[Question #8461] Semen Culture/Analysis for STI
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44 months ago
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Good afternoon, my prior questions were 8372 and 8380.
Last week I visited a urologist for a suspected case of prostatitis. He examined me, agreed it looked like prostatitis based on symptoms and ordered a urinalysis, blood tests and a semen analysis(culture)? He also diagnosed a case of balanitis and prescribed a steroid cream to use for 10 days.
The quick urine analysis done in the office showed trace leukocytes and blood in the sample. The full urinalysis (AIT Laboratories--tested for over 36 microbes including STIs) returned five days later with a sole finding of 95,000 copies/ML Escherichia Coli. The semen culture and the blood work are still outstanding.
To my questions:
1) What is the purpose of this semen culture (which cost me $150 out of pocket)?
2) What are the chances it would find any STI-related bacteria that have been missed by the urinalysis (as well as the two negative G&C urinalyses from Mid-October)?
3) Have you ever seen or heard of something like this happening - an STI infection only found by a semen sample and evading all urine-based NAAT/PCR tests?
I'm probably obsessing over these pending results too much, and the waiting isn't helping. Thanks in advance for your answers and for providing this service.
I;
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Edward W. Hook M.D.
44 months ago
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Welcome back to the Forum. As I suspect you know, Dr. Handfield and I share the forum. Today I happened to pick up your new questions. I have reviewed your earlier interactions with Dr. Handsfield and agree with all that he said. Your findings are certainly consistent with prostatitis and there is no evidence that an STI is present here. Prostatitis is virtually never caused by STI organicism's. With this, we'll address your questions:
1. Urine tests evaluate organisms present in the urine and the penile urethra but may miss organisms elsewhere in the genito-urinary tract, including the prostates' and it's communications with the remainder or the urinary tract. A semen culture will provide additional information which may help to guide the choice of therapies for your infection.
2. Virtually zero. As I mentioned above, prostatitis. is virtually never an STI complication.
3. no. I really think you have effectively ruled out the possibilities of STIs here.
I hope this information is helpful. Please don't worry. EWH
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43 months ago
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Dr Hook, thanks again for your reassuring words. The semen culture result did come back with "heavy growth of Enterococcus Faecalis", so indeed bacterial prostatitis. I'm deep into a five week course of Augmentin and hopefully that will knock it out.
We can close out my (final) question.
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Edward W. Hook M.D.
43 months ago
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Thanks for the follow-up. Given the results, the semen culture proved useful in guiding your therapy
We'll close the thread now EWH
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