[Question #2924] Not sure if ngu is back or not

39 months ago
I had unprotected sex with a woman 3 months ago. 2 weeks later had burning and itching in tip of penis with burning while urinating. Also yellowish discharge in morning. Negative for all std tests, doctor said I had ngu. I have taken  1 dose of azithromycin and minocyclin 2 times a day for 30 days. Symptoms went away and appear to be coming back. Can ngu reoccur after treatment? I have been constantly checking my penis due to anxiety and not sure iif I’m just overthinking it. I’m worried I can still give an infection to someone even though I’ve been treated twice.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Welcome to our Forum. I will try to help.  You do not mention whether the doctor who saw you early performed any tests or not  If he/she did not, rather than having someone guess at what is going on, you should be evaluated.  Your persistent symptoms could reflect an infection or it could represent a result of axiety and repeated examinatons. There are several relatively uncommon infections which can cause NGU that would not be treated with the treatment you took (FYI, recommended therapy for NGU is a single dose of azithromycin or a week of a drug like minocycline, 30 days is overkill).   I think you need to be seen by a knowledgeable health care provider who can evaluate you, including collecting and looking at a stained penile swab specimen for signs of inflammation.  The fact that your symptoms went away and then recurred make me slightly favor that your recurring symptoms may reflect your hyper-vigilance and repeated self examination but, as I said, they way to go is with an examination and testing by an experienced clinician.  EWH


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39 months ago
Thank you for your response. Sorry I wasn’t clear. After noticing initial symptoms, I went to an urgent care clinic to be evaluated. They gave me a full screen std test for everything. All results negative. They said they weren’t sure what the issue was, so they referred me to a urologist. I went to the urologist, who examined my penis and gave me a prostate exam. He said he thought it was ngu, didn’t actually test for it. But since I tested negative for stds and had yellowish discharge he figured that was it.  The symptoms aren’t as severe, just some itching and a once in a while shooting pain that seems to be in my urethra. But I do constantly check and squeeze to see if discharge will come out. I have another urologist appointment in 2 weeks. Does this sound like I still have an infection that could be transmitted considering the amount of medication I have taken?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
So as I read your response, it appears that you no longer have the discharge that you described and your symptoms are currently genital itching and an occasional sharp pain in the urethra.  Neither of these is a typical STI symptom.  The itching in particular is the sort of sensation that many people experience when they are looking hard for symptoms and tends to reflect awareness of normal sensations which would not be noticed if you were not looking for them.  My advice would be not to worry and to ask the same questions of your urologist when you see him/her (I hope this is the same urologist you saw earlier) as you have asked me.  I suspect they will tell you that the problem has resolved and all is good. 

FYI, even with exhaustive testing for STIs, in about half of men no clear cause of NGU is found.  Fortunately, this process responds well to therapy and does not appear to put persons or their sex partners at risk for transmission to others or for complications   EWH
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39 months ago
There is now burning when I’m urinating. My appointment with my urologist is not until the 21st so I’m hoping they can help me out. What could cause the burning after the previous symptoms mentioned?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
I'm sorry your difficulties at continuing.  I have two suggestions.  I would suggest that you call the urologist's office and ask him/her to see you sooner.  They should be able to work you in.  when they do, I would suggest you ask that they test of Mycoplasma genitalium, a rare sometimes difficult to treat infection.  EWH
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39 months ago
Thank you. I asked my doctor to test me for mg but they did not have the resources to test for it. I asked for avelox to treat with anyways hoping this will cure it.
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
 Thank you for the follow up.   Mycoplasma genitalium  testing is available at most commercial laboratories however the tests often have to be sent out and are primarily available on specific request. The tests are not listed on the test menu offered by most laboratories.    If your symptoms were due to Mg, the moxifloxacin (Avvalox) would  be the appropriate therapy. With all due respect, 

 I should also add that in those rare cases when NGU is recurrent and persistent  and resists therapy, it has not been associated with complications or transmission to others.    Thus, the following completion of the moxifloxacin if this were an STI of any sort it should go away and not causing further problems. 

 As I  suspect you are aware, forum policy allows us to provide up to three responses to clients. As a result this thread will be closed in a few hours. If there are further questions you will need to open a new thread. I wish you the best.  EWH
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