[Question #1645] More trich info

44 months ago
Looking to get more info so I can make informed decisions .,
1,is the tma trich test accurate and do you  the accuracies of the different tests 
2 best place to go for a test 
3 my only exposure was oral sex but was a prostitute so don't know who she was with right before, if this is my only exposure , should I still get tested 
4 symptoms are aggravated penis tip especially after ejaculation   and pretty constant pain ,with clear discharge , can it be trich?
5 what are health concerns with trich

44 months ago
Forgot to ask , , can you get Trich from protected sex 
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Welcome back to the Forum  As you probably know, Dr. Handsfield and I share the Forum and I happened to pick up your most recent question.  I have reviewed your earlier interactions with Terri and Dr. Handsfield and agree with all that they have said.  Like Dr. Handsfield, I am skeptical that your current problems are related to the receipt of oral sex you mentioned or that your symptoms are a manifestation of trichomoniasis.  I agree with him that the right thing to do is to continue to work with your urologist, approaching things as Dr. Handsfield has already suggested.  Having said this, let me go on and answer the questions you raise:

1,is the tma trich test accurate and do you  the accuracies of the different tests 
Several companies now make highly accurate NAA/PCR-type tests for trichomonas.   The TMA is one such test and it is highly accurate.

2 best place to go for a test 
Your urologist or regular doctor should be able to order a NAA/PCR-type test for trichomonas..  The usual specimen
 for such tests is a voided specimen, with the urine collected just as you begin to void.

3 my only exposure was oral sex but was a prostitute so don't know who she was with right before, if this is my only exposure , should I still get tested 
If your only exposure was receipt of oral sex I would be flabbergasted if your trichomonas test were positive.  On the other hand, it is clear that you want this problem thoroughly evaluated and since the test is accurate and easy to do, they is no reason not to do so.  As I said, I anticipate that the test will be negative if you choose to test.

4 symptoms are aggravated penis tip especially after ejaculation   and pretty constant pain ,with clear discharge , can it be trich?
Most trich in men is asymptomatic.  When it is present, it typically causes an NGU-type syndrome with mild discomfort on voiding and/or a urethral discharge which can be clear.  As Dr. Handsfield has indicated, for your symptoms to get worse with ejaculation is not typical of most STIs, including trich.
5 what are health concerns with trich
Trich causes few complications in men or women although it can be a cause of an uncomfortable urethral discharge in men.

Condoms are not perfect but they certainly are highly effective in reducing risk for STIs including trich.  As mentioned about, I have never heard of trich acquired through receipt of oral sex as well

I hope these comments are helpful to you.  EWH

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43 months ago
Just got two trich results from two different companies . Both tma urine  and both negative how confident can I be that I don't have trich . If not what else can this be ? Last couple days , extra pain at tip and excess of clear discharge in morning . This is getting very frustrating . Gon?   Ngu?   What are my next steps ? 3 gon tests would not be wrong ? 
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
The TMA test for trich is the best available test for trich diagnosis.  One test is about 90% sensitive but two negative tests, collected at different times, pretty much assures you that you do not have trich.  As I and others have said before, this, along with your other results is strong evidence that your symptoms are NOT due to an STI acquired at the exposure you described.   It is time to acknowledge that this is not an STI.  As Albert Einstein said, "One definition of insanity is to do the same thing again and again and expect different results."  EWH
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43 months ago
Doctors still can't figure what's going on . How accurate are gonorrah swab tests? 3 negative trich tests ? Pain and itching persists . What is best treatment for gonoreah?  Still getting clear discharge in morning with left testicle pain .tip of penis is red and agitated 
43 months ago
Getting lots of clear discharge in morning , left testicle pain , itching in urethra .   3 trich tests negative . Should I be concerned with Gonoreah or trich .   Urethra has been stuck shut last 2 days in morning . All urine and swab tests clean . It's getting to really weigh me down 
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
You seem to be having trouble accepting that your symptoms are not due to an STI despite both multiple negative tests and recommended treatment for Gonorrhea, Chlamydia and NGU.  I urge you to believe your test results and look for other, non-STI explanations for your symptoms, starting with the suggestions that Dr. HAndsfield made for you in his earlier reply to you.  This is not an STI problem.  I suggest that a good place to start would be working with a urologist who you plan to see  repeatedly, pursuing both three glass test and consideration of the CPPS (chronic pelvic pain syndrome, well described in Wikepedia) .

The tests you have had provide reliable results.  Please believe them.

This is my third and therefore final response to your questions.  Therefore, as describe in our Forum Guidelines, this will be my final response and the thread will be closed later today.  Take care.  EWH
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43 months ago
Just to clarify . Cipro , Zithromax , and doxy would cure Gonoreah and can Gomorrah be missed on tests if its mild ? 
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Sigh,   Last comment.  If you were infected the test would have been positive.  If you were infected, the medications you took would have cured it.  You need to give up on the STI angle.  EWH
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