[Question #12046] Follow up - Anxious
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10 months ago
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Good evening, following up on my post from last week. I have had an interesting turn of events since then.
Friday night my prostate became inflamed causing me not to be able to urinate, so I went to the hospital and the doctor said it was an enlarged prostate and prescribed flowmax.
It's been 2 days and am still having difficulties urinating.
My questions are;
1. Despite the aggressive antibiotics I took, could an STI have caused this?
2. There is some burning after forcing myself to urinate through the swelling, is this an STI in my urethra?
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H. Hunter Handsfield, MD
10 months ago
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Welcome back, but I'm sorry you found it necessary.
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This information doesn't change my previous reply. No STI is a likely cause of the sort of prostate problems you're having, despite the coincidence in timing. Being middle aged, as you said in your other question, you are naturally at risk for prostate enlargement and events like you describe. (You also said there that you had possible "prostate" symptoms; perhaps you have had previous symptoms or diagnosis of prostate enlargement?) If there is a relationship with your sexual exposure and STI concerns, it is an anxiety effect: urination is extremely sensitive to psychological influences, and might have contributed to lower urinary tract spasm and onset of your symptoms. But an infection of any kind is not responsible. Presumably the hospital and doctor's evaluation included consideration of infection (urinalysis, maybe blood count, etc), and obviously none was found or you would have been prescribed an antibiotic in addition to the tamsulosin (Flomax).
1. "Despite the aggressive antibiotics I took, could an STI have caused this?" Almost certainly not.
2. "... is this an STI in my urethra?" No it is not.
Please re-read and believe my advice in your previous thread. You were at little risk of STI from the event described -- and although I would have advised against the doxycycline (and still would do so), it did prevent any likely STI that could be related to your current symptoms. If you remain concerned about it, discuss it with the doctor now providing your care, if you have not yet done so. (They should know that you took the doxycycline, and preferably the reason for it!)
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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10 months ago
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Thanks for the reassurance, the ER doctor noted that I didn't have any cloudy or bloody urine and that I had no discharge so did not do a urine test.
Is it possible that gonorrhea may have infected it? I've heard the medicine I took is sometimes not effective against it.
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10 months ago
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Sorry also meant to ask, it's been 10 days, does gonorrhea have more obvious symptoms if I did have it?
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H. Hunter Handsfield, MD
10 months ago
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It is true that doxycycline and azithromycin are not effective against some gonorrhea strains, but gonorrhea almost always causes pus dripping from the penis, which would have been apparent within 2-3 days. And the statistical probability of gonorrhea resistant to both antibiotics is very low. There is no realistic chance gonorrhea is responsible for this problem. That said, I cannot say it is impossible; this is one reason you should have informed the ER doctor about your sexual exposure and self-treatment afterward. Probably he would have tested you for gonorrhea. That still could be done, but I am completely confident it would be negative.---
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10 months ago
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One last reply and then I'll put this to rest.
Was finally able to get testing done, had a urinalysis and culture test done, as well as test panel for gonorrhea and chlamydia, all tests showed no infection, no culture growth and negative for both sti's.
I'm still experiencing prostate issues, which, like you said, is more than likely not related.
Just a final question, more for curiosity than anything;
1. Can an sti show negative on urine and culture testing but still be hidden in the prostate? (I assume there's always a mix of prostate secretions in urine anyways?)
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H. Hunter Handsfield, MD
10 months ago
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No. If your your prostate were infected with gonorrhea or chlamydia, your urine test would have been positive.
That concludes this thread, which should be your last about this exposure and your non-STD prostate issues. I hope the two discussions have been helpful. Best wishes and stay safe.
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