[Question #11105] Follow up to #11030 Multiple unprotected oral, protected vaginal

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17 months ago
Hi Doctors,
I'm writing this to update you all on my last exposure (unprotected oral and protected vaginal, multiple CSWs) and treatment as the thread was closed and figured it would benefit the forum on what I did.

In my last closing thread, a previous doctor prescribed Metronidazole and you rightly said it's not a treatment for what you suspected was a NGU. I decided to go to a urologist, explained my problem, he did an ultrasound, of the prostate, nothing abnormal. Urine test found pus cells, he gave me Levotab and Kidnitan (a calculus was found in the kidney). Coincidentally, I had to visit a skin doctor the same day for what I think was an unrelated issue with a carbuncle developing, he gave me doxylag, cyteal and dexilant. I also did a urine culture bacterial count which showed no growth. 

Finished the course of the medicines as of today, discharge stopped but I still had a dull pain on and off in the left testicle and he did one more ultrasound and found the following: Bilateral testicular microlithiasis, Left sided grade 3 varicocele and left epididymal cyst. He has recommended diclofast for the pain which has stopped it now. He did mention that a varicocele might require surgery if my sperm motility is low so I'm doing that test later.

I ran additional tests for 16 pathogens again and this time nothing was found. My only question that remains is do you think I have to test for HIV or syphilis as it's only two I haven't checked. ( I will be getting a test in two weeks as part of my immigration pprocess anyway)

Do you think I'm in danger based on what you've read and my condition might have been caused by STDs ? Appreciate your time.
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H. Hunter Handsfield, MD
17 months ago
Welcome back and thanks for your continued confidence in our services. However, there really isn't much more to say.

It's good to hear your symptoms cleared up, probably because of the doxycycline (Doxylag). Levofloxacin (Levotab) has never been studied for treatment of NGU -- it's hard to know whether it contributed to your apparent cure. I'm not at all familiar with any of the other medications you mention -- I do not believe they are antibiotics and probably they had no effect on your urethritis. In any case, nothing more need be done at this time.

None of this has anything to do at all with your varicocele or epididymal cyst. These are common anomalies of the genital tract and generally harmless. Had you not seen a urologist, they might never have been noticeable. I know nothing about "testicular microlithiasis" but I'm sure this also has nothing to do with the symptoms you had. It's no surprise that your second 16 pathogen test was negative but glad to hear it.

HIV is rarely if ever transmitted by oral sex, but testing still is routine for any person with any STD. On that basis, it would be reasonable to be tested for it, but it's optional -- entirely up to you. Syphilis was very unlikely as well, and doxycycline is 100% reliable in curing it or in preventing syphilis from taking hold if exposed. So testing for it also is optional; if done, you can expect a negative result.

"Do you think I'm in danger...?" No, you never were in danger at all. NGU from oral sex is generally believed to be harmless. I'm sorry you ended up with a far more extensive evaluation and treatment than needed, but glad the NGU has resolved. I see no need for any further evaluation unless your urologist has advised follow-up for the other problems he uncovered.

HHH, MD
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17 months ago
Many thanks Doctor, I have been taking quite a few pills for minor issues that I'm not sure if I've been overmedicated by the doctors here, but still the problem has been resolved so I'll take it.

The urologist is doing the last test to make sure I will be able to have children down the line and that's the only reason for it.

Thanks for your time. Before you close the thread, I just want to verify, this is the correct link for the ASHA donation page  https://www.ashasexualhealth.org/donate/  ?

I want to give back to the medical community for all the help you all have given me in my various, ( sometimes anxiety driven!) enquiries.
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H. Hunter Handsfield, MD
17 months ago
I am skeptical you are at risk of infertility due to any of the conditions you describe. For sure there was no such possibility on account of your NGU. We try to avoid overtly criticizing forum users' doctors, but I have wonder if your urologist is recommending further evaluation largely for his own economic interests. (Where are you? Not the US, I suspect.)

Thank you very much for your intent to make a donation to ASHA! The link looks fine.
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17 months ago
I'm based in the UAE, and yes, you're not wrong, some of the doctors of late have been prescribing more medications than I have noticed and running a battery of more tests than usual especially with the medication prescribed to me for this exposure, but in all honesty, thank you for giving me a second opinion on this.

We don't have a very friendly and non judgemental sexual health system, which is why some of us are on this forum half the time and I hope it will change in time. 


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H. Hunter Handsfield, MD
17 months ago
Thanks for the clarifications. That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the two discussions have been helpful. Thanks again for offering to make a contribution to ASHA!---