Persistant Pain groin, inner thighs, lowerback and in urtethra

[gybek83]

7 months back I was treated for Chlamydia, it took multiple rounds of antibiotics to treat as I still had discharge, eventually it went away (Doxy & Zithro extended courses). 3 months ago I got Chlamydia again, I was treated w/ same extended round & STD tests came back clean. I still have pain currently & it's best to describe as radiating from inside the groin area, extends to my immediate inner thighs, center lower back, through my testis & urethra. I also still have a mild white/clear discharge & very mild discomfort when peeing. During intercourse I also can sometimes feel discomfort, not while ejaculating however. I went back to Urologist who tried me on Flagyl; that didn't help. His results showed white blood cells in my urine still but NEG STD's. He did digital exam of prostate & did show it to be sensitive to touch but not enlarged. Also, I just got off Keflex (for an ear infection) & that showed no improvement either (for my pain in groin/urethra). I have consistently had a strong stream when peeing, my freq seems norm too. I want my symptoms to stop, what is causing this: Prostatitis, or Urethritis & if it is why hasn't the antibiotics worked I've been on.

[Edward W Hook, MD]

You are in an areea where there are not formal recommendations. On the other hand, the moxifloxacin is good for both prostate infections, mycoplasma genitalium and other urianry tract infections.  When we are at the satge of "trial and "error", this has been helpful in the past.  My consern would be that you have prostatitis.  EWH

[gybek83]

Yes, I still am. I am confident I am not getting re-exposed with Chlamydia as my testing is on a 3-4 week basis. I am positive I only had Chlamydia as well, (we test for HIV, Chlamydia and Gonorrhea every month... Syphilis I was just screened for as well, and HSV every 6 months). Chlamydia was the only test to come back positive with regards to the symptoms showing up. So, I was treated and the Chlamydia went away but the other symptoms have since stayed. Should I go on a treatment course of using doxy & adding Avalox? Also, I am curious about Avalox, as I thought it was only useful for mostly upper respiratory infections, and nothing to do with the groin area (this is "off-lable"  but proven use? as that drug is quite expensive for me at around $140 for 7 day treatment w/insurance). I had been on it once before almost a year ago for upper resp infection, (and worked great for that). I checked this AM for the first time in about 2 weeks, I noticed a very small amount of a more white-ish milky discharged, (however I don't continue to have a noticeable discharge throughout the day). It did not hurt when I urinated first when I woke up either. But regardless if you feel it's prostatitis it's not so "horrible" as I don't have urinary issues, (just yet)?

[Edward W Hook, MD]

Welcome back to the Forum.  Are you still in the adult industry?  If so, are you sure that part of what is going on here does not reflect re-exposure?  It seems that if you are still in the adult industry the issue of re-exposure is a potential problem.

As for your specific problems, let me start with another question.  Are you sure you had chlamydia, as identified by a test each time or where you treated for NGU or another chlamydia-associated problem.  The reason I ask has to do with what might be going on and whether this is all one problem or two different problems both of which affect your genital tract.   The WBCs in the urine, as well as some of your symptoms (back and thigh pain) are more consistent with prostatitis than a "run of the mill" NGU or other STD.  Treatment of prostatitis sometimes takes longer courses of medication as well, i.e. 3-4 weeks.  Be that as it may, with repeated treatments with both doxycycline and azithromycin, you may wish to talk to your doctor about  a course of moxifloxacin.  Your situation is a difficult one and moxifloxacin has proven to be effective against chlamydia, mycoplasma genitalium and gets into the prostate well.  

Hope this helps.  EWH