Prostatitis and Urethritis/ureaplasma urealyticum

[Rocky4444]

I had unprotected sex about 4 months ago and I started developing NGU--symptoms of Urethritis and prostatitis. (Pain during urination, itchy irritated butt, SOMETIMES a small amount of white discharge, sometimes a tingling in scrotum, sometimes irritation in urethra )  Doc's tested me for STDS--all came back negative. They put me on the works--Cipro, Doxycycline, flagyl--etc. While they seemed to help, it never went away. Now my health insurance is gone and I have a few questions:

1) I read through the CDC  with my doctor that Ureaplasma urealyticum, while is found in 60 percent of sexually active people, can cause these symptoms but ultimately goes away within 6 months without treatment.  Does this apply to prostatitis caused by said infection? everything I read says it is near impossible to treat prostatitis effectively.

I still have some doxycline that I am taking.

2)Sex. should I treat this as if I am able to transmit? If so, how should I know shes in trouble?

3)any ideas you know of that can kill this thing?

Thank you

[H. Hunter Handsfield, M.D.]

This is a confusing question.  I'll try to sort it out by starting with a few facts.

For the most part, Ureaplasma urealyticum is a normal bacteria that people have in their genital tracts.  Tests for it are not routinely done in cases like yours.  There is no reason to believe UU has anything to do with your symptoms.  And if it did, the antibiotics you had would have cleared it up.

Second, prostatitis and NGU are entirely different conditions.  They can cause similar symptoms, and sometimes are hard to tell apart, even by an STD expert or urologist.  NGU is usually sexually acquired, but prostatitis is not.  Most cases of prostatitis are not due to infection; therefore, antibiotics often make no difference in symptoms.

Anal symptoms ("itchy irrirated butt") have nothing to do with either urethritis or prostatitis.  That symptom could be due to a yeast infection, triggered by the antibiotics you were given.  Or you might have any number of other minor problems, like an anal fissure, or just garden-vareity itchiness of unknown cause.  Also, "tingling in scrotum" is not a symptom that goes along with either prostatitis or urethritis.

To the specific questions:

1) UU probably has nothing to do with your symptoms. You don't say what examinations and tests were done to determine whether you have had NGU, prostatitis, or both.  As I said, it can be difficult to tell them apart.  But if the problem started as sexually acquired NGU, that problem has been adequately treated. Whether NGU or prostatitis, at this point any continuing symptoms probably are due to residual inflammation, without any persisting infection.  I doubt that further antibiotic therapy will make any difference, but this is something for discussion with the doctor in charge of your care.

2) Because any sexually acquired bacteria is long gone, there probably is no reason you cannot safely have sex, with no risk to either you or your partner.  (However, if you are planning to return to sex with the partner at the time symptoms started, that person also should be treated to make sure you don't get reinfected.)

3) No, I have no additional ideas.  Continue to work with your doctor.

I hope this helps clear up some of the mysteries, even if it doesn't solve the problem.  Best wishes--

HHH, MD

[Rocky4444]

Thank you for your perspective!!!

Oh, and this should clear up any ambiguousness you had about my original comment.

"While NGU most freqently is caused by C. Trachomatis, U Urealyticum seems to be responsible for a significant proportion of the remainder of cases (20-30%) Without treatment, the disease usually resolves  within 1-6 months although asymptomatic infection may persist thereafter. In women, salpingitis, endometritis, and chorioamnionitis can occur. Prostatitis and epididymitis have been associated with U Urealyticum infection in men."
-CDC's Redbook.

[H. Hunter Handsfield, M.D.]

That statement is a decade or more out of date (which of course isn't your fault!).  UU was once believed to cause up to a third of NGU cases; I was one of many researchers who drew that conclusion in the 1970s and 1980s.  Now we know that most organisms previously callsed UU in fact are a newly described species, U. parvum, which clearly is not disease-causing.  Some strains of true UU may be disease causing but most are not; and overall UU probably causes at best a few percent of NGU cases.

And for what it is worth, the female complications described apply only to chlamydia.  Finally, "have been associated with" is intentionlly nonspecific wording.  It only means that one or more studies found "an association" (which does not necessarily imply causality)  The majority of the research on prostatitis or epididymitis found no relationship at all with Ureaplasma; and prostatitis definitely is not an STD.

Cheers.

[Rocky4444]

Thanks again.

I just assumed I had prostatitis as well as Urethritis because when the infection first started, I felt a STRONG discomfort, an inflammation, in both my butt and urethrus.

Now, my butt has gotten so irritated that it is bothersome to walk. (although the doxycyline seems to be doing its part to kill it)  and it still burns a little to urinate.

Last question: What is Residual Inflammation?

[Rocky4444]

So I read this:

There is a simple test to see if you have a male yeast infection. The very first thing when you wake up in the morning, before you even get out of bed, spit twice into the glass of water that you left on your nightstand from the night before. Now over the course of the next 15 minutes watch the glass of water. If your spit just kind of dissolves and dissipates in the water, you do not have an infection.
If on the other hand it becomes cloudy, with strings, sinks to the bottom, looks like spider webs, you could possibly have it. If there is sediment in the bottom of the glass after 30 minutes or so then you have parasites also and will have to deal with them first. It will be very noticeable, so don't worry about being unsure if you have it or not. In most cases, you will be able to tell in the first 5 minutes.

It happened. does that explain the NGU and inflammation?

[H. Hunter Handsfield, M.D.]

The "spit test" for yeast infection is pure quackery.  Anyway, yeast doesn't cause the symptoms you describe.

Stop searching online for answers to your diagnosis.  You will not find them.  At least pay attention to the professionalism of the sites you visit. No reliable medical source would ever describe the spit test as anything but BS.

Time to end this thread.  Work with your health care provider if you have continuing questions.