[Question #4295] This is very odd

29 months ago
Hi Doctors. I am hoping you years of experience can shed some light on whats happening. In the last 6 months I have visited with 3 high end csw'ers. In each case, there would be unprotected oral on me, unprotected oral on her, some mutual masturbation, some genital to genital rubbing, possible fluids from her vagina coming in casual contact with my penis, and maybe protected vagina penetration. In each case, a day or so later, I would have tingling in my penis, aching in my bladder, and slight, but not always milky discharge. First time went to a STD clinic in Chicago. They treated for chlamydia (2 g arithro) and gonorrhea (injectible). Urine test came back negative. As did throat swabs. Symptoms vanished after a couple of weeks. So far, pretty straight up. 2nd and third was much the same, AND the same type of symptoms returned. Urine tests with trich this time. And unsurprisingly negative. Symptoms fade after a couple of weeks. Third time. No penetration at all, not oral on me. A bit of genital to genital rubbing, but after a long day my penis could not get erect. Same symptoms. My doc though UTI (?) but no sign in urine ( as I expected). Prostatitis? I could really affirm if any discomfort was a finer in my butt fiddling around or actual inflammation. Awaiting urine results for chlamydia and gon, but I suspect will be negative

In any event, the symptoms appear after sexual activity, and have slight symptoms,but not overwhelming, and they vanish after a few weeks.. But they are consistent. Any advice on what to look for next? NGU? If so, they didnt respond very much after first treatment. Seems my activity was pretty low risk.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Welcome to the forum. Thank your for your question and your confidence in our services.

There is no STD that would behave this way. Although some of the symptoms are not inconsistent with urethritis (virtually always due to STD), other aspects argue against it. First, 1-2 days is too early for onset of urethritis except for gonorrhea, which clearly has not been present. Other causes, i.e. nongonococcal urethritis (NGU) do not have symptoms before a week or so after exposure, often 10-14 days. Second, the sexual exposure events were very low risk (virtually zero risk) for any STD causing urethritis. Third, no STDs are transmitted with the efficiency implied by getting infected after every exposure. In other words, the consistency of symptoms after each of 3 sexual events argues against infection as the cause.

Two main possibilities come to mind. First, perhaps there is underlying prostatitis, with symptoms stirred up by sexual activity. This isn't a common sort of even, but possible. However, if this is the explanation, I would expect the symptoms to occur after any orgasm and ejaculation, e.g. with masturbation, and not only after these sexual exposures. Have you masturbated from time to time since the problem arose? If so, did it seem to trigger symptoms. (And by the way, prostatitis often causes no pain at all, so absence of pain or discomfort does not exclude the possibility.)

Second, I wonder about a psychological origin. Some of the symptoms are typical, but actual discharge is not.

You have had appropriate diagnostic testing, and you also have been treated with drugs that would be effective against any STD that might cause this problem. So I am confident you do (and did not) have gonorrhea or chlamydia, and probably not NGU either. At this point, I would recommend watchful waiting; and if symptoms continue, evaluation for prostatitis. In the meantime, don't be seriously worried. There is little chance of anything serious or dangerous either for you or for your current or future sex partner(s).

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

HHH, MD

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29 months ago
Thanks Doc. That's pretty much what I was thinking as well. From what I can tell from this forums responses, my activities seem to be pretty low risk. And as you say, I figured that these STD's don't transmit THAT easily. Masturbation does not necessarily trigger any symtpoms. I have also noticed a pattern with responses on this forum that many times the symptoms may be exagerrated from any sort of anxiety or guilt, and maybe that is the case here is well that any little tinge or sensation is being overly questioned.

I will have a discussion with my primary care about prostatitis. And in the meantime, it will be watchful waiting. If anything changes, I'll send a quick note. Have a great weekend.