[Question #1704] NGU

44 months ago
I had never heard much about NGU until I read your site yesterday and I had a question about it.  Several months back I would intermittently experience a slight vibration from within my penis.  It seemed to coincide with when I was sitting a lot in dress pants and never hurt, just would notice the vibration and would eventually go away; usually within 12 hours, often much sooner.  Of late, its been very infrequent because I am more aware of not sitting too much and my overall posture.  I do not currently have any discharge from my penis (and do not remember any really back then except possibly some pre-ejaculate when masturbating).  Also I do not have burning when I pee, underwear stains etc.  In addition, I have been tested through blood and urine twice for STI's (including NAA tests for Chlamydia, Gonnorhea & Trichomoniasis) and come up clean.  Furthermore I have gone to the Urologist twice and they have checked my prostate, cultured my urine and did an ultrasound on my testicles, all of which have come back fine.  I think the Doctor thinks I am crazy.  I am asking all of this because my girlfriend had a UTI in June (which she has a history of since I've known her) and another very mild one in December.  Each time they have checked her urine, saw the bacteria and given her an antibiotic to help fix the issue and all has been well.  My question is, is it safe to assume that I have nothing to do with it?  Do I need to go seek out a Gram stain test or something else on my end to further diagnose?  I know I am likely being overly paranoid, and have read that the STI tests I have taken are highly reliable and the Urologist has given me a clean bill of health; but I wanted to seek your expert opinion to see if you think this is all in my head?  Or if I should seek out some additional testing.  Like I said for me, that initial vibration issue is largely an afterthought now.  I would appreciate any thoughts/guidance that you may have on this subject.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Welcome to the forum. Thanks for your question.

Thanks also for reading other discussions pertinent to your question. However, you may have misinterpreted some of the comments. By far the main symptom of NGU is discharge of cloudy mucus, or sometimes overt pus, from the penis. Often there is mild dysuria (pain in the penis with urination), but rarely alone -- usually with discharge. Despite the symptoms reported by many questioners on this forum, symptoms like yours are not suggestive of NGU. Why the confusion? Because when men have unexplained genital area symptoms like tingling, pelvic area pain, urgent urination, bladder discomfort (often best described as increased bladder awareness), have had a sexual contact they consider risky, and test negative for specific STDs (gonorrhea, chlamydia) they put two and two together. However, they typically come up with something other than four. In some cases, such symptoms probably are in fact the result of the sexual encounter they are concerned about -- not because of an infection, but because anxiety about it can contribute to all these symptoms.

In your case, you don't describe any particular sexual exposure that concerns you, so perhaps this explanation doesn't apply entirely. Further, it seems your main symptom -- the sense of genital "vibration" -- is clearing up, now only "an afterthought". That's exactly what happens to most men with nonspecific genital discomfort:  once they have been medically evaluated and assured nothing serious is wrong, the symptoms tend to fade. (The same with almost any unexplained human discomforts:  back pain, headaches, unexplained abdominal discomforts, the sprained ankle that continues to hurt long after healing. Once assured it's nothing serious, the problem becomes much less bothersome.) As for your partner's symptoms, women get UTIs all the time -- almost all women get a UTI from time to time, often more than once (the result of their genital anatomy, which exposes the urethra to intestinal bacteria that cause UTI). There is absolutely no reason to connect your symptoms with her UTIs.*

For those reasons, I'm confident you have nothing to worry about. You definitely do not have NGU and there is no realistic chance that your STD testing and two urological evaluations have missed NGU or any other infection that could explain your symptoms. There is no evidence of anything that will ever harm you or a current or future sex partner. I strongly recommend against any additional testing.

I hope this information has been useful. Let me know if anything isn't clear.

HHH, MD

* Sex sometimes triggers UTI in women, because sex can massage bacteria into the urethra. But it's not an STD, because the bacteria are the women's own, not acquired from their male partners. If sex seems to be triggering your partner's UTIs, she should ask her doctor about the possibility of a prescription for taking a dose of antibiotic after sex.

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44 months ago

Dr. Handsfield, I wanted to thank you very much for your reply and your consideration.  I can not tell you how much I appreciate it!  This service is an invaluable tool for those of us trying to parse through all of the information we read on the internet while managing our anxieties.  At the risk of beating a dead horse, I wanted to ask one clarifying question if you wouldn't mind.  To answer your question, I did have one potential exposure event last May that I thought could have been worrisome; but seemed unlikely.  Then I read about this formerly unknown affliction (to me at least) and begin to vaguely recall maybe some white discharge during masturbation a time or two (likely pre-ejaculate I would assume, but what do I know).  Then I think about the vibration and her UTI's and I get to a scary outlier scenario in my head.  That all coupled with some soreness in my groin/hip flexor area for the last week or so (I tore them in college playing baseball, so its likely I re-aggravated that injury working out) and see that one of the symptom's if untreated is Epididymitis and my mind begins to race again.  So to ask once more in a slightly different way, with all of what I told you both past and present, and the fact that I had two consecutive clean STI tests and two Doctor's evaluations where I laid out my concerns to him in detail; you do not think NUG is a valid concern and I should move on with my life right?  I mean its not likely that my symptoms would begin to curtail over time right?  Also, just out of curiosity, what percentage of NUG is not related to chlamydia or Trichomoniasis (since that was seemingly ruled out in my case)?  Once again, I can not even begin to tell you how much I appreciate what you do.  The peace of mind from talking to an expert such as yourself is so helpful.  Thanks again for everything

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Thanks for the additional information. Still, you're seriously over thinking all this. A bit of discharge or increased urethral discharge is normal during or after sexual arousal; absence of discharge at ohter times means you had no abnormal discharge. All the rest has been fluff:  it was clear long before your multiple medical evaluations that you don't have NGU. And if somehow you had it, when not due to chlamydia it is generally harmless for both affected men and their partners, and clears up over time. And nonchlamydial NGU doesn't cause epididymitis, so that's not a worry. So at this point none of this matters one way or the other.

About one third of NGU is due to chlamydia, 1-2% trichomonas. The cause is unknown in 50-60% of cases.

Do your best to move on without giving any of this another thought. You've spend the better part of a year overreacting to a non-problem! It's time to let it go.

Thanks for the thanks about our services. That's why we're here.

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44 months ago

Dr. Handsfield,

I just wanted to thank you once again!  Your thoughtful and detailed responses have given me a great deal of peace of mind, especially with the groin discomfort I've been feeling for the last few weeks (which like I said is probably due to the groin tear that I experienced at a younger age that I merely re-aggravated).  So your advice is that I should just move on from this issue and that I do not need to have further discussion with my girlfriend; and that I can have sex with her with no additional concerns right?  I just wanted to make sure all along that I was not at risk of hurting her or causing any unknown harm.  I knew that I was likely creating much of this angst in my own mind; but having someone like you to help to confirm that has been a huge help.



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
44 months ago
Thanks for the thanks. I'm glad to have helped. Best wishes and stay safe.

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