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Urinary Disorders

Incurable Urethral Discharge

06/11/2007

Question:

I am 35 years old and live in a third-world country called Pakistan. Ten months ago, I contracted STD, i.e., urethral discharge, from vaginal intercourse in which I broke my condom. A day or two after the contact, I felt severe pain at the tip/head of the penis with clear watery discharge from the urethra. Initial treatment, i.e., Ceftazidime injection, relieved the pain but discharge symptom remained intact. Three injections of 1g each were used during the first month without any improvement.

From the last four months, I have taken a variety of antibiotics courses of Moxifloxican, Ciprofloxican (tablets and injection), Levofloxican with Azithromycine (more than 10g during a month), Erythromycine with Flagyl, Doxicycline. These courses were for 10, 7, 30 days. However, none of these drugs worked.

Doctors suspected the disease as Urethritis, Non-Gonoccocal Urethritis, Prostatitis and nothing. Urine cultures for prostatitis were negative except for prostatic fluid, which shows moderate growth of Staphylococcus Saprophyticus and Acinetobacter Species. The positive culture was attributed to contamination by my physician. Radiologist observes distended bladder and 20CC residual urine in Pelvic ultrasound.

I felt testis pain a week or so after three attempts to get prostatic fluid for the culture test. As in one of the attempts, I vigorously milked from base of penis, or from testis to have few drops of prostatic fluid.

These days, I begin to experience a drop or two of urine a few minutes after post voiding. I do not feel any pain in urination, ejaculation, or in erraction. I do not feel pelvic pain or any other pain. The only concern I have is urethral discharge, i.e., clear and watery, which makes the tip of my penis tender and its friction with cloths causes discomfort as I walk. The discharge does not come in drops: it is only observable.

The doctors in my country do not know it. They think whatever it is it is beyond them. The other day a urologist asked me what he should prescribe me after I told him what medicine I have taken so far. He rejected my idea for the diagnoses of urethral stricture. I was referred to this urologist by an infectious disease specialist after his various treatment failures. However, the urologist prescribed me Fortum (Ceftazidime) 1g IV BD X 5-days. I have not initiated this course so far. I have stopped taking any medicine.

I wish to know if it is chronic prostatitis or a minor urethral stricture. Or it is something else. I am at loss about what should I do? – Forget the disease and wait for the complication. Or try herbal treatment. Please advise.

Answer:

I suspect you have non-specific urethritis and I generally treat this problem with tetracycline 500mg four times daily for 2-4 weeks.  You should also have a culture of the discharge which may be, but is not always, helpful.

Hope these suggestions are of value.

For more information:

Go to the Urinary Disorders health topic, where you can:

Response by:

Case Western Reserve University Martin I Resnick, MD
Formerly, Professor of Urology
Department of Urology
School of Medicine
Case Western Reserve University
Martin I Resnick, MD