[Question #4047] Possible symptoms, negative test

30 months ago
Hi experts!

I am a 30 y/o male based in the UK.

I had 2 exposures - 1 on the 27th March (genital rubbing with a female at a massage place), and 1 on the 29th March (unprotected sex and oral with a female friend).

I have since spoken to the friend, and she says she has had no symptoms and is not worried at all.

Around 3-4 weeks later, for some reason, I 'milked' my penis and noted a very very small amount of discharge from the urethra (I am uncircumcised). I repeated this again over the next few weeks, sometimes with, sometimes without the very very small amount of discharge - it was almost clear.

I then took a full STI screening at an NHS sexual health clinic on 8th May. 2 days later, all results were negative.

However, around 2-3 weeks after this, I experienced a very dull ache in my groin, which would not subside, nor leave my head! I also noted at the time that one of my testicles (right) was more prominent (poking forwards) than the other, which I had never noticed before.

I kind of forgot about it eventually, and it subsided, although the testicle remained in its prominent place.

However, something triggered me the other day - for some reason, my urine smelled a bit odd, just the once. I then obviously had all these anxious thoughts, and since then, there has been a feeling that there are drops of urine trapped in my urethra. I instinctively hold it in, although even when I relax, there are never any drops from the penis. This feeling completely subsides when I am not sat down. 

Additionally, the old very dull testicle ache has returned, and I'm very much noticing that it is poking forward.

The testicles have never swollen, or been painful to the touch. I have not experienced any pain during urination.

Am I being extremely paranoid and sensitive, or could I be experiencing symptoms of an undiagnosed STI?

Kind regards.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
Greetings. Thanks your question.

First, the exposures described were zero to low risk for any and all STIs. For sure no risk from the massage parlor episode. Unprotected oral is very low risk. Your only potential risk of any potential significance was the unprotected vaginal event, but it sounds like your friend is very unlikely to have anything that could explain your symptoms. Women's judgment they are not infected and have good genital/sexual health usually is accurate.

As for your symptoms, the only one that even hints at an STD is the urethral discharge. But even that sounds insignificant. Entirely healthy men may have scant discharge of the sort you describe from time to time, especially if uncircumcised. The negative testing at the GUM clinic further confirms no infection. The dull testicular and groin discomfort or the apparent prominence of one testicle sound like things that you wouldn't worry about or not even notice except for your anxiety about all this. And ino STI causes such symptoms anyway.

So I really wouldn't worry about this. I see no need for any additional STI evaluation or treatment.

I hope this information is helpful. Let me know if anything isn't clear.

30 months ago
Thank you for your reply. Very helpful and reassuring. Is the urethral feeling I mentioned anything to be concerned about?

 I have read up on genitally focus anxiety and associated CPPS, so could the vague ache and urethral sensations result from this?

That will conclude my questioning, thank you for the wonderful expertise!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
30 months ago
A urethral "feeling" is poor evidence of any infection when the standard tests are negative and show no evidence of urethritis. Your symptoms indeed are suggestive of genitally focused anxiety or CPPS.

I hope the discussion has been helpful. Best wishes and stay safe.