[Question #6876] STD or smth else?

11 months ago
Hi Drs,

This question isn't based on a specific exposure. On Thursday (2,5days ago) after sex with my regular partner I tried to urinate and felt a sting/pain/burning on my bladder area and couldn't urinate. It smoothly went away and I eventually managed to urinate. Since then always feels like I want to urinate but then when I try, very little comes out and sometimes very little but then ends up all coming out. Together, also feel really bloated and like I can't properly defecate. 

Went to the urologist and he examinated me. Did an ultrasound and all good, urinalysis all good, WBC all good. Also ordered c/g tests but will only know next wed. He doesn't think it is gono but could be chlamyidia. I haven't had ANY discharge or burning. Only that feeling of wanting to pee and sometimes sitting on te toilet and only a bit coming out. 

I would like to just ask what you guys think so I can relax a bit. Thank you so much for your time.
11 months ago
When I say that this wasn't based on a specific exposure, I mean as it could be that she could be carrying any type of STD without us knowing even tho she hasn't had any symptoms and I don't have reasons to believe that she would have any std. 

When I pressure my bladder also feels it is full but my intestines also feel like being full. could this be related? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
11 months ago
Welcome back to the forum.

Your symptoms don't fit with any STD. You could have a lower urinary tract problem, like overactive bladder, a prostate problem, or just genitally focused anxiety. But not an STD. You're doing the right thing by seeing a urologist, and I would advise you to continue to work with him (or her) if your symptoms persist. (That said, I do disagree with your urologist that "it could be chlamydia". That's no more likely a cause of these symptoms than gonorrhea.) On top of that, you describe a partner unlikely to have any STD.

Sorry I can't be more helpful. Good luck.

HHH, MD
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11 months ago
Hi Dr and thank you for your reply. 

Let me add something that maybe wasnt clear as I my first post was written in a rush. For your reference I am 29 years old.

Symptoms:
My bladder often feels full and when I tried to urinate the urine comes very slowly and it takes time to finish. Sometimes only a little bit comes out even if I feel like having a full bladder. It is not painful, but uncomfortable.  It seems like I can feel the urine coming down my urethra and then only after a few seconds it comes out.  I read on healthline that this could be something like urinary hesitancy and one of the causes is STD infection and that's why I am here too.

Possible explanation for C:
My partner isn't likely to have a STD but in my head and makes me overthink is if I could have in the past passed something to her at some point (I had C long time ago - maybe 6months - but was treated with 1g of AZI, waited 7 days before resuming sex and didn't do a cure test) and then she passed it back to me and I'm having symptoms now. She never had any kind of symptoms. 

Please don't see this as going against your advice but more like trying to answer all questions in my head. Once again, thank you so much.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
11 months ago
These symptoms still are not typical for any STD. The STDs that infect the lower urinary tract (gonorrhea, chlamyida, Mycoplasma genitalium, NGU, rarely herpes or trichomonas) only cause symptoms of the urethra. They rarely if ever affect the upper urinary tract e.g. bladder or prostate -- which are where symptoms like yours originate. In my 4+ decades in the STD business, I've never seen a patient with urinary hesitancy, urgency, or tenderness ove the bladder who turned out to have any STD. All this could be nothing more than genitally focused anxiety; or earlier than average onset of common problems in aging men like overactive bladder or prostate gland enlargement.

Having said that, azithromycin fails to cure a small percentage (2-5%) of genital chlamdial infections (15-20% of rectal infections). For that reason, it would be reasonable for you to be retested for chlamydia. However, if positive, it's unlikely that re-treatment would have any effect on your symptoms.

Keep working with the urologist; consider printing out this thread as a framework for discussion with him or her.
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11 months ago
Hi again Dr,

I was awaiting for my results and they came back negative today. I still have the same symptoms and really don't know what to do. 
Ultrasound says:
The prostate is normal in size and echotexture
The gallbladder is normal in terms of size, shape and content.
Both kidneys are normal in size, shape and position. No evidence of hydronephrosis, scarring, focal lesion or stone is
identified.
No stone is seen in the urinary bladder.

All is good really.. As you said this might be anxiety or some other thing and I know that you don't discuss those things on this forum. I will work on it. I just left this info here that might also help someone else in the future. Thank you and all the best.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
11 months ago
Glad to hear your work-up is normal so far. For the reason you already understand, I won't speculate further on possible causaes for your symptoms. 

That completes this thread. I hope this discussion (and your previous one) were helpful. Best wishes and stay safe.
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