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What Do My Lab Test Reports Indicate?

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Posted on Wed, 9 Mar 2016
Question: I had unprotected oral sex with a stranger in July 2015. Immediately following the encounter, I felt a burning sensation at the tip of my penis, which remained the next morning. Since the encounter, I have experienced a sensitivity in the tip of my penis when it rubs against my boxer shorts. Using boxer briefs has mostly relieved this problem, but not completely. I have never experienced any painful urination, painful ejaculation, or discharge from my penis. The head of the penis seems overly sensitive to rub, but it is not necessarily painful to the touch. The slight irritation with my penis rubbing against my boxer shorts while walking is the only remaining symptom. Nothing is noticeable while sitting or not moving. I have been with one partner for six years and have experienced significant anxiety from this event.

I have had the following test, all with negative results:
HIV Early Detection @ 2 weeks
10 Test Panel @ 10 weeks
10 Test Panel @ 16 weeks
HIV Antibody @ 13 weeks
Mycoplasma Genitalium NAA @ 6 months
Antifungal Cream Treatment for 3 weeks
Urologists Office Urinalysis and subsequent "culture," both negative.

My General Physician thought he saw some slight irritation inside the urethra, which lead him to suspect M. Gen. I have taken the following medications:
Azithromycin 500mg once a day for four days
Augmentin 875-125mg twice a day for ten days
Doxycycline 100mg twice a day for 10 days
Levofloaxacin (levaquin) 500mg once a day for fourteen days.
My urologist took a quick look and said that my penis looked completely fine, which conflicted the information my GP gave me. I visited my GP again after the urologist and he confirmed that the urethra still looked slightly irritated. I plan on getting one more M.Gen test to confirm the previous results, but my question is, do I need to keep going back to my urologist or is this problem entirely a result of my own anxiety and overreaction to normal sensations?
doctor
Answered by Dr. Vivek Chail (47 minutes later)
Brief Answer:
Anxiety is probably causing persisting vague symptoms

Detailed Answer:
Hi XXXXXXX troutman,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. You have been through extensive testing for STDs including HIV and all tests are negative. Transmission of HIV is negligible from oral sex.

2. Your symptoms is a subtle irritation in the head of penis when it rubs with clothing and not a serious problem which indicates an infection. Concerning the appearance of the penis, I would say that the urologist is better experienced to know the normal from the abnormal penis. Therefore your GP might be making an over diagnosis if urologist has told your penis is normal.

3. You have been given broad spectrum antibiotics which would control any bacterial infection. Antifungal treatment has also been given. Therefore continuing infection is unlikely if you maintain genital hygiene. In case you work in damp surroundings or wear wet clothes and share towels then a chronic fungal infection might have to be evaluated.

4. Mycoplasma genitalium is an emerging infection and is a diagnostic challenge. However treatment with antibiotics which you have been given are sufficient to cure mycoplasma genitalium. This is a difficult organism to grow in culture and diagnosis is difficult. But I assure you that treatment with antibiotics should have controlled any infection due to mycoplasma genitalium should you have it.

5. Your anxiety is one of the important areas which can be causing distress to you. Please try not to think of the oral sex event and keep your mind away from the thoughts of the penis being over sensitive to clothing. Anxiety is one of the important causes of people complaining of genital symptoms even when there is no disease.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Vivek Chail (21 minutes later)
Thank you very much for the thorough reply. One last concern that I didn't address in my previous post was trichomonas. Is this a possibility to be transmitted orally and do my symptoms suggests this as a possibility?
doctor
Answered by Dr. Vivek Chail (57 minutes later)
Brief Answer:
Trichomonas is less likely in your case

Detailed Answer:
Hi XXXXXXX troutman,
Thanks for writing back with an update.

1. Trichomonas is a protozoan an common cause for sexual infection in women. It is less commonly seen in men.

2. The condition is usually spread through penile vaginal intercourse and rarely through oral sex. In your case it is less likely to have trichomonas.

3. Many people are unaware and do not have symptoms of infection due to trichomonas. In men symptoms might include burning or irritation inside the penis during or after urination or ejaculation.

I do not think you have this condition. However for peace of mind you can get tested for it.

Hope your query is answered.
Please do write back if you have any doubts.

Regards,
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. Vivek Chail

Radiologist

Practicing since :2002

Answered : 6873 Questions

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What Do My Lab Test Reports Indicate?

Brief Answer: Anxiety is probably causing persisting vague symptoms Detailed Answer: Hi XXXXXXX troutman, Thanks for writing in to us. I have read through your query in detail. Please find my observations below. 1. You have been through extensive testing for STDs including HIV and all tests are negative. Transmission of HIV is negligible from oral sex. 2. Your symptoms is a subtle irritation in the head of penis when it rubs with clothing and not a serious problem which indicates an infection. Concerning the appearance of the penis, I would say that the urologist is better experienced to know the normal from the abnormal penis. Therefore your GP might be making an over diagnosis if urologist has told your penis is normal. 3. You have been given broad spectrum antibiotics which would control any bacterial infection. Antifungal treatment has also been given. Therefore continuing infection is unlikely if you maintain genital hygiene. In case you work in damp surroundings or wear wet clothes and share towels then a chronic fungal infection might have to be evaluated. 4. Mycoplasma genitalium is an emerging infection and is a diagnostic challenge. However treatment with antibiotics which you have been given are sufficient to cure mycoplasma genitalium. This is a difficult organism to grow in culture and diagnosis is difficult. But I assure you that treatment with antibiotics should have controlled any infection due to mycoplasma genitalium should you have it. 5. Your anxiety is one of the important areas which can be causing distress to you. Please try not to think of the oral sex event and keep your mind away from the thoughts of the penis being over sensitive to clothing. Anxiety is one of the important causes of people complaining of genital symptoms even when there is no disease. Hope your query is answered. Please do write back if you have any doubts. Regards,