[Question #1484] ngu2

47 months ago

Hello,

I have a couple more questions regarding NGU. Went to a urologist 2 days ago and based on clean urine, She says I do not have NGU but will treat for it. Gave me cipro for 10 days.


1.  based on my research , I read the cipro does not help with NGU. What is your opinion on this.

2. I have also researched that virus's like HPV and HSV, can cause it. Would the virus itself cause it or would you need to have warts or lesions  from the virus to cause NGU

3. If the treatment works, I asked the Dr what my next step would be because it would show that it was bacterial and she informed me to do nothing with notifying my partner and to move on. Is this safe?

Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Welcome back to the Forum.  Today I happened to pick up your question. and will be answering your continuing questions  As an FYI, having worked closely for more than 35 years, Dr. Handsfield and I never disagree on the content of our replies although our verbal styles vary. I have read your interaction with Dr. Handsfield last week and agree with his comments.

Your doctor is treating you without evidence of infection.  Thus whether or not you will respond to therapy remains to be seen.  On to your questions:

1.  Ciprofloxacin and related quinolone antibiotics are not recommended for NGU treatment.  Much of this recommendation is based on careful studies which have shown that ciprofloxacin does not effectively treat chlamydia infections.  Your tests were negative for chlamydial infection so this should not be a concern.

2.  HPV does not cause NGU.  HSV is rarely present in men with NGU.  If you had HSV related NGU you would most likely have had genital lesions as well.

3.  This recommendation is consistent with what Dr. Handsfield has told you.  Many doctor do offer treatment to partners of men who have NGU but there is no proven benefit from this practice. 

I hope these clarifications have been helpful.  EWH

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47 months ago
Would  herpetic urethritis show WBC  in urine and  how long would  it last ?   Meds aren't working  , also took  Zithromax . No pain with peeing but pain and irritation in urethra 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Herpetic urethritis most often is present with lesions and if it were present there would be cells present on urethral gram stain and perhaps in a urine specimen.  If there are no lesions, the chance that this is herpetic urethritis is very low. 

As Dr. Handsfield and I have both told you, the symptoms you describe (urethral itching, discomfort present in the urethra but not on urination) are really not suggestive of NGU.  EWH

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47 months ago
Went to a std clinic , she was very knowledgeable and was very happy with the time and effort she gave . All tests negative and she did gram stain and found no WBC issues . I'm on antibiotics so either the antibiotics worked or there was no infection to begin with ?   My only concern I still have is the possibility of herpes since I do still have irritation and pain in urethra . Have you ever treated or heard of herpes in the urethra that has no outside lesions , no pain on urinatiion and can last 6 weeks ? would the  antibiotics hide the WBC if it was herpes in urethra on the gram stain culture 
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

You really seem quite fixated on NGU and I am not sure why.  You have asked our advice and gotten it, have been seen by a trained professional with a negative evaluation yet you continue to worry. 

There are rare cases of herpes urethritis without external lesions but they are quite rare and when this is present it does NOT last more than a few days and typically DOES have white blood cells present on stained smears.  What you report is not consistent with HSV.

As you know, we are limited to three follow-ups to questions. this is your third and therefore this thread will be closed later today.  I urge you to look to other causes of your persistent symptoms, they are not suggestive or consistent an STI .  Take care.  EWH

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