[Question #9141] Symptoms but all tests neg follow up
35 months ago
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Dr handsfield. First thanks so much for this service and your prompt replies. You may remember I asked recently about symptoms I developed days after an oral encounter. A scratch sensation on the side of my penis and then urinary symptoms. All tests negative then 5 weeks later burning prostate pain that has not remitted. I had been catheterized 6 weeks before the bj for hernia surgery. Given the timing …6 weeks…it seems cath infection less likely than oral infection so wanted to follow up. You wrote an article where you stated that half of men diagnosed with NGU will never be able to pinpoint a bug from the infection. Chlamydia etc account for only half of the infections. The others are never found. Good article. You also said urea and myco plasma cannot be contracted orally. But I found a study that said it could showed a case of oral infection by UU see
A case of oropharyngeal Ureaplasma urealyticuminfection in a human immunodeficiency virus positive bisexual male co-infected with human papilloma virus and Treponema pallidum.
I tested positive for urea parvum and myco hominis and treated them. But the burning persists. My question is this can I have acquired NGU from oral with an unidentified mouth bug? That has now gotten into my prostate? Is it possible a myco or urea bug was transferred from the mouth and the testing just missed it? I see many many guys online who claim they got prostatitis from oral sex. And many claim that myco plasma or urea plasma were eventually found in their prostrate fluid. Thanks Dr. You are doing gods work here.
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Edward W. Hook M.D.
35 months ago
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Welcome back to the Forum. FYI, Dr. Handsfield and I share the Forum and on this occasion I happened to pick up your questions. In preparation for replying, I reviewed your earlier interaction with Dr. Handsfield and agree totally. As an FYI, in the 1970s the role of M. hominis and U. urealyticum was intensely and aggressively studied and failed to demonstrate a causal role for either organism as a cause of urethritis, including NGU. Both organisms are normal parts of the urogenital flora and demonstration of their presence is a coincidental demonstration of normal genital flora, not identification of something that needs to be treated. Further, with treatment, will these organisms may be eliminated fo a period, as normal flora they tend to recur. Case reports such as the one you have found are suspect and of little relevance to your situation.
Urethritis following oral sex appears to be the result of introduction of normal oral/mouth bacteria into the urethra where they cause transient irritation. There is NO indication that they represent a health problem for sexual partners and sexual health experts debate whether non-chlamydial, non-MG urethritis require treatment at all.
My sense is that the oral exposure you are focused on is coincidental, not causal. Your urinary tract has been instrumented (catheterized) and they may have something to do with your symptoms. Alternatively, you may have the chronic pelvic pain syndrome (CPPS) which is not associated with STIs.
I hope these comments are helpful. EWH
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35 months ago
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Thx DR Hook. Such a great service you provide. Sorry for the follow up but I am about to pull out the hernia mesh in an effort to stop these terrible urinary symptoms. Do want to be sure it’s not std related. Two things. I had a very definite scratch/paper cut sensation on the side of my penis the day after the oral encounter there was no abrasion of any kind. Wondering if that symptom is a sign of any infection you are aware of. 2. If this was a catheter infection from surgery I find it hard to believe that symptoms would appear over 6 weeks after catherixation. Any thoughts? The symptoms came on so directly after oral exposure that it’s hard to ignore. By Non-mg urethritis I trust you mean non microgen genitalium? There are whole Reddit boards boards full of people claiming prostatitis from oral urea plasma infection.
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Edward W. Hook M.D.
35 months ago
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The "scratch/paper" discomfort you mention on the side of your penis is not a recognizable STI symptom. I will however point out that on occasion when clients are focused on looking for abnormal symptoms they sometimes become aware of otherwise normal sensation which ar mistaken for pathological processes. Such symptoms are often described an "itching" or "scratchiness" and are present unless a person is distracted. No sure if this is what you are experiencing but the symptoms you describe raise no concern for STI. . Further , STI symptoms rarely develop within a day of exposure as take time for the infectious process to get to the point where symptoms are detectable.
2. Agree, typically complications of urinary catheterization occur soon after catheter placement. Six weeks would be most unusual
Sorry I don't have other answers for you however nothing here suggests an STI. EWH
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