[Question #11030] Discharge after unprotected oral
17 months ago
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Hi Doctors,
Not sure if the formatting isn't updating on the website, but I have been trying to adjust my question and I think I'm well within the word limit but it's not letting me post. Apologies for posting twice here as I wasn't sure how else to post my question.
17 months ago
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Symptoms are here.
For 2 weeks, I have been having leaking discharge which is clear, and looks closer to semen, it builds as a droplet. It comes out more when I squeeze it and there's slight itching. I've had four separate unprotected oral and protected sex exposures with CSW's who say they are healthy.
At the same time, I also had injured myself by holding down on my penis tightly when urinating and I felt a sharp pain, there was a day where it bled a little and since then either there's a droplet of urine or what looks to be mucus or semen. I have a habit of excessively masturbating and read there's a correlation with fluids coming out even when not aroused.
I saw the doctor; blood results are normal, and no bacteria detected in urine but there were amorphous urates. The doctor said there was no need of medication other than drinking a lot of fluids. Should I be concerned and do a full panel STD/STI test?
17 months ago
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Also thank
you for being an amazing valuable resource! I am much calmer about my activities. I
have now limited my sexual contact to women only and test regularly as well. I only asked this question as I refer to the forums regularly but didn't see anyone who had a similiar problem.
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H. Hunter Handsfield, MD
17 months ago
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Welcome back, and thanks for your continued confidence in the forum and your kind comments about our services.
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Based on the doctor's evaluation, it seems likely this isn't an STD problem. However, it would be helpful to know the timing and nature of the sexual exposures that preceded the start of these symptoms. In general, any abnormal urethral discharge should be evaluated for inflammation (white blood cells microscopically, or leukocyte esterase test, which also is an indicator of WBC) and, if there has been a potential sexual exposure, tested for gonorrhea and chlamydia. But let me know more about your recent sexual activities and we'll take it from there. In the meantime, I see no need for any sort of a "full panel" of STD testing.
Is the discharge continuing at this time?
HHH, MD
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17 months ago
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Hi Doctor Handsfield,
The exact timeline was as follows.
3 weeks ago - 2 Unprotected oral exposures
2 weeks ago - Injury occured around this time and 4 protected sexual encounters. Doctor's visit was around this time, blood test showed that total WBC, neutrophils, lympocytes and and eosionophils normal, monocytes were slightly elevated by a little.
The discharge is going on but it's not a lot and comes out when I squeeze the head.
The exact timeline was as follows.
3 weeks ago - 2 Unprotected oral exposures
2 weeks ago - Injury occured around this time and 4 protected sexual encounters. Doctor's visit was around this time, blood test showed that total WBC, neutrophils, lympocytes and and eosionophils normal, monocytes were slightly elevated by a little.
The discharge is going on but it's not a lot and comes out when I squeeze the head.
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H. Hunter Handsfield, MD
17 months ago
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You should be evaluated and probably treated for urethritis (NGU), likely acquired during one of the oral sex events if the timing is right. The incubation period (time from exposure to symptoms) can be as short as 2-3 days for gonorrhea, but gonorrhea is unlikely unless the discharge is thick and yellow (pus); for nongonococcal urethritis, the most common STD after oral sex, it's usually 1-2 weeks but can be as short as 3-4 days. If NGU, I would expect WBCs to be seen if a sample of discharge were examined microscopically. You definitely need testing for gonorrhea. (Chlamydia is almost never acquired by oral sex, but testing is pretty much automatic along with gonorrhea testing.) The usual treatment for NGU is doxycycline for 7 days. You might discuss all this with your doctor; you could print out these comments as a framework for discussion.---
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H. Hunter Handsfield, MD
17 months ago
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And don't be misled when urethral test result is negative for everything. That's the expectation for most NGU, especially when acquired by oral sex. And by the way, your normal blood count means nothing one way or the other. Blood counts are not normally done in evaluation of urethritis or any other STD; they never contribute to diagnosis of any STD, including HIV.---
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17 months ago
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Thanks Doctor, I will get a test for this today and update for my last response. Many thanks!
17 months ago
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Apologies Doctor, I sent the message early, just to clarify, do I need to do tests for anything other than what you mentioned?
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H. Hunter Handsfield, MD
17 months ago
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Gonorrhea/chlamydia testing is all that I would recommend. Threads normally are closed after two follow-up exchanges, but I'll leave it open for one more if you would like to report your test results, as well as your doctor's response and what treatment is prescribed.---
17 months ago
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Hi Doctor,
I tested over the weekend and the clinic recommended to do a 16 pathogen urine test that included both Gonorrhea/chlamydia and others. Gardenerlla vaginalis was detected.
Let me know what your thoughts are and you can close this thread with your final response.
Once again thank you for your patience and being obliging!
I tested over the weekend and the clinic recommended to do a 16 pathogen urine test that included both Gonorrhea/chlamydia and others. Gardenerlla vaginalis was detected.
I explained to the doctor my symptoms with minor discharge, coincidental injury and exposures and she mentioned that gardenerella shouldn't cause any symptoms in men. With that said, she prescribed medication to deal with my current symptoms. ( my discharge and slight burning sensation has reduced today as of this writing)
She has prescribed Metronidazole 400 mg for a week and when I asked if I need to do any further tests for the other major STD's , she said there was nothing else to be concerned about.
She has prescribed Metronidazole 400 mg for a week and when I asked if I need to do any further tests for the other major STD's , she said there was nothing else to be concerned about.
Let me know what your thoughts are and you can close this thread with your final response.
Once again thank you for your patience and being obliging!
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H. Hunter Handsfield, MD
17 months ago
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Your doctor is correct: Gardnerella vaginalis is normal in the genital tract and is not the cause of your symptoms. Metronidazole is not active against Gardnerella is not a recommended treatment for NGU, which probably is what you have. Doxycycline is the recommended treatment for NGU. Try to find a doctor who better understands STDs, NGU, and their treatment. Consider a local public health or Planned Parenthood clinic. Good luck.---
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