[Question #4803] Follow up to query #3993

25 months ago

July end: Blood test for HIV, Hep B&C and Syphillis were negative. With discharge still ongoing, I went to the local STD clinic. Learnt at this visit that I have phimosis - for the past 27 years, I never knew foreskin was meant to pull back all the way. We did a swab sample from my penis and a urine test to re-check for Chlamydia/Gonorrhea/Mycoplasma/Ureaplasma etc.

 

In the meantime, he prescribed me moxifloxacin which did the trick. My discharge was gone. Above mentioned test results back negative a week later as well. In light of my phimosis, he referred me to a Urologist.

 

Nov 4: Saw Urologist, got prescribed betamethasone to see if it helps loosen up the foreskin. At this point, I had started to notice some dribble after peeing. Mentioned this to him - he suggested a couple of techniques to try to milk out the remaining urine at the end of each pee. 

 

Dec 13: No effect of steroid cream on foreskin and my dribble continued. Went back to the STD clinic. The doctor there said it likely isn't an STI but we decided to do a urine test again. Also, there was some burning around my anal area - this was a yeast infection for which I applied some nystatin over the next few days and it went away.

 

Jan 3: Above noted test results were negative. Saw the same doctor that I'd seen back in July. I asked if it was a UTI/Urithritis - he said that the urinalysis done on Dec 13 tested for Chly/Gon/Mycoplasma/Ureaplasma type bacteria which came back as negative so it is unlikely that I have an STI.

 

Noticed burning sensation in my groin at the time, he looked at it and didn't see anything. Confirmed that my symptoms weren't indicative of herpes. Asked what it was that originally cause the discharge back in July - he said that it could have been a bacterial infection that the broad spectrum moxi took care of - asked me to go see the Urologist again for the dribbling.

 

Today: So, are we missing anything here? My current symptoms are -  burning sensation in the groin (mostly on the left side) but no visible rashes, dribbling after peeing enough to have me put paper towel in my underwear and on occasion, an increased urge to pee. Is urine getting trapped underneath my foreskin? Could it be a due a blockage/inflammation that isn't showing up on the tests? Why did the dribbling never happen for the past 27 years, and just began a couple of months after the discharge issue was treated?

Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Welcome back to the Forum.  On this occasion I will be answering your question.  I have however reviewed your earlier interaction with Dr. Handsfield and agree with all that he has said.  You have been evaluated and cared for quite well by both the clinicians at the STD Clinic and by your urologist.  Your most recent tests do show that your possible STI problem, most likely related to normal bacteria introduced during oral sex, has resolved.   Your groin discomfort may have reflected a yeast infection subsequently, possibly related in part to he antibiotics you took- this is not uncommon.  I suspect your STI-related problems are behind you.  The continued dribbling and perhaps discomfort are most likely urological in origin and my advice would be continue to work with your urologist- he has the advantage of having seen you before so he knows what things were like before and can directly examine you, something I cannot do.  Likewise he is in a better position to help with your persistent dribbling than I.

I hope these comments are helpful.  If not, please feel free to use your up to two follow-up questions to seek clarification.  EWH
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25 months ago
Thank you for the response, Dr. Hook. To follow up:

1) Could my dribbling issue be a UTI/urithritis that isn't showing up on the urinalysis (which I have had done 3 times in the past 6 months)? Is there another type of test to check for a UTI that you'd recommend? Would it help to go to my family doctor and possibly get a standard dose of antibiotics used to treat a UTI?
Since the last 2 days, my urge to pee has increased significantly, especially when sitting down. This combined with other symptoms of candida overgrowth (some fatigue, burning sensation in the groin, recent yeast overgrowth in the anal region) leads me to think that I could have a UTI since that is another candida overgrowth symptom.

2) If not a UTI, could an enlarged prostate be an issue here? As mentioned in my previous query, the doctor at the ER had done a rectal exam to check for this - I presume that is a conclusive enough test? I do understand that given my relatively young age, this is a low chance to begin with.

Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
As I've already told you, this is not urethritis.  By definition, urethritis is an inflammatory process. There was no inflammation (leukocytes) on your urinalysis.  As I also have said, I believe this issue would be best addressed by returning to see your urologist.  

Your follow-up question suggests to me that you have been to the internet for information, something that I would advise against.  Symptoms of fatigue are no a sign of candida.  Similarly, UTI is not a symptoms of yeast infection

2.  Dribbling and incomplete urination are possible signs of prostate problems.  Once again, the person to see about the possibility of prostate problems is a urologist.

Apparently, even though you've already seen a urologist, you do not want to do this.  I am not sure why.  Irrespective, it is time to put aside your concerns that your urinary problems are an STI.  EWH
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