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STDs (Expert Forum)
Answers Needed
Answered by
University of Washington
Seattle - WA
This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomoniasis, Warts, Yeast Infection.All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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Answers Needed
by Ginushyne, Feb 08, 2005 12:00AM
I was told that I had Trichomonas and received medicine, but it seems it is still here. There is a shiny coating on my penis and my urethra has been inflamed since contact. I was diagnosed with Nonspecific Urethritis. Could this be my only problem because all Gonorhea and Chlamydia tests were negative. I have also taken an HIV test last week. I first experienced flu like symptoms that have since went away and now feel fine, except for the Urethritis problem that I will be heading to a urologist to determine the problem. I sent in a question last week and I was told in could be Herpes, but I don't have any bumps that are showing so what could it possibly be.
Doctor's Answer
by H. Hunter Handsfield, M.D., Feb 08, 2005 12:00AM
, Feb 08, 2005 12:00AM
Nonspecific urethritis is more properly called nongonococcal urethritis, or NGU. The name itself tells a lot: urethritis (inflammation of the urine passage in the penis) not due to gonorrhea. (Sort of like saying diarrhea not due to salmonella--it says nothing about what IS going on.)
Chlamydia causes about 25-40% of NGU cases--so you are in the majority there. Trichomonas causes no more than 5%, one case in 20. If the trichomonas diagnosis was because you were tested for it and the test was positive, you undoubtedly had it. If it was because a female sex partner had trichomonas at the same time (it is easierr to diagnose in women), then it's a good bet you had trich, but not proved. If neither of those, you probably didn't have trichomonas at all. The causes of NGU in the 50-60% with neither chlamydia nor trich are not well known; various bacteria have been implicated (the most recently identified new one is called Mycoplasma genitalium).
Your question doesn't provide enough information to go much further. The "shiny coating" probably is meaningless. The meaning of "my urethra has been inflamed" needs more information: painful? uncomfortable urination? abnormal discharge? You say nothing about how you were treated: for trich only (usually metronidazole/Flagyl, perhaps tinidazole/Tindamax)? Normal NGU treatment is with doxycycline or azithromycin/Zithromax; most cases respond in a week, but some require repeat courses or extending treatment to 3 weeks or more. Nothing you describe suggests herpes, and certainly not HIV.
If you haven't yet visited your local health department STD clinic, do that beffore you see a urologist. An STD clinic or other STD expert could determine whether you in fact have continuing urethritis and need further evaluation by a urologist or other specialist. Many people with urethral symptoms--such as slight discomfort, with or withoutt urination--don't have any infection at all.
Finally, most NGU that persists after treatment is an entirely benign condition, i.e. the odds are you have nothing at all that will harm you in the long run or create any risk for a future sex partner.
Good luck-- HHH, MD
Chlamydia causes about 25-40% of NGU cases--so you are in the majority there. Trichomonas causes no more than 5%, one case in 20. If the trichomonas diagnosis was because you were tested for it and the test was positive, you undoubtedly had it. If it was because a female sex partner had trichomonas at the same time (it is easierr to diagnose in women), then it's a good bet you had trich, but not proved. If neither of those, you probably didn't have trichomonas at all. The causes of NGU in the 50-60% with neither chlamydia nor trich are not well known; various bacteria have been implicated (the most recently identified new one is called Mycoplasma genitalium).
Your question doesn't provide enough information to go much further. The "shiny coating" probably is meaningless. The meaning of "my urethra has been inflamed" needs more information: painful? uncomfortable urination? abnormal discharge? You say nothing about how you were treated: for trich only (usually metronidazole/Flagyl, perhaps tinidazole/Tindamax)? Normal NGU treatment is with doxycycline or azithromycin/Zithromax; most cases respond in a week, but some require repeat courses or extending treatment to 3 weeks or more. Nothing you describe suggests herpes, and certainly not HIV.
If you haven't yet visited your local health department STD clinic, do that beffore you see a urologist. An STD clinic or other STD expert could determine whether you in fact have continuing urethritis and need further evaluation by a urologist or other specialist. Many people with urethral symptoms--such as slight discomfort, with or withoutt urination--don't have any infection at all.
Finally, most NGU that persists after treatment is an entirely benign condition, i.e. the odds are you have nothing at all that will harm you in the long run or create any risk for a future sex partner.
Good luck-- HHH, MD
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