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Suggest Treatment For Stinging Sensation On The Penis Tip

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Posted on Mon, 17 Oct 2016
Question: Hello,

I had a sexual encounter and received oral sex without a condom 12 months ago. I started experiencing a stinging feeling at the tip of my penis 11 months ago along with a very small amount of clear or cloudy sticky discharge . I got tested for every std I could HIV, Syphilis, Chlamydia, Gonorrhea, Hep, herpes 1 and 2, and all came back negative. I tested again 2 months later for Chlamydia & Gonorrhea via urine and results still negative. My doctor said since test were negative its not chlamydia or gonorrhea but still gave me a Z pack. 4 Months later and have the same problem I have take 3 more Chlamydia & Gonorrhea tests at different times and all negative. Last night I felt a stinging feeling in the tip of my penis 10 minutes after i ejaculated and cloudy watery discharge came out. I don't know what this could be? Everything I read say this is Chlamydia or Gonorrhea but test keep coming back negative. Could all these test be wrong? Please help.

I also tested for Trichonomas 3 separate times via urine also came back negative.
doctor
Answered by Dr. Tushar Kanti Biswas (10 hours later)
Brief Answer:
Chronic urogenital infection?chronic prostatitis

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

It is quite possible that you are having deep seated infection like chronic prostatitis which is the underlying cause of recurrent cloudy urethral discharge. In such cases urine sample after prostatic massage should be subjected to culture and sensitivity tests and antibiotic course for longer period (if possible as per culture & sensitivity report ) would clear the infection.

For documented chronic bacterial prostatitis, a 4- to 6-week course of antibiotics is often necessary. Ultrasonography (USG) of KUB (Kideny, ureter, bladder) and prostate is needed to exclude involvement of prostate and seminal vesicles.Urine routine examination and semen analysis will also give some clue to chronic urogenital infection.


Regards

Dr. T.K. Biswas M.D. XXXXXXX



Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Tushar Kanti Biswas (1 hour later)
Thank you for your response.

Are you saying that it could still be Chlamydia or Gonorrhea? My doctor keeps telling after so many urine tests it can't be. If its not that then what kind of bacteria could it be. I want to rule out STI. Can you get Chronic Prostatitis from something other than an STI?
doctor
Answered by Dr. Tushar Kanti Biswas (4 hours later)
Brief Answer:
Chronic urogenital infection?chronic prostatitis

Detailed Answer:
Some cases of chronic prostatitis may be caused by persistent infection by fastidious bacteria, such as Chlamydia.
Gonococcal prostatitis occurs rarely.

Nucleic acid amplification tests (NAATs), including the Roche Cobas Amplicor, Gen-Probe APTIMA COMB 2 , and BD ProbeTec ET detect N. gonorrhoeae & C. trachomatis and are more sensitive than culture identification of either N. gonorrhoeae or C. trachomatis.Sample is urethral discharge.It is not clear which tests you have undergone to rule out Chlamydia or Gonorrhea(not mentioned by you).

Chronic Prostatitis can be caused by host of other bacterias including anerobes. A diagnosis of bacterial prostatitis is made on the basis of microscopy and culture of expressed prostatic secretions/ post-prostatic massage urine culture .

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Tushar Kanti Biswas (6 hours later)
The urine test I used for the Chlamydia & Gonorrhea test are NAATs test Gen-Probe APTIMA COMB 2. When you say "not mentioned" I am assuming you mean the test used as I have mentioned my fear of having Chlamydia & Gonorrhea extensively.
doctor
Answered by Dr. Tushar Kanti Biswas (2 hours later)
Brief Answer:
Chronic urogenital infection?chronic prostatitis

Detailed Answer:
You are negative for Chlamydia & Gonorrhea as NAATs tests Gen-Probe APTIMA COMB 2 are negative.

Hence other bacteria/s are responsible for urogenital infection. Microscopy and culture of expressed prostatic secretions (EPS)/ post-prostatic massage urine culture ( Meares–Stamey 4-glass urine test ) are needed to identify the causative organism/s.

In men with recurring urinary tract infections /Urethral discharge , the prostate is a likely source of bacterial persistence.

Regards

Dr. T.K. Biswas M.D. XXXXXXX
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1920 Questions

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Suggest Treatment For Stinging Sensation On The Penis Tip

Brief Answer: Chronic urogenital infection?chronic prostatitis Detailed Answer: Hi, Thank you for your query. I can understand your concerns. It is quite possible that you are having deep seated infection like chronic prostatitis which is the underlying cause of recurrent cloudy urethral discharge. In such cases urine sample after prostatic massage should be subjected to culture and sensitivity tests and antibiotic course for longer period (if possible as per culture & sensitivity report ) would clear the infection. For documented chronic bacterial prostatitis, a 4- to 6-week course of antibiotics is often necessary. Ultrasonography (USG) of KUB (Kideny, ureter, bladder) and prostate is needed to exclude involvement of prostate and seminal vesicles.Urine routine examination and semen analysis will also give some clue to chronic urogenital infection. Regards Dr. T.K. Biswas M.D. XXXXXXX