[Question #6939] Std questions help!

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63 months ago
Hello Doctors, I’m very glad I found this website. 
I’m here because I just received negative test results for ch,gon,trich, hsv2,hiv. However I still have these weird symptoms that presented after unprotected sex with a women I hardly know (not a sex worker). About a day or 2 after I started having burning immediately after urinating (during urinating I felt no pain I actually felt relief) pain in low abdomen, and aches/pain/irritation in penis or urethra. after seein the doc and explaining my symptoms my doc did A urinalysis and that was clean, prescribed antibiotics for the burning feeling, I went back a second time and had a clean urinalysis again and that’s when I tested for the stds I listed, I started googling and then came across mycoplasma genitalium? & gardenella? Never heard of these but I’m concerned why my doctor never mentioned testing for these? My main concern is passing whatever is bothering me to my wife, about 2 months after my one night stand my wife started having burning upon urination & strong urine smell, went to her doc and had a clean urinalysis as well. Doc put her on 10 days of bactrum but she quit taking 5 days in (at her doc request)because the side affects were terrible. Since then she hasn’t had any issues at all no urinating problems just occasional strong smelly urine that she started complaining about. And occasional burn upon urinating after drinking alcohol. I’m concerned that we are planning on a third child & id really hate to see her test positive for something during her pregnancy. There is no discharge from me at all. Quick google search shows: Penis pain & irritation is a sign of urethritis? I don’t think I have penile swelling it seems normal to me just has pains that come and go. Similar to a google search of Prostatitis However I’ve seen some posts on here that you guys say no std causes Prostatitis it’s confusing because when you google Prostatitis it says multiple std can cause it. Should I test for these two STDs I just
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Edward W. Hook M.D.
63 months ago

Welcome to our Forum.  I appreciate your confidence in out site and I'll be glad to comment.  Even before I address your specific concerns however, the most important advice I can give you is to stay off of the internet.  While the internet is a great place for communication, much of the health related statements there are incorrect- they are either out of date, misinterpretation or just plain wrong. 

The doctor you saw did not do you any favors by prescribing antibiotics without testing.  The tests taken following antibiotics may have been compromised by the effect of antibiotics.  How long was the interval between taking the antibiotic, which antibiotics, and for how long)?

Strong smelling urine smell is not a sign of STIs or anything else.  It suggests you are paying more attention to yoru urine than normal. 

Additional comments:

While the timing of your symptom onset is suggestive of STI, your symptoms are atypical. STIs do not cause abdominal pain in men and for the discomfort to be most prominent following urination is likewise uncharacteristic.  Further, while a urinalysis is an insensitive test, that it was normal also does not suggest and STI diagnosis.  Mycoplasma genitalium is an emerging. recently discovered pathogen which may cause urethral symptoms.  Many doctors are not aware of it but you can arrange for testing using an initial void urine specimen. 

My advice first and foremost is to stay off the internet.  Although your symptoms are nor typical, you may want to test for Mycoplasma genitalium.  I would NOT test for Gardnerella.  If your MG test is negative, my advice is to try to move on without continuing concern. 

I hope that these comments are helpful.  EWH

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63 months ago
Thanks Doctor,
I was prescribed cipro for 7 days
My std test was taken a month & a half or maybe 2 months after when I returned to my doc. However I did take amoxicillin for a tooth infection , my last amoxicillin pill was 11 or more maybe 2 weeks prior to my test. Would that have an affect on the results that far away?  also my doc did a second urinalysis that day that was also clean with no sign of infection.  So that’s 2 clean urinalysis.  I’m glad you think my symptoms don’t match any STDs that does help me relax, however I added in my post that I also experienced symptoms of “Prostatitis” or at least what google has for symptoms of Prostatitis, perenium pain, testicle pain, tailbone pane, back pain  etc. all of that has since subsided although it did last a few months & I’m left with the penile ache every now and then that most of the time is accompanied by a pain in low back. In your professional opinion do you think I need to test for Mgen? My doc seems to think there is no infection based on the two test and lack of discharge ?? Would Mgen  show on any type of labs or testing for pregnant women? I will stay off the internet regarding these issues as it seems that I’m really misinformed. So you’re saying smelly urine, and frequent urinating  is not A sign of std infection?
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63 months ago
Also, the female I had the encounter with also went and tested because I reached out to her and let her know all of what was going on with me, she tested for everything I tested plus, hiv, hep b, hep c, hsv2 all negative as well with no symptoms on her part.  
The penile pain that’s accompanied by the low back pain is hard to describe m but say when I feel the pain in penis, if you were to make a straight line from penis pain through body to my low back it’s in that area, sometime when feeling the ache or pain in penis if I actually touch that are I don’t feel that type of pain but if I press on my low back area that I was talking about I can almost re create that penile pain or ache feeling. 
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Edward W. Hook M.D.
63 months ago

Thanks for the additional information, given the timing of your testing and antibiotics, you can believe your test results which show that you were not infected.  I agree that your symptoms (including the additional ones you report, do suggest prostate problems.  FYI, prostatitis is virtually never caused by STIs).

I do not feel strongly that you need to test for Mycoplasma genitalium

Correct, smelly urine is not a sign of STI.  In women frequent urination may be a sign of a urinary tract infection or STI, not so much in men.

The fact that your casual partner tested negative adds to the evidence that this is not an STI.

The penile pain radiating to your back adds to concern about prostatitis, not STI. 

Hope this helps.  EWH


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63 months ago
Yes your response helps Doctor Hook!
I agree with you + the fact the penile pain really shows up with prolonged sitting but when standing or walking I almost feel nothing. 
I will move on with no further testing, 
Lastly do you think it’s fine for me to continue normal and proceed with attempting to have a 3rd child without the possibility of Mgen showing on any type of tests taken during pregnancy? 
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Edward W. Hook M.D.
63 months ago

I would not worry about M. genitalium at this time and see no reason for testing.  I also think you can move forward towards having a 3rd child without concern.

I hope my responses have been helpful. We provide up to three response to each client's questions. This is my 3rd response. Thus this thread will now be closed without further replies.  Take care.  Please don't worry. EWH

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63 months ago
Hello Doctor, today i noticed after urinating I looked at my urine and I saw what looks like semen in the bowl along with my urine, it was sort of thick and strand like, I’ve never had any discharge from my penis, does this sound like semen or discharge?
Also I experience a feeling of not fully emptying my bladder
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Edward W. Hook M.D.
63 months ago
This thread should have been closed earlier, therefore the response will be brief and then the thread will be closed.  You need to stop worrying an looking so hard for signs of an infection that is no there.  This does not sound at all like an infectious discharge.  Please relax and move forward.
EWH
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