[Question #13385] Please help

3 days ago

One time mistake outside relationship. Unprotected oral & vaginal sex, brief with low risk woman 9 months ago (recently divorced.) anxiety & regret. She tested negative for Chl, Gon and Trich a week later. I later realised she hadn’t tested orally. 2 months later I noticed urethral irritation/burn/itch, split stream & redness/swelling of glans & meatus. Not always obvious. No discharge, no pain during urine, only after. negative at 3 months Chl, Gon, HIV, Syph at GUM. They declined to test NGU without discharge I did a home dipstick for UTI - no leukocytes. Tested negative again using broader test, including MGen. Positive ureaplasma which I know is flora. Symptoms remain. What am I missing?Some sort of unlucky ping pong with partner? Did I clear something in the first 3 months and now have a stricture? I know UU can sometimes cause NGU, but with no discharge could it cause irritation?Anxiety/CPPS? Please help

Edward W. Hook M.D.

3 days ago

Welcome to the Forum and thanks for your questions. You clearly have an understanding of the situation and have taken appropriate steps to rule out the possibility of having acquired an STI ( including non- chlamydial NGU) from what you now consider a misstep. Your continued symptoms are not those of an STI but do suggest that you are continuing to look for any signs of infection. I suspect you are noticing normal sensations. This is entirely consistent with CPPS.

I see no medical or scientific need for further testing. Your partner is not at risk. Perhaps a urologist or counseling to address your continued concerns would help. You need to figure out how to move forward and continued testing is not going to help. I hope my comments are helpful. EWH

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3 days ago

Thanks so much Dr Hook for your response.

I have been struggling with guilt and anxiety for 9 months.

My main concern as you guessed is that I passed something to my partner and then cleared it during the 3 month window before testing - I resumed intercourse at once the other person tested negative (then later I realised the oral risk.)

Could you please give some more detail as to why you don't think this is a risk? I have persuaded myself that I could have a stricture which could 'prove' that I had an sti during that window.

Is there any way that UU could be harmlessly causing irritation having changed my microbiome?

Edward W. Hook M.D.

3 days ago

I've detailed the basis for my assessment above. Most persons do not have STIs and most STI's are not transmitted following a single exposure. You yourself assess your partner as low risk and both you (repeatedly) and your partner have had negative tests for STIs - the tests are highly reliable. STIs do not cause intermittent symptoms. No change in my assessment or advice

The symptoms you describe are not those of a stricture either.

One follow-up remaining. EWH

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3 days ago

Thanks again Doctor Hook,

Just to clarify, my partner has never tested, the other person did, but I take your point and presumably that doesn't change your asessment?

I was also under the impression that a split urine stream is a symptom of a stricture. Is that not the case?

Other than those questions, just to say thank you and I will take your advice and see a urologist or seek some counceling.

Edward W. Hook M.D.

3 days ago

Final response. There should be no need for further questions.

Your partner was not exposed to infection. There was no need for her to be tested.

Spit stream urine can have many causes including stricture but it would not be intermittent. As I said, if you remain concerned, a urologist is an option, just as you indicate you plan to pursue.

Take care. Please don't worry. EWH

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