[Question #12490] Urinary burn/irritation/testicular aches

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7 months ago
Hello,
To provide some context - Since Feb 2017, I have been experiencing burning/irritation/and testicular aches (nothing too painful per se ; moderate to mild) ; I do also experience this burning/irritation after ejaculation ; this started happening after I got married that same month - I have been faithful to my spouse. I think it is important to note that this has been on and off and I have not experienced any penile discharge. 

Just in case, I did get an STD test for Chlamydia & Gonorrhea in both 2020 & 2021 and both urine tests were NEG (Quest diagnostics just said "NOT DETECTED"). 

I spoke w/ my virtual doctor this morning explaining the above & he pretty much brushed it up saying it could be caused by benign bacteria but should have no negative impacts on my health and said seeing a urologist should not be needed. Said it could be sexual trauma, but I am not that rough when having sex, so I doubt this. I brought up possible prostatitis, and he said due to my age (28 years old), this is unlikely. 

However, I do feel it was not looked into seriously by the dr I spoke to and want to get a second opinion. Thanks in advance for the help on this!
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H. Hunter Handsfield, MD
7 months ago
Welcome to the forum.

But while I appreciate your confidence in our services, I'm afraid we can't help very much. No STD ever causes the sorts of symptoms you describe, and we deal only with STDs -- i.e. we're not a resource to sort out non-STD genital health issues, except when an STD is potentially in the picture. That doesn't seem to be the case here. I'll just say your symptoms don't sound worrisome. In other words, I agree with your online ("virtual") doctor, who probably "brushed it off" [not up], although I doubt it's due to any bacteria of any kind. Sexual trauma? Maybe, but just like you do, I doubt it very much. All in all, I would ascribe this to psychology:  your symptom are typical for genitally focused anxiety, making you more aware of minor symptoms or even normal body sensations that otherwise would not be bothersome and perhaps you wouldn't even notice. Prostatitis? Probably not, but you might google "chronic pelvic pain syndrome", or CPPS. The Wikipedia article is good, and so is information from the Stanford University Dept of Urology. As you'll see, there's often confusion and overlap of CPPS with what sometimes is called nonspecific prostatitis. You'll also see descriptions of CPPS that fit with anxiety as a contributing factor.

Please don't count this as a second opinion. We do not provide medical care, only general advice, and make no attempt to diagnose or treat any medical condition -- and certainly not non-STD problems. If your symptoms continue and/or you otherwise remain concerned, my advice would be to see a urologist. I agree with your online resource that this may not be necessary from a medical standpoint, but if you remain concerned, a urologist's confirmation that nothing is seriously wrong might be reassuring.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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7 months ago
Thank you for the reply, Dr. Handsfield!
Considering that my wife did a recent STD screening as a part of her wellness exam a couple weeks ago & everything was in the clear, it makes sense that no STD is contributing to that. I guess my concern was that some other bacteria like Mycoplasma Genitalium or something else I am not aware of is down there causing these intermittent annoying symptoms. But my understanding is that if it was something like that, it would not just remain in my system for almost 8 years. That is why I did not seek testing outside of the major 2 I mentioned. If I am incorrect in this, let me know!
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H. Hunter Handsfield, MD
7 months ago
I didn't think to mention your test results, which were reassuring. And given the minimal risk and your symptoms, I intentionally didn't suggest your wife be tested. But in any case, her negative results also should be reassuring.

M genitalium has not been reported to cause the symptoms you describe. There are no good data on how long M gen can persist in absence of treatment, but I agree that 8 years is very unlikely.
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