doctor to doctor to find out what i have have been infected with. From what you describe i thing it is M Genitalium and you should get NAAT test to find out if you really have that infection. I have been infected with resistance M genetalium for about 4 months. I have taken moxifloxin and pristimycin however they were not helpful to get rid of this infection. Finally I have been given doxycyline 100mg twice a day for 6 weeks. After finishing the course last week i got back a negative result today. I would 100% recommend 6 weeks of doxy to get rid of M genitalium.
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Avatar universal
Thanks for the info. Part of why I’m posting here is that I’m not really confident in the answers and suggestions I’ve received from the doctors so far, though of course I have and will continue to follow any instructions they provide.

Every doctor I’ve seen so far is treating this very casually, so I’m trying to be as informed as possible and give them feedback that can accelerate successful treatment. Nothing I hear on this forum will interfere or confuse me I can assure you. For example an antibiotic sensitivity test has not even come up yet and that’s the sort of thing I want to be able to suggest proactively...
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Avatar universal
1) you are suppose to do an antibiotic sensitivity test. This is the job of ur doctor, go ask him
2) depends on drug resistance
3 and 4) complete the cost of treatment. Wait 2 weeks. Get a test of cure. Important to establish clear diagnosis

You should talk to your doctor i shouldnt interfere with this and might confuse u.
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Avatar universal
Hi, I’m circling back on this thread I started a few weeks ago. It’s been nearly 1 month since first appearance of symptoms and I’m frustrated to report that I’m still dealing with the same issue.

3 weeks ago I was given Azithromycin at a clinic, no effect.

2 weeks ago I stared a 7 day course of moxifloxican (400 mg 1x per day) prescribed by a dr at a different clinic, no effect (retest for gon and Chlamydia both negative, Trich test negative, wbc still high)

10 days ago I went to Urologist, who didn’t think it was necessary to test again, and prescribed 10 days of doxycycline 2x per day. Today was my 10th day and no significant change in symptoms (which are burning/itching near end of urinating and usually 1-2 hours after, as well as a heightened feeling of needing to urinate).

I have a follow up appointment with urologist tomorrow and hoping for some guidance on where to go next.  Some general thoughts/questions:

1. Do I just keep trying different antibiotics until one works? And does that not come with risks?

2. What are the chances this is Mycoplasma Genitalium? I plan to ask him to test for it tomorrow but if it were that wouldn’t moxi likely have eliminated?

3. How worried should I be at this point? Is it just a matter of finding the right drug? Doctors continue to have a nonchalant attitude toward this each time I meet with them, but the stress from all of this is really starting to consume me.

4. Most importantly, what if anything should I be doing differently?

Thanks
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Avatar universal
Just an update in case it’s helpful to anyone: went to sexual health center this morning (7.5 days since initial encounter) and had swab test.

Negative for Gonorrhea (dr. felt this result is 100% reliable based on time elapsed).

White blood cells elevated, doctor suspects an NGU (I think mycoplasma was something she mentioned, don’t remember ). Chlamydia is a possibility but she thinks it’s unlikely due to quick onset of symptoms after contact.

Prescribed single dose of 500 mg Azithromycin. If symptoms are gone in 7 days then I can resume sex. Overall she had a “no big deal” attitude so hoping her assessment is correct.

Hoping symptoms go away on the sooner side so I can get some peace of mind. I’ll try to update in 7 days.
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Avatar universal
You will know you are cured when the drip stops and the burning stops. Your urine tests will likely come up with WBC’s also and that’s a sign of infection. When it’s cured you won’t have WBC in your urine. I ended  up taking about 6 different antibiotics and they tried everything to grow the bacteria that was causing my infection to do sensitivity tests but they were never able to. Sometimes it’s just shots in the dark when it’s unknown.
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Avatar universal
It’s most likely NGU, or Gono. When I had NGU it was clear, and my symptoms mirrored yours. Normal mouth bacteria can cause NGU. It can move quickly to your prostate(mine did) and it was a pain to cure because antibiotics do not do a good job of getting into the prostate. One things for sure and you have some sort of pathogen causing an infection. Seek treatment. Most will treat you right away before tests come back.
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Avatar universal
Thanks. I’m open to taking antibiotics but don’t different ones treat different issues, how will the dr. know which to prescribe?

Also can taking antibiotics alter the results of testing? I’m worried about taking antibiotics now, testing in a few days and coming back negative, because antibiotics suppressed but didn’t 100% eliminate.

And related, how do I know when I’m 100% “cured.”

Lastly, I read elsewhere on this forum that Chlamydia is unlikely from oral only (and trich also unlikely based on answer above). If accurate, does that mean its either Gon or urethritis?

Thank you
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20620809 tn?1504362969
Ya, I agree with biology that you tested too early for a conclusive result.
For chlamydia ---  possible early detection can take place at 2 weeks, the result of a test at 3 weeks is unlikely to change and it is completely accurate at 4 weeks.  
For Gonorrhea--- possible early detection at 1 week, tests at 1 to 2 weeks are unlikely to change and completely accurate at 3 weeks.  
Trich is not really a concern if you only received oral sex.  
There IS a link between receiving oral sex and urethritis. That usually goes away on its own or you can take antibiotics.  
Biology is suggesting to just take antibiotics which is something a lot of doctors will just do.  Not a bad idea since you are worried about infecting your partner.  
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Avatar universal
1. Not conclusive
2. Other uti such as tricho... The list is very long and u should ask ur doctor
3. Wait until for 2 days before getting urine test again. Sources say test are conclusive after 1 week.
Can ask ur doctor to give u antibiptics first
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