[Question #1670] Unusual sensation in uretha

43 months ago
Dear Doctor,

About end of October beginning of November last year 2016 I started to experience an unusual sensation in my uretha, it's predominantly around the tip of the penis.  The first time I noticed it my penis kept sticking to my underwear overnight, I went to urinate and after that it stuck again to my underwear so I thought to myself something isn't right.  After that my penis did not stick to my underwear anymore, but I felt very slight burning sensation in my penis and a tingling feeling at the uretha.  I also noticed that my penis slips we always stuck together and it became very uncomfortable.  

I went to get std checked at my local clinic, had a urine test and blood test done, and all tests came back negative.  I then seeked advice from an online doctor who diagnosed it as just an irritation in my uretha and nothing serious to worry about it.  

Since the tests were negative, and the online doc diagnosed it as just an irritation syndrome I just moved on and didn't give it another thought.  About 3 weeks later, this condition healed in its entirety and completely went away.  

However within the past week and a half, after so many weeks of being symptom free, the exact same symptoms have come back but this time  they are much much milder.  It was much more uncomfortable the first time round, and to be honest this time I am only feeling 30% of what I went through in the first episode.  The unusual tingling sensation in the uretha has returned and my penis lips are sticking together.

I have absolutely no problems urinating or ejaculating, there is no burning sensation during urination or anything, and there is no other discharge, the urine comes out clean.  However because the lips of my penis are stuck together I do notice as the urine comes out, it has to pass through the penis lips, and I can feel the lips unsticking to get the urine through, same with ejaculation.

I went back to the clinic in december, but this for a mild fungal infection in my thigh area, whic
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago

Welcome to our Forum.  I'll try to help.

You don't mention your age or recent (last 3-4 months) sexual history but the fact that you chose to go to an STI Clinic for evaluation, as well as your asking questions on our site suggests to me that you are concerned that this could be an STI.  Your negative urine tests do not necessarily rule this out.  Typical STI urine tests test only for gonorrhea and chlamydia and, as a result do not detect non-gonococcal, non-chlamydial urethritis which is actually a more common cause of urethral symptoms such as yours than either gonorrhea or chlamydia. Non-chlamydial NGU can be caused by a wide variety of bacteria which are not routinely tested for.  Common signs of NGU are a slight amount of clear even or no urethral discharge (this could also cause the lips of your urethra to stick together) mild burning on urination.  In situations such as yours, the best test is to stain a specimen taken from your penis with a small swab inserted into the penis.  If white blood cells are seen as a sign of irritation, then this is quite likely to be NGU. 

From your comments, it sounds like something is causing penile irritation.  I may have additional comments after you provide some details on your sexual history.  Also, have you taken any sort of antibiotics since this all began? EWH

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43 months ago
Hi there,  i ran out of characters so i couldnt type anymore.  Im 35 years old,  i did have unprotected oral sex in mid october.  But i went to see a doctor only 1 week ago about this and he told me antibiotics were not necessary and he doesnt think its that serious,  he told me just to monitor it.  

What do you think i should do?  
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
The onset of your symptoms corresponds well with possible NGU from oral sex.  your symptoms have now lasted longer than something that would resolve on its own.  I would suggest further evaluation for NGU, either with your own doctor or at an STD Clinic where a urethral gram stain can be performed.  Such tests are best when you have not voided for at least an hour before the specimen is collected.  EWH
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43 months ago
Edward W. Hook M.D.

Thank you for your advice and information.  I did go to the clinic on saturday and they did a blood test and urine test again 2nd time round and the results of both came back negative again.  They did however this time do a swab test, and found I have white cells inside the urethra so it is determined that I do have an infection.  

Now in this particular scenario, what do I know and what don't I know?  

Well I know I have an infection.  

What don't I know?

Neither myself or the doctors who examined me can determine what the infection is or the cause.  Whilst it is possible it could've come from unprotected oral sex, it is also possible that it could be vaginal thrush (male version of it), male thrush, caused by use of chemicals/oils/soaps, bad bacteria from somewhere that could've somehow entered the urethra.  The conclusion of this matter is there could be 101 possible explanations for this, and even the nurse told me herself that this is not a serious condition to the extent that if the std tests come back negative than I do not need to return.  I went to the toilet roughly 3-4 hours before giving the urine test, and they said this was more than enough time to give an accurate result.

Further to this, if the tests come back negative which they have done twice now, I cannot continue living my life in anxiety I have to accept this information and move on, I can't say to myself "what if this and what if that, or what if they missed something in the results or didn't do the test properly."  If the tests come back negative I have to go with that and just get on with it.

I would like to end this by thanking you for your advice and instructions because had you not recommended I get tested for gnu, then I wouldn't have an infection, but bear in mind the doctors cannot identify this problem and cannot be certain it's even gnu 100%.  From here I will take my medicine and see how I go.  Thanks again.
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago

I'm glad the you have had the swab test.  The presence of white blood cells supports the possibility of non-chlamydial NGU as mentioned above. I anticipate that your tests will once again be negative.  this will leave you with a likely diagnosis of non-chlamydial NGU which is a non-specific inflammation of the male urethra.  This problem typically does not progress to cause complications, does not put sexual partners at risk for infection or complication and most often resolve with therapy using either a single dose of azithromycin or a seven day course of doxycycline taken twice daily for 7 days.  I anticipate that this will be the course you follow.  If that does not occur, it will be time to discuss prostate infection with a urologist.

As this is my third reply to your questions, as per Forum guidelines, this thread will be closed later tonight.  I wish you the best- take care.  EWH

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