Good afternoon Dr Hook or Handsfield ,I opened a new question to ask some additional follow up hypothetical questions for educational purposes as Dr Hook has already assured me that after 9 months of unprotected sex with my wife since my exposure (and likely gnu infection not caused by chalymdia) and treatment since we are both symptom free and that I have tested neg for Chalymdia/Gonoherrea/Trich/Hiv 3 times and no WBC in urine analysis that there is no further evaluation or swab tests required and it is safe to say neither of us are infected and she was likely never infected (luckily)My questions are as follows:

1.  I have noted in previous posts that both of you referred to NGU as a somewhat harmless infection which goes away in weeks or months if left untreated.  I am curious to know, does this apply to both men and women and if left untreated and the infection and symptoms go away does this mean the GNU is no longer present and therefore no longer tramsmittable?

2.  Does NGU always show symptoms in men? is it possible to be infected with NGU and have no symptoms whatsoever, as is my case now and has been for 9 months?  Do symptoms of reinfection differ from the symptoms of original infection, i.e could an original infection show signs of discharge, pain urinating. blood in urine etc but then a unknown reinfection show no signs whatsoever?

3.  As also noted in your previous posts that NGU rarely causes in harm or fertility issues to infected males female sex partner, I probably shouldn't be asking this question for anxiety reasons but I will nontheless do you have any examples in your lengthy careers that you have seen serious health or fertility issues in men or women as a result of NGU?

4. If someone with no symptoms and negative chalymdia/gonherrea/ trich and hiv tests and no elevated WBC and no leukocytes if somebody walked into your clinic looking to do a swab test for GNU what would be your response?

5.  Lastly, I am curious to know can a woman be infected with NGU for several years but show no symptoms however not pass the NGU to her male partner.

Thanks in advance.

Christopher:  Your perseveration on an event that occurred over 9 months ago, for which you have taken antibiotics for on a number occasions, and after having had sex with your wife over 70 times since the event is worrisome.  I have done my best to assure you that you have been treated more than adequately for any infection which MIGHT HAVE OCCURRED yet now you come back and ask "hypothetical questions".  I will answer them for you but, before I do, I need to counsel you that "hypothetically" you could also be struck by a meteor from space while reading this.  Just as I trust you to not worry about meteors, I also urge you to put your guilt and anxiety aside and move forward.  If you cannot, then I urge you to seek help with a counselor or mental health professional who can help you move forward.  Now on to your questions:

1.  I have noted in previous posts that both of you referred to NGU as a somewhat harmless infection which goes away in weeks or months if left untreated.  I am curious to know, does this apply to both men and women and if left untreated and the infection and symptoms go away does this mean the GNU is no longer present and therefore no longer tramsmittable?

Women do not get NGU.  there may be a female counterpart called mucopurulent cervicitis but this is debated and of questionable significance..  If the syndromes go away, then they are no longer transmissible, if they are at all.

2.  Does NGU always show symptoms in men? is it possible to be infected with NGU and have no symptoms whatsoever, as is my case now and has been for 9 months?  Do symptoms of reinfection differ from the symptoms of original infection, i.e could an original infection show signs of discharge, pain urinating. blood in urine etc but then a unknown reinfection show no signs whatsoever?

NGU can be asymptomatic.  Symptoms of re-infection with the same organism tend to resemble the original symptoms.

3.  As also noted in your previous posts that NGU rarely causes in harm or fertility issues to infected males female sex partner, I probably shouldn't be asking this question for anxiety reasons but I will nontheless do you have any examples in your lengthy careers that you have seen serious health or fertility issues in men or women as a result of NGU?

"Have you ever" questions serve little effective purpose.  The scientific associations with infertility and STIs are not related to syndromes such as NGU but to specific organisms such as gonorrhea and chlamydia, both of which you have been tested (and treated) for.

4. If someone with no symptoms and negative chalymdia/gonherrea/ trich and hiv tests and no elevated WBC and no leukocytes if somebody walked into your clinic looking to do a swab test for GNU what would be your response?

I might test that patient ONCE.  If he persisted as you have, I would then decline to test further and suggest that he seek psychological help for his inappropriate concerns.

5.  Lastly, I am curious to know can a woman be infected with NGU for several years but show no symptoms however not pass the NGU to her male partner.

Another senseless, "what if" question- our responses are based on scientific studies and data, not curiosities and one time occurences.  I suppose this might have happened somewhere, sometime but not that I am aware of.

I hope these responses will allow you to move forward and put your unwarranted continuing concerns behind you.  EWH

Hi Dr Hook, thanks for your response once again, I apologize for the senseless and hypothetical questions.  I can assure you I don't need to see a therapist over this issue, I am sure you can appreciate the fact that I did not even know that non chalymdia NGU existed prior to two weeks ago so the fact that I perhaps was infected with it 9 months ago without knowing and exposing my wife to caused some anxiety and I had some questions which I was looking to be answered and I have been this site to be my best resource with your advice as there seems to be not a lot known about ngu not caused by chalymdia (hence my original incorrect diagnosis 9 months ago as a UTI or prostatitis).  Nonetheless rest assured I value and respect your comments, I just want to make sure my bases are covered and all my questions are ticked off for peace or mind.  A few follow up questions (not hypothetical) and they I can assure you I will leave your alone turn my attention to looking for meteors :)

1) As both you and Dr Handsfield stated that there is no female counterpart of non chalymdia NGU and that it is likely not transmittable at all from an infected male to female and in most cases no health risk and is more of an inconveinience that anything and likely clears up on it's own.  If this is the case it would seem to me that I was not 'lucky' that my wife was not infected but more so it would have been rare for her to be infected after the two unprotected times I has sex with her prior to my treatment.  Is this fair to say or am I mistaken?  PS - I visited a STI clinic in Canada and they said not only do they not test for NGU after a negative chalymdia test but furthermore that NGU "can't be transmitted to my female partner" which makes me wonder why it is recommended that the partner is treated?

2) We know for sure that I was not infected with chalymdia or gonoherra or HIV or Trich as I was tested before and after my treatment.  The only bacteria we don't know for sure if it caused my NGU not from Chalymdia is MG.  As I understand testing is not readily available for this bacteria.  As you know I have tested neg for the STI's as noted above several times so they are not of a concern, my final and last concern is MG at this stage and I would like to answer this question and put this to bed once and for all. Is the fact that all of my recent clean UA and STI tests (no WBC - leukocytes) coupled with the fact that both my wife and I are NGU symptom free and have been for 9 moths enough evidence for you to conclude that there is not MG infection in either of us hence the fact no further testing (incuding swab testing) is required?

Thanks again, this will be the last you hear from me.  After your educated answers to what I hops you deem to be legit questions I will be putting this behind me.  Thanks again for this amazing service.  I will be making a donation to the ASHA in appreciation for all the time and efforts you put into these questions and help people day in and day out.  All the best Dr Hook.

1. " Lucky vs it would have been rare".  Seems to me that you are arguing semantics.  You are lucky the your NGU was not due to chlamydia.  Partner treatment is recommended for partners to men with NGU because in most cases, clinicians do not know their patient's chlamydia status (since a laboratory test is needed to show chlamydia) at the time the syndrome is diagnosed and treated.  Given the import of timely treatment when chlamydia is present, better to treat all partners.  Some clinicians do not even test for chlamydia when NGU is diagnosed since the testing would not change the immediate treatment

2.  Mycoplasma genitalium is know to be associated with urethritis in men which is often not responsive to recommended treatment for NGU.  The absence of symptoms and a clean U/A are strong evidence that you do not have M. genitalium.  I (once again) urge you to move forward are stop this perseveration.  I will add to this that searching the internet is not a wise course of action either as there are many mis-statements and incorrect statements to be found there. 

You need to move on.  EWH