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Strange leakage/Discharge. Negative Tests however

August 3 2023. This is a long story please bear with me.

For my sexual history, I had a complete STD panel in February, all negative. I had two sexual encounters in April & early June, both protected. On June 29 this year, I hooked up with a male partner I haven't seen in many years. In the moment we didn't use protection. They assured me they were on PrEP medication for HIV, but I began a month-long regimen of PEP for my own peace of mind. That regimen ended July 27. I also had a very brief encounter with a new person on July 9, Mutual masturbation with about 10 minutes receiving oral which was interrupted and didn't finish. I also frequently masturbate using an oil-based lubricant.

My issue, on July 23 I woke up with white fluid collected on the tip of my penis. I have never experienced something like this before. I did have a solo masturbation session the night before using my normal lube. It could have been aggressive? The fluid didn't exactly resemble a wet dream, it was a pinky nail sized droplet just coming out of the penile opening when I woke up. After cleaning, since then I've noticed that if I sit still a small drip will periodically leak from the tip of my penis. It appears clear, but I think if I go a long time (i.e. overnight) without wiping it will collecting into a whitish droplet. I can't say that there is pain or burning, but when I sit still there is a faint tingling sensation that I'm aware of at the tip. And sometimes a feeling like I need to urinate even if I do not.

July 23 I purchased a UTI test strip from the drugstore. The colors for Leukocytes indicated an active urinary infection?

July 24 There was more white discharge when I awoke. Possibly not as much as before but some could have wiped off while sleeping. A telehealth provider suggested a Gonorrhea, Chlamydia, and Trichomonas exam so I went to lab testing center and ordered those plus a urinalysis.

July 25 More discharge in the morning. Another UTI test strip came back in the negative range. Received results of previous days test, all STDs were negative and the urinalysis was in the normal range. I went to an urgent care and showed all results to a doctor. He said it was odd but with my symptoms so far he gave me one injection of ceftriaxone and a prescription for 1 gm of azithromycin. He also took a urine sample for another test for the same STDs, a urinalysis, and a urine culture to look for bacteria. I took the prescription as soon as I got home.

July 26 similar discharge in the morning, Minimal amount. clear dripping throughout the day

July 27 similar discharge in the morning, minimal amount. Took my final round of PEP. Received results of doctor-ordered tests: STDs negative, urinalysis normal, urine culture-no growth. 3rd UTI test strip, slightly seemed to give color indicating at least some sort of urinary tract problem.

July 28  small amount of discharge in the morning, whenever I think the clear dripping has stopped I notice a tiny amount. Tingling, need to urinate sensation still present.

July 31 There was not a large amount of morning discharge. mostly the clearish fluid surrounding the opening. I think if enough of the clear fluid were to collect in one place though then it make take on that cloudy white hue again. I took Azo max strength pain relief for the discomfort. Which feels sort of like tingling after urinating or as if someone was pinching the tip of my penis.

Aug 1. I'm not super certain if the Azo has been working. But the orange urine and leakage freaks me out. I switched to Azo Urinary defense which does not have dye. I think it temporarily dulled the discomfort.

Aug 3. I still take the Azo defense maybe once or twice a day with food. I'm afraid to take it too often because the box says you should not take it more than a few days. The leaking and discomfort has continued periodically. When I sit perfectly still I feel that unpleasant sensation which im still hesitant to call burning more like pinching inside the penis head. My urine is no longer orange from the first round of Azo. This morning when I woke I didn't see much other than the clear fluid, however before using the restroom I noticed that if I squeezed a droplet out it took on a very faint cloudy appearance.

Does anyone have any input? I am trying not to wig out but my brain is going to all the worst places right now. I think I am past the incubation window for the most common stds, so if I had them I would have thought they would show on one or both of the tests after I presented symptoms. I obtained a referral for a urologist, but they cannot see me for quite some time.Should I return to an urgent care & request antibiotics for a UTI in the meantime? I can't reliably tell  how much my symptoms have diminished. The stress is genuinely getting to me. It's all I have thought about for the last two weeks. I have not had a real appetite lately, because my stomach is balled up with anxiety. Often I'll wake in the middle of the night thinking about it. I did try to engage in some self pleasure the other day but I'm terrified of aggravating or causing some further infection. More tests would also get expensive, as my grandfathered insurance plan does not have to meet the affordable care act guidelines of providing some preventive services.
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3191940 tn?1447268717
Given the entire scenario, I wouldn't be concerned about HIV. If your partner was on PrEP, and you took PEP, the odds of getting HIV are extremely low. If you want to test for peace of mind at the end of this month, you can do that, but I'm confident that result will be negative.

HIV wouldn't cause the discharge or discomfort. Just wanted to step in re: HIV while you're waiting for feedback on other potential causes.
Helpful - 1
Thank you, I do plan to test for HIV along with a metabolic panel for my scheduled PEP followup, but honestly HIV is one of the things that is not on my list of concerns at the moment. These symptoms just happened to appear in the middle of my PEP regimen.
207091 tn?1337709493
So first, some questions -

When you took the PEP, was it because you had unprotected anal? Were you the insertive or receptive partner? When you were with the partner that you had the interrupted oral, did you give and/or receive oral?

The only STI that you haven't tested for is mycoplasma, but honestly, I don't think you have that. No STI gives you discharge that comes and goes. Discharge in the morning isn't uncommon, and can occur at different points in your life. Discharge that you have to squeeze to get out isn't actually discharge.

Have you recently switched lubes? Maybe you're having some reactions to that? Try a water based lube? Or did you switch to a new soap or something?

Are you hydrated? If you aren't eating enough, are you drinking enough water? The urinary symptoms might just be dehydration. If you are drinking alcohol or caffeine, cut way back on those, and increase your water. If you drink a lot of caffeine though, cut back on that slowly, though, because caffeine withdrawal causes a hell of a headache. At least alternate a caffeinated drink with a water - like a soda, then a water, then a soda, then a water.

You mention that your partners were on PrEP. That's something you might consider, too. Talk to your local clinic about it, or your doctor.

Helpful - 1
Thank you for your response.

Yes I initiated PEP because of the unprotected anal. I was the insertive partner, or top. That partner and myself had not been together in a many years and never without protection, but we got caught up in the moment. I felt some regret and started PEP the next day. But I also had another conversation where he assured me he was already taking PrEP when we hooked up. I still finished the full regimen, for safety but also because I did want to see how my body might handle that particular daily medicine. I agree that I need to further consider a full time prescription. I do not have a PCP, but the clinic that I do my regular non-rapid std testing should have plenty of information.

During the oral, I received but did not give.

Originally I didn't have to squeeze any out, the first week or so I would notice the white droplet sitting on the outside when I first woke because it leaked out overnight. It still behaves that way somewhat, just perhaps less in volume. Throughout the day I am dealing with a constantly leaking wet tip plus discomfort, that fluid usually gets wiped on the inside of my underpants as I move around. The biggest amount will be when I lay down overnight.

I have been using this particular lube for about 2 years. It is vaseline-similar but was manufactured specifically for self play, which is my primary and preferred activity since the start of the pandemic. I haven't tried any other types or really any lube since onset out of fear. I can't say I've had too many changes to my routine with soaps I have been using a certain brand most of the year. Again, I was fairly aggressive with myself the night before everything began but I don't know if this is all due to that.

I am trying to stay hydrated as much as possible in the hopes of flushing whatever this is from my system. I don't believe I have had more than two sodas and a lemonade in the past two weeks. A few times I have drank water to the point of completely clear urine. But then there are other times where I have felt like I had to urinate but nothing would come out.

I'd say it's not from being that aggressive with masturbation if it's lasted this long. Even if you did something that injured yourself, it should be healed by now.

Since the discharge is more constant than I originally thought, the only thing left that I can think of is to test for mycoplasma.

The only place I can find that does a mycoplasma test without insurance is https://www.healthlabs.com/mycoplasma-testing - and it's EXPENSIVE at $198. They often run specials and you can google for coupon codes, but still, I get that it's a lot of money.

Call around to STI clinics near you and see if they offer it. Also, if you're a student, maybe with college starting soon, your health services will offer it? (I have no idea how old you are, and you don't have to tell me - I'm just offering up ideas.)
Thank You
You're welcome. Let me know what you find out.
I was not able to find someone who will do that test yet. But my urology referral did go through and I have a consult next week...
I got another Urinalysis performed (it was only 20 dollars) & I don't exactly know how to interpret this. It still says no bacteria were  detected, but the Leukocyte Esterase shows trace amounts. Ketones have elevated from trace to moderate. WBC are between 16-25, and healing casts are >10. All other values on the report are within negative or normal ranges
Trace amounts don't matter, but the moderate ketones do, and the WBC means an infection.

Hyaline casts could indicate a kidney infection or kidney problem.

It's good that you're seeing a urologist. I really don't think this is an STI, I think this is something a urologist needs to help with. Let me know what they say. Go relax and have a good weekend. :)
I'm actually on vacation trying to distract myself this weekend. Are kidney infections also a potential cause of NGU? Or a side effect?
Anything that causes an infection (other than gonorrhea) in the urethra can be a cause of NGU. NGU stands for non-gonococcal urethritis, and literally means any infection in the urethra than gonorrhea.

The ketones and hyaline casts in your urine suggest something other than an STI. You really need a urologist to sort through all this.  
I had a consult this morning. The urologist didn't feel that the levels in the urinalysis were cause for concern (right now) but he is sending another sample for testing. This should also include testing for ureaplasma and mycoplasma along with other bacteria. They will view for gonnorhea and chlamydia also but his visual inspection said it did not resemble gonorrhea and the fact that i did have the typical antibiotic 2 weeks ago means it is likely not either of those as you have said. I have been given a prescription for doxycycline 14 days and a followup in four weeks. He is hopeful that the discharge and discomfort clears up within 2 weeks and that the new tests come back without problems.
Good. Keep me posted. :)
Avatar universal
Have you heard of something called CPPS? It can cause similar symptoms to yours and gets worse with anxiety.
Helpful - 0
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