[Question #917] Irritation Symptoms/Test Results

50 months ago
Hi Dr, I have posted a few questions here and it has been very helpful. However, I feel I left out pertinent info in my post. To recap, I had unprotected vaginal and oral sex with a random girl who I met in a sports bar one evening.  A week after I had a slight irritation and was tested for Chl. And Gon. Both negative on a first catch sample. 3 weeks post the irritation was worse, I went to GP but was embarrassed and told her I received oral but was not honest about the vaginal. They took a urine sample where I wiped the tip and urinated in the toilet a few seconds prior. The sample came back negative for Gon and Chl but found "a small amount of normal bacteria" was placed on 10 days of cipro and the irritation went away. Throughout the time I had no noticeable discharge and no pain during urination at all, just the irritation when nothing was happening. Fast forward a few months later and the irritation returned but only for about 2 weeks and has disappeared a few days ago. I have also been tested for trich and mycoplasma and ureaplasma all negative but all on samples where my first few seconds of urinating was in the toilet not in the sample.  I have not been "tested" for NGU but does it sound like it could be that? Also, how much of any effect does the first few seconds of urination not being in the sample effect results? I've tried to pass off the irritation as anxiety but I had completely moved on from this until the irritation returned for a few weeks, so I don't believe it is anxiety related. I don't think I have anything STD related but finding out I took the tests incorrectly along with the irritation led me to these concerns. Thanks for your time and response. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Sigh. My last comment in your previous thread -- which was the second about the same exposure and symptoms -- ended with " Please refrain from any more questions on this exposure and the same issues discussed. Repetative questions are not permitted."

You did leave out any pertinent information in your previous threads. There is nothing new here that makes any difference. You did not acquire any STD, period. I will succincgly answer your specific quesitons and that's all.

"I have also been tested for trich and mycoplasma and ureaplasma all negative." Testing for these bacteria was unnecessary, but the negative results are valid.

"I have not been "tested" for NGU but does it sound like it could be that?" Your sympotms do not suggest NGU, and if somewhere along the line you had a urinalysis and it didn't show increased white blood cells, then you don't have it. In any case, NGU with no known cause (negative tests for chlamydia etc) is believed to be harmless both for affected men and their partners. And clears up on its own. So it's a non-entity and you should not be concerned about it.

"how much of any effect does the first few seconds of urination not being in the sample effect results?" No effect at all. All your test results remain valid.

"I don't believe it is anxiety related." In my opinion, that's all it is.

Do your best to move on. Do not confuse a sexual decision causing guilt, anxiety and regret with the possible infection consequences of that event. Deal with the former issue as you need to, but you can entirely disregard the latter. As I said in one of your other threads, you cannot go through life assuming that every twinge and ache is somehow related to that event. They are not and never will be.

HHH, MD

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50 months ago
Dr, I promise you this will be my last thread. I had moved on and was practicing regular sex with my wife until the irritation popped up again. It was just a constant irritant in my urethra, the same that started my questioning of an STD to begin with, so I panicked a little bit.  I don't believe the urine sample was looked at for white blood cells, but I doubt it considering I believe it was just a dip stick. I should clarify the mycoplasma test was for hominis, although an MG test was requested. I don't believe my GP knew anything about it when I asked. Regardless, I can accept that whatever caused the irritation is no threat to me or my pregnant wife. Thanks for the reassurance on the mid stream tests and their validity. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Urine dipsticks test for leukocyte esterase, a measure of WBC. If the dipstick was normal, increased WBCs were not present.

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50 months ago
Thanks Dr. I was able to contact my GP and she notified me that I did have "slightly elevated white blood cells" back in my sample 3 weeks post exposure. She did recommend seeing a Uroligist if irritation returned as it could be a prostate issue. I assume the elevated white blood cells could have been caused by other things, and the fact that my urine was clear after the cipro would lean that it was not indeed an std, because cipro does not actively used to treat stds? Either way I appreciate the certainty that NGU mostly does not cause any issues if not caused by chlamydia and that helps ease my mind. Thanks for all your help and I appreciate your final thoughts. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
50 months ago
Thanks for the thanks about our services. But for sure this is your last question about this exposure. OK?

Best wishes and stay safe.

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