Expert: Stephen W. Leslie, MD - 11/2/2009

Question
Hi Doc,
I've read through loads of related threads on the site and I just wanted to the pose the question myself. I strayed from my relationship and slept with another girl i know. She said she had a recent STI check and came back clear. However, after doing the deed I felt something was wrong. As this was 24hours after I put this down to guilt at first. Then after a week or so I noticed symptoms like urgently needing to urinate but not going as much as felt. Lower abdominal pain, sometimes painful urination but not always, pain in lower back,pain in the penis and weirdly, never felt this before, pain in the perinium(area between anus and scrotum correct?), and a discharge. The discharge looks, smells and feels like semen, though I am not one to notice pre-cum or discharge like this before so i know it is not normal. I went to see the doc and he prescribed Trimethropin for a UTI. This did not cure it although I dont ever feel a burning when urinating at all now. I was too scared/guilty to face the fact of an STI. I have had Chlamydia in the past and I know the symptoms, whilst this was similar it didnt feel like it was that. As I dont itch at all and remember that itching like crazy, as well as discarge being yellow like, mine looks like semen and i dont have a lot. Sometime none sometimes some, depends. Ironically, I was seen by NHS staff sweeping local area for awareness and managed to get a test done for Chlaymdia....it was negative!

I went back to the doc and said im still getting symptoms, it is hard to explain as they vary from day to day, but this has been going on 2 months now. If i was to explain my symptoms at the mo they are perinium pain, testicles slightly sensitive not massively painful, pre-cum like discharge, pain in penis (comes and goes) and I get leg aches. Likewise, sometime it can take a while to pee, but it doesnt necessarily hurt to do so, as well as an abdominal pain.

The doc has given me co-amoxiclav and metornidazole. I have one tab of each today to take, and three more tomorrow to finish course but I dont think it is any nearer to clearing.

I have a urology appointment pencilled in in two weeks.

Does this sound like prosatitis to you?

Likewise, the only other thing I could think it could be is gonorrhea. Though, research suggests discharge would look more pus like, or smelly, and urinating painful? is this true?

And if it were gonorrhea, whats with leg aches/pain? and surely discharge would be getting worse and worse by the day rather than varying from being there to not being there?

If its worth noting, I do masturbate a lot! Atleast once, sometimes twice a day. Likewise, healthy sexual relationship with the GF. I am 23 years old too, if that bares any relvance.

I know i have brought this on myself but please help me if you can. In someways i wish it was gonorrhea as it is easily treated, but I dont it to be as it is going to cause issues with the missus so wish it was prostatitis, but from what i have read this problem sounds very problematic and people are living with hell becuase of it but atleast im not spreading or giving disease to the missus.

Lastly, its worth noting that the pain is not an incredible disabling pain. Its just a constant ache that after a while starts to get to you.  

Answer
What you've described with the discharge is not typical for prostatitis.  And just because the Chlamydia culture was negative does not rule out other organisms.  You  might want to check with an infectious disease specialist as well as a urologist.  Trying to diagnose this yourself is pointless; you will just drive yourself crazy.