[Question #6648] STD? incontinence? Other?

12 months ago
Hi,

I have for the past 2 weeks been experiencing slight watery discharge from the penis. It has no color, looks like water, and is very minor. Mostly it is a slight "glisten" at the tip. Only in two instances has it been present enough to constitute a "drop" per say. Sometimes it is not even there. More often than not, I have to "milk" it from the head of the penis toward the tip. Most commonly, I have to spread the tip of my penis to see the moisture inside, then go about this milking process which may be causing it in the first place.

Today I just finished a regimen of Azithromycin (for bronchial issues unrelated). Day 1 I took 500 mg, and the past days 2,3 & 4 I've taken 250 mg apiece. The moisture is still present leaving me to wonder what it may be assuming if I had had an STD, even though it wasn't the reason for my prescription, a biproduct of the Z-Pack may be curing a STD had I had one. 

I am in a committed relationship where we don't use protection.

I have been sexually active with sex workers outside of it. In these encounters they include: protected intercourse, protected oral (receiving not giving), kissing and masturbating each other. As I've read even with female secretions on my hand  likely coming into contact with my penis, those secretions aren't a risk.

I am also wondering if what I'm seeing is terminal  or stress incontinence as I wear polyester briefs, exercise, drink caffeine etc.

Ideas? Thanks!

Edward W. Hook M.D.
Edward W. Hook M.D.
12 months ago

Welcome to our Forum and thanks for your questions. I'll do my best to help.   This is unlikely to be an STI.  As I read your question it appears to me that in the past two weeks you've noted small amounts of thin, clear secretions from your penis which on two occasions were enough to form a drop when you milked your penis- is this correct?  If so, is there are reason that you have been observing yourself more closely than in the past?    Also, could you provide me with your age and information about whether following urination there might sometimes be a drop or two of urine that appear following urination?  I should state at the outset that your condom protected exposures with commercial sex workers should be close to no risk events and that what you may be noting may be normal urethral secretions which are normally present but usually go unnoticed unless one is looking for them. The volume of these secretions can vary from time to time so what you may be noticing may not be an STI at all.

You are correct that any contact with a partner's genital secretions transferred to you in the course of masturbation would not put you at risk for an STI.

Also, I should comment that while the azithromycin z-pak that you have taken might cure non-gonococcal urethritis but the way the drug is given as a z-pak leads to slightly lower cure rates than when an entire 1.0 gram dose is taken at one time. 

Bottom line, at this juncture, rather than taking additional antibiotics, my advice would be to get tested with an initial void urine being tested for chlamydia, gonorrhea (doubtful) and a urinalysis.  What you may be experiencing may be entirely normal, may be a non-STI genitourinary problem, or could (but is probably not) be an STI.  Testing will help to sort this out.

That's it for my initial reply.  I may have additional comments after I see your reply to this preliminary response.  As per Forum guidelines we will have the possibility of two follow-up exchanges.  EWH

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12 months ago
I phrased poorly, apologies and much more info as the field was short:
About 60% of the time, I see moisture in my urethra (which may be normal as I'm OCD at the moment) when I open the glans,  and when I milk it I can get enough of it to the top of my penis so when I close it there is a slight bit at the tip. 40% of the time I don't notice excess moisture at all if I look when I open glans. & on 2 occasions, there was a moist tip visibly without my coercion. Again, looks/feel like water/urine.  No other symptoms. There is definitely post pee dribble as you asked as well and is noticeable.  35 y/o and feeling guilty (the why part). Even with the slightly lower cure rate, could I assume the Z-Pack by now (day 5) would have killed most STI, and thus, if the secretions I'm still seeing are likely not STI related? Too soon to tell? If it were an STI in theory then, would acquisition have likely occurred in the protected incident with workers or unprotected with my partner? Say it was NGU, can that develop without other exposure outside of my protected exps.(basically, assume she is STI free as well and get it from rectal bacteria, oral bacteria etc.)? I assume she is. We did have 1 mutual exp.  3mo. ago where a female went down on her, I went down on this other female, then I had sex no condom with my partner. Neither of us with any symptoms since. 

Thanks for your help. I know testing is the sure answer to tell.





What current 
Edward W. Hook M.D.
Edward W. Hook M.D.
12 months ago

Thanks for the additional information, it is helpful.  What you describe as noticeable moisture is most likely entirely normal secretions which you are more aware of because of hypervigilance.  you are of an age when the sort of post-void "dribble" you describe not uncommonly begins.  As you point out, while the Z-pak may not have been curative, it would have been expected to at least reduce any symptoms (not that I find what you describe as worrisome).

You additional questions regarding NGU within the relationship or other source fall into the "what if" category and serve no realistic purpose.  My sense is that it is unlikely that you have anything abnormal going on and would urge the testing I suggested to resolve your concerns and questions.  Dealing with all of the "what if" scenarios you describe really just leads down a no win rabbit hole.  Please set them aside and get tested.  When your tests come back as normal as I anticipate they will (I'll be happy to comment if you have questions) it will be time to move forward and set your concerns aside.  EWH

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