[Question #13624] Lots of negative testing, yet my symptoms persist. What can I do now?

23 hours ago

I (29m) had unprotected PIV sex on 10/18. Symptoms began 1-2 days later. All tests negative; symptoms persist. What can I do now?

Symptoms:

First, tingling on penis. No lesions. Then 3 weeks of nonstop urethritis & dysuria, some pain in bladder/pelvis & testicles/epididymis. Urethra spasms & (feels like) discharge. Now, come-&-go pain in urethra, bladder/pelvis, testicles/epididymis.

Testing:

10/22: Urine test: chlamydia, gonorrhea, trich. Urinalysis.

10/28: Urine test: chlamydia, gonorrhea, trich. PCR test for m.gen. HSV urethra swab. M.hominis & ureaplasma cultures. Urinalysis.

11/18: Urine test: A.vaginae, C.trachomatis, G.vaginalis, H.ducreyi, HSV, N.gonorrhoeae, T.pallidum, T.vaginalis. Blood test: Syphilis & HIV. “Antibiotic Resistance Markers” test. “UTI pathogen” test.

11/28: Blood test: HSV; Hep. B & C.

This began 1-2 days after sex & never stopped. I’ve seen urgent care, a urologist, an infectious disease doc. No diagnosis; docs have no answers. What can I do now? I’m scared.

Edward W. Hook M.D.

12 hours ago

Welcome to our Forum. Thanks for your questions. I'll be glad to provide some comments. I'm sorry to hear of your prolonged symptoms. I see no evidence that they are due to an STI and can think of may reasons why they are not (as I suspect you do). These presents include:

1. It is statistically unlikely that your partner had an STI.

2. If your partner did have and STI, condoms are highly protective and there is no mention that it may have failed which I doubt

3. Your symptoms began rather early for most STIs.

4. Multiple tests, at times when tests will provide highly reliable results have been negative.

5. You have been evaluated by multiple trained clinicians who have not provided a diagnosis.

I would suggest that you choose one of these specialists, likely the urologist or the ID specialist for continuing evaluation for non-STI causes of your discomfort. Over the month you've had them your has the nature of your symptoms changed? Did any of the specialists you saw have thoughts or suggest follow-up? On occasion it will take multiple evaluations by the same clinician to determine the cause of clinical symptoms. Sorry I don't have a direct answer. EWH

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6 hours ago

The sex was unprotected (vaginal).

The ID doc told me to go back to the urologist, who said it was from stress.

In 7 weeks, symptoms went from tingling on my penis (first few days), to constant dysuria & urethritis with some testicle/bladder pain (about 3 weeks), to intermittent dysuria & roving urethral, testicle, & bladder pain (last 3 weeks).

Aren’t there many things I wasn’t tested for? Like M. Penetrans, Adenovirus, or H. Influenza. Maybe HSV testing was too early? And clinics couldn’t test for M.Gen. til 2019; before, were M.Gen. sufferers also just told they had anxiety? Could this be the same—inadequate tests?

Could this be a new disease?

Could I just ask a doc for Doxycycline, Ceftriaxone, or Azithromycin?

Are there more tests I could do (blood, semen)? Any specialists I could see, anywhere?

If not an STI, what’s happening to me?

This began right after unprotected sex. I’ve never had these problems before. It’s not psychosomatic, it HURTS. I can’t see how this isn’t infectious.

Edward W. Hook M.D.

3 hours ago

Thanks for the clarification. Sorry I misunderstood your original description.

As I said in my original response, the onset of your symptoms was early for most STIs and your negative tests should be believed. I wondered of this might be herpes urethritis and if it were a blood test would be the wrong test at this time ( a urethral swab tested by PCR is the appropriate test) but newly acquired herpes would not cause 7 weeks of discomfort, nor would it cause bladder or testicular pain. The long duration of your symptoms really speaks against STIs in general. The other organisms you mention not compatible with your symptoms or duration but do suggest that you may be searching, and being misled by the internet.

Have you had a urinalysis looking for moderate to high concentrations of white blood cells? If WBCs are not present this virtually rules out infection and further suggests a need to look for other causes. In addition, does your prior partner know this is going on and have they been tested?

I’m disappointed that the specialists you have seen were dismissive. Perhaps 2nd opinions are in order. Overall however this really does not suggest that your symptoms are an STI. EWH

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