Negative results... what now?

Sexual health
1

Hi,

I'm male 42. Last December I had sex with a new female partner. We used a condom for intercourse, but I received unprotected oral sex. In the following days/weeks I had no evident lesions, sensations, etc. However, about a month after the encounter I began to have a strange sensation in my urethra, not really pain or burning, more like a needle or a light cold burning feeling acompanied by ocasional itching. There is no pain when urinating nor in orgasm. These symptoms were accompanied by an increase in urinating frequently up to 10 times a day for a little more than a week and also by a feeling of urinating even when unrequired. I had these symptons for nearly two weeks when I managed to visit the urologist (1 month and a half after the sex encounter), who prescribed some Flavoxate for the urinating urgency/ferquency and a set of STI tests. The tests included urine culture and semen sample for mycoplasms, bacteria and chlamydia. All came back negative. The doctor was nonchallant about the results (this is about two months after the encounter)... the results are negative, so he figures whatever mistery there is it will clear by it self, and that it is also possible that I had some physical damage. Since I have absolutely no cause to suspect physical damage, I wondered and questioned him if there could be any another cause (sexual or not) for these symptons, but this made no change to his advice. He prescribed me some anti-inflamatory (Nimesulide) to take for a week, which I did. During the nimesulide week my symptons did tone down, albeit at times became worst.... for two days my urethra was painfully sensitive along the shaft. I have now been 6 days of the Nimesulide and my symptons are intermitent, generally during the evening it is quite disconforting, though I never had pain again. Currently my sensation is more like the begining disconfort in the initial area of the urethra (the gland portion), no pain, but a little itching, which increases during the evening.

I'm unhappy with my situation and with the prospect of infecting my girlfriend sex partner. So I have had no sex since that encounter. I'm aware that contracting some decease (STI or not) for a male receiving oral is unlikely (but possible).

I wonder if there could be some other infection which would not be detected in the tests performed, that I should test for? And generally what advice would you give me on how to proceed.

2

John, 

 Did your tests include a check for a urinary tract infection?

3

Your tests are negative; your doctor is nonchalent.   Probably because s/he feels there is nothing organically wrong with you.  And even [perhaps to raessure you] has prescribed somethings.

Try to believe that is the case. Had you had some organic disease that could be passed on then it really would show on tests.

There is next to no chance of infecting a partner [though good of you to consider - of course] if you have nothing wrong.

4

Hi Kathee,

I believe the urine culture, which to my best knowledge is a microscopy test after culture, would include most (all?) UTI sources.

Your question is similar to mine, since I wonder if there are any deceases that might elude the urine / sperm/ mycoplasm tests/culture. Chlamydia was explicitly ruled out. There is no cause to suspect ghonorrea, since I never had any sort of discharge, but it should have also be detected. Another very common is trichomonas, which should also be detected.

However, I do not know if this is the case for some other, perhaps more exotic "bugs", and for viruses. Or if the possibility of a false negative test is something I should consider and perhaps repeat the tests.

5

Hi SimonTheThird,

Sure, I believe the doctor was that believe, and that his prescriptions were, possibly or at least partially aimed at reassuring me.

However, I don't tend to be a high-strung individual, and it's the first time I had such issues, so I'm really not inclined to dismiss the affair as a product of my imagination. Being the devil's advocate the likelihood of a man being infected receiving oral sex is quite low... then again it is not unheard of.

It would be very nice to find out this is/was a psicosomatic thing, however it would not be something I would personally like to gamble on.

6

As you say - and I agree - the risk of a man getting anything from Oral sex is minimal. You describe the other person as a partner and that to me also sounds encouraging. 

I am sure that you have nothing to worry about - is there a counsellor that specialises in such things that you could talk to?

7

Your comment question lead me to re-read my initial posting, which is a bit unclear. I have a regular sexual partner, my girlfriend. The encounter in mid December that percipitated this all issue was casual sex. I guess should have not described this acquaintance as a sex partner, since this was a one time affair.

So there is really no issue of me being suspitious or in some way requiering counselling - though it could be argued that I should have a honest talk with my girfriend... though that would be a moral issue, not a health issue.

8

Yeah.. They didn't teat for herpes, which you soecificihave to ask for. My friends husband never has external sores. He just experiences what you do and has herpes. You need to ask specifically for a herpes test

9

Thank you so much for mentioning that possibility. I'll make sure I'll be tested for that possibility.

10

Well it would be a moral and health issue and if it is herpes, herpes is much worse for women than it is for men. So I suggest refraining from sex w her

11

Well said

12

Hi,

Updating on my first email it has now been 20 days since the Nimesulide course finished. I have frequent, albeit intermitent itching and a little occasional pain. Some times, but rarelly, the disconfort is quite extreme. My urinary frequency has dropped to normal, but the feeling of urgency (i.e. feeling the need to urinate) is almost always there. In this last 14 days I have experienced a very very tender urethra; for a few days all of my urethra felt painful along the penis shaft. The rest of the time my urethra disconfort has focused near the base of the penis (at the beginning I felt it in the beginning of the urethra near the gland).

Following the advice from feelbroken's answer I got tested for herpes: negative

I repeated the initial tests and added some. Basically fishing since there is no concrete theory about what could be the cause.

At this moment, I'm mostly concerned with two possiblities. First, that I might have an assymptomatic or diminished symptoms infection, gonorrhea or trichomonas could be a possibiliity and I'm unsure the tests I did would cover these possibilities. Second, I'm have a doubt about testing. Chlamydia is negative, but it is tested via DNA in the sperm. I wonder if this should not also be done in the urine sample.

I'm now considering visiting a different doctor, because the first one just said, "go ahead and have sex, after the first exams" which I find to nonchalant given I don't feel right.

Thanks for all the questions you may anser and ideas you may have.

13

Sorry to hear things have not gone back to normal. I recommend being tested for herpes again, about two month since secuak contact, as it takes time to build antibodies.

So did you test negative for a UTI? I recommmend going to see a urologist to be honest.

14

Hi feelbroken,

Thank you for your words.

As per my original post, I've been seeing an urologist since this all thing begun.

Yes urinalysis covered for UTI according to the urologist.

Regarding HSV2 it is highly unlikely to be the cause. I had none of the associating symptoms, and it should burn intensely during urination, which is just normal for me. Additionally herpes bouts do not last for months on end, and I've this symptoms for 2,5 months now :-( Also, it would be very unlikely to have it in the urethra from reciving oral sex, and not having it in the shaft and or my own mouth (since there was kissing). Likewise, there were not systemic symptoms at all (which is possible, bu accrues against the possibility). Moreover urethritis due to herpes is only the cause of about 2% of the cases. Nevertheless, I'll retest in due time.

At the moment it is far more likely that I have some fungi / candida spp. Which I'm being empirically being treated for. Lets keep our fingers crossed!

15

John,

 Sometimes frequent urination/urgency is caused by prostate problems.

Did your doctor check you for that type of problem? It could just be a coincidence the symptons showed up after the encounter and are unrelated.

 I agree, you should see someone that does not dismiss your concerns.

16

I know sometimes it can be hard to take the step to get tested, because you don't want it to be that, but you are not correct on how long it can last and the symptoms. 85% of people are asymptomatic or w such mild symptoms, they mistake it for other things, like UTI, heat rash, ingrown hairs, thrush, etc. It absolutely can go on for months at a time, as there is a gentlemen in here that has had his primary outbreak still going on three mo this later. The stuff you read online mostly, are people who are experiencing really bad primary obs.. Not everyone's does that. I have had fissures on my rectum for almost four weeks caused by herpes, so it absolutely can last for months.

There is no such thing as text book herpes. How your body responds to it, is based on your immune system., which is as unique as your thumb print. So w that said, why would you think everyone would experience the same symptoms to a T?

In regards to not having it on your mouth. That could be, because you have contracted HSV 2, typically known as genital herpes. HSV 1 spreads both locations, but isn't as likely to spread from the genitals to another genital, but mouth to genital it is easily spread.

HSV 2 is almost unheard of spreading to the mouth. The few cases it has, it has been w immune-compomised patients. If contacted orally it is likely to never breakout and if so, maybe once and never again.

The one down side to beinf tested for hsv 1 by blood is, it won't tell you the location of the infection. So if you have it orally already and suspect on your genitals too, a blood test will just say positive, but not for where. However if taken w in a month or two after possible infection, being tested for Igm type antibody test for hsv 1, may give you more insight into it being a new infection, which would mean it is on your genitals. If you're confident that it isn't herpes and you've been checked for everything else and being that 85% of people don't even know they have it, which means you should get tested for that to start, why not just take it? Remember, you have to specifically request a herpes test, as it is not included in the full panel.

You don't have to have severe pain and I already explained that my friends husband gets no external outbreaks, he gets it internally, so he feels it in his urethea. I just had two internal sores and non on my external genitals. It happens.

Also if you already have hsv 1 orally, you're not going to break out on your mouth, if you contract it genitally.

I suggest in the mean time, that you take a high quality live culture probiotic in the event that it is yeast or something like that. I have found that taking a daily probiotic has kept my obs at bay and minimized my daily symptoms. Remember, 70% of our immune system is in our gut, so keeping our pH balancareis detrimental to the strength of our immune systems. High quality zinc, vitamin C and Bs are also what is needed for a healthy immune system

17

Feelbroken,

As per posts above, I tested for HSV2 about two months after possible exposure (both IgG and IgM), and plan to retest since antibodies can take some time to build up. Also, I'm not discarding HSV2, that's why I plan to retest, it is just that the likelihood is low according to my doctor (urologist) and other sources (mostly scientific journals). By the way, I "only" had kissing and received unprotected oral sex (i.e. no genital to genital unprotected contact, and did not "give" oral sex).

Thanks for the probiotic tip, I'm already on it ;-)

18

I have been thinking about that possibility, which is an avenue neither the doctor (urologist) nor I considered. But will need to.

Again, I have been seing a doctor since the symptoms begun (1st visit to doc's office about a week after initial symptoms). Regarding this I've been thinking about a second opinion (fresh thinking). I've not appretiated much the aparent(?) nonchalant attitude of the doctor, but have not pursued that because up until now he has basically followed what my cursory exploration of the literature advices on diagnosis of uretritis. However, it seems that it is about time to do it.

 

19

The likelihood of what is low? Getting HSV 2 from oral sex? If yes, that is true, but is possible. I also question now how accurate the numbers are on hsv 2 oral transmission as, having a discussion w my sister in-law who is a dental hygienist, informed me she sees HSV 2 orally much more frequently than is stated in medical literature. I asked if they're actually swabbing these folks and she said some, yes. So now I wonder, because it wasn't too long ago that, they thought you couldn't spread herpes when there was no active ob, hut we all lnow that to be true now.I noticed you used a condom during sex, but that only gives you a 30% protection rate from transmission.

If you're saying getting heroes from oral sex is rare, you and your doctor arw incorrect. 70% of new genital herpes cases in the UK are from oral to genital transmission and it is 30% in the US. If you say this is true in medical literature, please provide sources, as I will provide you sources to show this as well. I haven't found many doctors to lnow much about herpes, unless an infectious disease doctor and have a lot of old school train of thought.

I guess maybe then the question is since you apparently have already tested positive for herpes, what answers are you looking for in this forum? Arw you hoping that your test results say different when you retest again?

You are stating now in your post that you didn't have intercourae, but your original posts states you had protected intercourse and unprotected oral sex. So I'm confused now, especially after learning all this time you tested positive, but because you and your doc think the likely hood that it's low to be herpes, that you think it may be something else?

20

John,

  Sometimes the difference in doctors and their knowledge can be eye opening. I had a female type problem years ago and went to four different gynecologists, they all did the same test and came up with nothing, Then I found a great doctor that knew what was wrong by just the symptons I gave him,  and he solved my problem. Naturally, he became my doctor for life! Don't give up, and try to let the next doctor diagnose your problem instead of trying to guess what it might be. Find someone with a good reputation if possible.

Good luck and let us know when you solve the mystery.

Kathee