[Question #5552] Guidance on what to do next

22 months ago
Hey, i've talked to you guys twice the past 2 years for some guidance on what to do, i wanna give a quick resume about my situation

in 2017 February i had unprotected sex with a girl at a party, around 1½ month later i started to develope Epididymitis, at that point i was with a girl im still with to this day, as you already know, i have been tested for several things, and i highly trust the tests, since i dont really have another choice but to do so. The reason im coming back now, is that 2 months ago i started discovered some clear fluid coming out of my urethra, in the beginning i only noticed it cus it blocked my urine in the morning, like it was complete shut, but the last month it has started to come during the day, like a clear discharge, at the same time i also started to get frequent urination which i still have aswell, im really lost in all the confusion, my gf still says she hasn't experienced anything wrong with her for the last 2+ years. 
So here is what i got tested for, so you dont have to find my last post
Chlamydia and gonorrhea 
Mycoplasma Genitalium
Mycoplasma hominis
Ureaplasma urealyticum
Trichomonas
and then ofc i had some urine test but im not quite sure what they check for
all the stuff had come back negative but i wanna ask a few questions. So ofc im really worried i have been giving my gf a std and we've had it for 2 years, i wanna hear from you if you think this could be NGU with the new symptoms? and is there a test for verifying if this is NGU?
and how accurate are the Mycoplasma tests and Trichomonas test? From what i've read different places they barely work.
I really hope you can guide me in which direction to go next, since my own doctors have given up on finding out what is wrong with me.. 
I have made an appointment in 3 weeks for a STD clinic, and i hope they wanna test the discharge i have, i think that is the best way to go now, but what do you guys think?

Im sorry for keep coming back, but it's only because i started to develope these sympto
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Welcome back to the Forum.  I'm sorry to hear that your difficulties continue.  The new discharge which dried to the point of closing your urethra may represent a continuation of the non-STI problem which we discussed in the past   I remain confident that the problems you describe then and now are not STIs and see no reason for concern about that possibility unless you have had sex with partners other than your regular partner/GF since we last interacted.  My concern/suspicion was and is that this is a non-STI urological problem.

Testing for NGU would be looking for WBCs in a urine or swab specimen of your discharge.  This same test would show similar results however whether or not you had sexually acquired NGU or an non-STI inflammatory process involving your urogenital tract.  

If your tests for MG and trich were PCR/NAATs tests, the test results should be believed. Further, I should add that trichomoniasis is not know to cause epididymitis or other similar symptoms similar to those that you report.

I hope this information is helpful.  In my opinion, if you continue to persist in only searching for STI-related reasons for your symptoms, you will not get an answer.  EWH
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22 months ago
My urine tests hasn't shown any WBC as far as i can and what i have been told, my Mycoplasma test was DNA/RNA test, i dont know the difference between tests, but is that one accurate? 

If i had a STD wouldn't it have shown WBC in my urine after all the tests?

as far as i can see, all my STD tests have been DNA/RNA, is that something you know anything about ?

Ye, I agree on that, It's hard to get out of my head all this stuff, especially when all the other symptoms just shows up like that.
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Thanks for the additional information.  Your negative test for WBCs makes NGU not a possibility.  

Yes, the RNA/DNA tests for both MG and trich are the most sensitive tests available. Their results should be believed.  In general, the RNA/DNA tests, sometimes referred to an NAATs are the most sensitive tests for these infections available. You should believe the test results.  EWH
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22 months ago
Ahh thanks for the answer about the test, i really never understood anything about the test difference and their names, i really appreciate the fast replies, my therapist convinced me to try another urologist so im trying another hospital out actually tomorrow, and they wanna check on all the other stuff, so i hope i will be free from pain soon, im so glad you guys in here helped me, you've really supported me mentally through these 2 years of battle, I have no words. 

Thank you so much!
Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
I agree with your therapist's suggestions.  A second opinion is a wise move.  I will leave the thread open so you can report back on what the new urologist suggests.  EWH---