health STD & AIDS

[Mr. Clean]

are you an athlete ba..? do you ride a bike/ motorcycle frequently..? do you drink a lot of caffeine..?

 

you could have any of the following conditions:

 

1) a compressed nerve at the perineum

2) pelvic floor muscle spasms

3) urethral spasms

 

i suggest you consult a urologist if your condition is starting to bother you...

 

 

doc, di naman.. once a week my sked for basketball tapos gym lang 2x a week. how do i get these conditions? TIA

[TyoPaeng]

Hi MDs. I hope you can help respond regarding this hypothetical situation.

 

A guy has been abstaining from sex for almost a year. He recently met a girl and has been dating her for the past 5 weeks or so. They sometimes engage in unprotected sex. The girl claims to have been abstaining for quite sometime before meeting the guy too.

 

The guy suddenly got some burning sensation when peeing and a few days later noticed some discharge on his penis which is sometimes white, sometimes yellow and sometimes yellow-greenish. He went to a urologist and without doing any more test the doctor diagnosed the case as urethritis. The doctor said that they now don't usually do any more test to distinguish it if it is gonococcal or non-gonococcal urethritis and that they usualy just treat it as gonococcal since the antibioutics will also treat the non-gonococcal case. The guys was given a prescription for Azithromycin (2x250mg single dose) and Doxycycline (100mg, 2x/day for 7 days).

 

Now, the guy is almost sure that he got it from the girl since the girl has been his only partner for almost a year. However, he does not know how to approach her since he is not sure if it is gonorrhea or not. The girl has also not reported feeling anything unusual. One more thing, the guy also performed oral sex on the girl but did not smell anything foul to suggest an STI.

 

My guestions:

1. Was the doctor right in giving antibiotics without having any laboratory test done?

2. Could the guy be just having a really bad case of UTI? Can UTI result to the discharge on the penis? If yes, is it possible that he did not get the UTI from the girl?

3. Is it possible for the girl not to have symptoms if it is gonorrhea?

4. This is not a medical question but you might have some idea on how to approach this due to past patients you had who had a similar situation. How can the guy discuss this with the girl without it looking like he is accusing her? How can he convince the girl to have herself tested and what tests are needed?

 

Thanks in advance for those who will respond. This thread has really been very informative and kudos to the MDs who are giving advises here.

 

Docs, the story continues.

 

After a 1 week treatment of Azithromycin and Doxycycline, the discharge has disappeared. However, the symptom of burning sensation while urinating still persists although it is less painful now. He recalls having this kind of burning sensation while urinating for over a year now but it was an on and off thing and the pain is not really that much (maybe 3 - 4 out of 10 in a pain scale) and no discharge. He told the urologist about it. The urologist prescribed Solifenacin Succinate (5mg, 1/day) for 7 days. He also ordered a KUBP ultrasound with Dx - R/O Urolithiasis.

 

Here are my questions:

1. What could be causing the burning sensation while urinating for over a year now (w/o discharge)?

2. I read through the internet that Solifenacin Succinate was indicated for control of urge to frequently urinate. Why was the guy prescribed with this?

3. I tried searching over the internet but could not find any good explanation for a KUBP ultrasound. What is it and how is it done? Is there any preparation needed before the ultrasound is done?

 

Thank in advance.

[peterparker]

Docs, the story continues.

 

After a 1 week treatment of Azithromycin and Doxycycline, the discharge has disappeared. However, the symptom of burning sensation while urinating still persists although it is less painful now. He recalls having this kind of burning sensation while urinating for over a year now but it was an on and off thing and the pain is not really that much (maybe 3 - 4 out of 10 in a pain scale) and no discharge. He told the urologist about it. The urologist prescribed Solifenacin Succinate (5mg, 1/day) for 7 days. He also ordered a KUBP ultrasound with Dx - R/O Urolithiasis.

 

Here are my questions:

1. What could be causing the burning sensation while urinating for over a year now (w/o discharge)?

2. I read through the internet that Solifenacin Succinate was indicated for control of urge to frequently urinate. Why was the guy prescribed with this?

3. I tried searching over the internet but could not find any good explanation for a KUBP ultrasound. What is it and how is it done? Is there any preparation needed before the ultrasound is done?

 

Thank in advance.

 

 

let me try to answer your queries again...

 

1. There are many possible causes of painful urination, not necessarily caused by an STD. Some of these include:

 

- inflammation to any part of the urinary tract including the bladder, the kidney, or the urethra

- chemical irritation to the lining of the genitals and urethra, such as from soaps, bubble bath, or detergents used to

wash undergarments

- conditions or diseases of the kidney, such as polycystic kidney disease or medullary cystic kidney disease

- sudden rupture of one of the small sacs, or cysts, in the kidney

- urinary obstruction, such as kidney stones

- autoimmune disorders, which are conditions in which a person's immune system attacks his or her own body for

no apparent reasons

- certain antidepressant medications

- tumors or cancer of any part of the urinary tract

 

2. He was prescribed Solifenacin in order to help control an overactive urinary bladder, which means allowing the bladder to retain larger volumes of urine and reducing the number of micturition (urination) episodes, urgency and dysuria (burning sensation) episodes. Less peeing, less pain...

 

3. KUBP ultrasound means examining the kidneys, ureters, urinary bladder and prostate by the use of ultrasound, the procedure similar to doing abdominal ultrasound in pregnant women. The physician is trying to look for problems in the urinary tract, in particular kidney and urethral stones which can cause burning sensation during urination. Before undergoing the procedure, you will be asked to drink fluids so that the bladder will be filled and can be visualized properly...

 

 

 

:mtc:

Edited May 2, 2009 by peterparker

[NASTYMERLIN27]

ok, in the first place bro, did you ask her who gave her these meds, and why is she taking them..?

 

the only reason i can deduce from this is that she has something, most likely an STD judging from the meds she is taking...

 

something tells me that you really like this gal.. and it`s up to you how you can convince her to trust you..

 

try to tell her that you are concerned for her well-being, and convince her that it`s for her own good that she should consult an OB-GYNE if she has problems down there like you mentioned...

 

 

 

 

:mtc:

 

thank you for the headsup...peter & mwah..im not being judgemental..i just want to know...and yes i have to admit i really like this person inspite of the fact that she is really a g.r.o and that she did some "things" before that why she got it...( i was able to get a confession..and yes it does bring the hurt close to home ) anyway now im asking is it possible if i can get her disease via oral contact..intense kissing, french kissing etc. since that is the only initimate activity im able to achieve at the moment...

 

do i need to see a doctor, what do i do?

 

thanks for the help

[peterparker]

thank you for the headsup...peter & mwah..im not being judgemental..i just want to know...and yes i have to admit i really like this person inspite of the fact that she is really a g.r.o and that she did some "things" before that why she got it...( i was able to get a confession..and yes it does bring the hurt close to home ) anyway now im asking is it possible if i can get her disease via oral contact..intense kissing, french kissing etc. since that is the only initimate activity im able to achieve at the moment...

 

do i need to see a doctor, what do i do?

 

thanks for the help

 

 

the sad reality is that you run the risk of getting what she has from all your intimate activities, if ever there are any STD`s that she is presently harboring...

 

i`m not being insensitive to your feelings, but you should tread carefully with this relationship... for your peace of mind, you can have yourself tested if it`s for your own well-being...

 

 

 

:mtc:

[greatliving]

ask ko lang, may rashes na lumabas sa dibdib ko, related ba to sa sexual disease? pano mallman kung 100% safe ka na at wala ng genorrhea or chamyladia?

[mwah]

thank you for the headsup...peter & mwah..im not being judgemental..i just want to know...and yes i have to admit i really like this person inspite of the fact that she is really a g.r.o and that she did some "things" before that why she got it...( i was able to get a confession..and yes it does bring the hurt close to home ) anyway now im asking is it possible if i can get her disease via oral contact..intense kissing, french kissing etc. since that is the only initimate activity im able to achieve at the moment...

do i need to see a doctor, what do i do?

I agree with doc peterparker that you do have the risk of getting whatever she has right now. Remember that kissing involves exchange of bodily fluids too.

 

Keep yourself healthy and have yourself screened for STDs and always practice safe sex.

 

 

ask ko lang, may rashes na lumabas sa dibdib ko, related ba to sa sexual disease? pano mallman kung 100% safe ka na at wala ng genorrhea or chamyladia?

Naku, maraming dahilan ang rashes sa dibdib. Better consult a dermatologist so you can have it evaluated. AFAIK, the most common manifestation of STDs would still be urethral discharge rather than skin rashes.

[peterparker]

ask ko lang, may rashes na lumabas sa dibdib ko, related ba to sa sexual disease? pano mallman kung 100% safe ka na at wala ng genorrhea or chamyladia?

 

 

i don`t want to scare you bro, but AFAIK the STD which can manifest as a rash sa dibdib is syphilis, particularly during the secondary stage...

 

pero this is highly unlikely in your case, if you did not manifest any symptoms usually seen in the primary stage of syphilis...

 

if you are sexually active, and you have more than one partner and you don`t practice safe sex, you can have yourself tested for STD`s if you want to...

 

 

 

 

 

:mtc:

:mtc:

[greatliving]

i don`t want to scare you bro, but AFAIK the STD which can manifest as a rash sa dibdib is syphilis, particularly during the secondary stage...

 

pero this is highly unlikely in your case, if you did not manifest any symptoms usually seen in the primary stage of syphilis...

 

if you are sexually active, and you have more than one partner and you don`t practice safe sex, you can have yourself tested for STD`s if you want to...

 

Thanks, may i know what the primary stage of syphillis? how many months to qulaify to be tested on STD? thank you

 

:mtc:

:mtc:

[peterparker]

Primary syphilis is typically acquired via direct sexual contact with the infectious lesions of a person with syphilis. Approximately 10-90 days after the initial exposure (average 21 days), a skin lesion appears at the point of contact, which is usually the genitalia, but can be anywhere on the body. This lesion, called a chancre, is a firm, painless skin ulceration localized at the point of initial exposure to the spirochete, often on the penis, vagina or rectum, but any part of the body that becomes the point of entry for the bacterium may be affected. Rarely, there may be multiple lesions present although typically only one lesion is seen. The lesion may persist for 4 to 6 weeks and usually heals spontaneously. Local lymph node swelling can occur. During the initial incubation period, individuals are otherwise asymptomatic. As a result, many patients do not seek medical care immediately.

 

Syphilis can not be contracted through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing.

 

You can have yourself tested asap for STD`s but go and consult a physician first before doing so...

 

 

 

 

:mtc:

Edited May 7, 2009 by peterparker

[greatliving]

urologist? or M.D. na?

[peterparker]

urologist? or M.D. na?

 

 

you can consult a general practitioner muna... then you will be referred to a specialist if necessary..

 

 

 

:mtc:

[mindreader]

hi doc peter,

 

i had protected sex with an mpa. i'm just curious if i'm at risk... when i removed the intact condom, i showered immediately... pero i'm not certain if i washed my hands thoroughly after i removed the condom.. i cleaned my penis and scrotum with water and soap... am i at risk for HIV, Herpes, etc. ? 4 days after the deed, nagkaruon ako ng pimple sa top cheek ng buttocks ko. it doesn't have a red patch underneath it.. it's like a regular pimple... could it be herpes?

 

thanks doc... anxiety is killing me.

[haringpulubi]

san ba ok magpatingin w/in metromanila and yung tipong hindi naman nakaka hiya.. what test ba dapat ang gawin? tnx

[peterparker]

hi doc peter,

 

i had protected sex with an mpa. i'm just curious if i'm at risk... when i removed the intact condom, i showered immediately... pero i'm not certain if i washed my hands thoroughly after i removed the condom.. i cleaned my penis and scrotum with water and soap... am i at risk for HIV, Herpes, etc. ? 4 days after the deed, nagkaruon ako ng pimple sa top cheek ng buttocks ko. it doesn't have a red patch underneath it.. it's like a regular pimple... could it be herpes?

 

thanks doc... anxiety is killing me.

 

 

yeah, you are still at risk of acquiring an STD even with the use of a condom bro.. but the risk is smaller compared to doing it bareback..

 

genital herpes usually presents as inflamed vesicles and blisters, so i suggest that you should have yourself tested just to make sure that this is not an early manifestation...

 

 

 

 

:mtc:

[mindreader]

yeah, you are still at risk of acquiring an STD even with the use of a condom bro.. but the risk is smaller compared to doing it bareback..

 

genital herpes usually presents as inflamed vesicles and blisters, so i suggest that you should have yourself tested just to make sure that this is not an early manifestation...

 

:mtc:

 

thanks doc. should i look for a dermatologist or infectious disease MD? or an accredited STD clinic will be alright? thanks very much...

[walanjoe]

Hi folks,

 

Can anyone recommend a doctor (preferably male) who specializes in STDs and has a clinic at the Makati Medical Center? I want to be a responsible horn dog and have myself checked. Any information anyone might have will be greatly appreciated.

 

Thanks!

[MaxHardcore]

thanks doc. should i look for a dermatologist or infectious disease MD? or an accredited STD clinic will be alright? thanks very much...

 

It is certain that Anxiety plays a major role in this scenario. It would be best to have it checked by a doctor, tell him/her all your worries, so that he/she can direct you on what to do, of course this is for your peace of mind. I hope all will turn out well for you... After this is over and all is well, be sure to reflect not to do the same mistakes again. A moment of lust can end up in a lifetime of regrets.

[mindreader]

@walanjoe

 

look for a urologist or infectious disease MD sa directory ng MMC... ako i just got home from the hospital, pinacheck ko yung pimple ko sa butt.

he told me that my pimple is not vesicular naman, so pimple lang daw ito... pag herpes kasi, vesicular siya & clustered... dapat may rash din daw sa ari ko.

 

@maxhardcore

i feel better now.. i hope time will heal the anxiety and guilt... i'll try to stay away sa mga medical forums and google muna...

prolly it's anxiety that caused the pimple and my jeans being rubbed hard to my rear end.... first 3 days was really tough... i frequently urinate and have an irritable bowel movement... para akong namatayan ng kamag-anak hehehe... ngayon ok ok na naman ako... it's still in the back of my head though....

 

iniisip ko din na kung madaling makakuha ng STD sa mga recommended MPs natin, hindi tatagal biz nila... so probably they make sure that their attendants are well trained in safe-sex and they are clean.

[peterparker]

^^^

 

you can never be sure of the mpa`s that you patronize... most of the time yung mga may sakit are the ones na mukhang normal, mukhang malinis...

 

it`s because they are in a very high-risk profession kaya they should practice good hygiene and safe sex...

 

in any case, kung makakaiwas ka naman, just stick to one partner...

 

 

 

 

:mtc:

Edited May 8, 2009 by peterparker

[mindreader]

^^^

 

you can never be sure of the mpa`s that you patronize... most of the time yung mga may sakit are the ones na mukhang normal, mukhang malinis...

 

it`s because they are in a very high-risk profession kaya they should practice good hygiene and safe sex...

 

in any case, kung makakaiwas ka naman, just stick to one partner...

 

 

 

 

:mtc:

 

 

yup. that's why i promised myself that i will not do anything that will put myself in harms way again... i had a bad judgement that night... i was down and angry kasi with problems and i needed an outlet... bad choice...

 

^doc ung pagiging non vesicular nuong pimple is a good sign right? 3 days na siya, hindi naman nadadagdagan or nag pop.

 

thanks thanks!

[peterparker]

yup. that's why i promised myself that i will not do anything that will put myself in harms way again... i had a bad judgement that night... i was down and angry kasi with problems and i needed an outlet... bad choice...

 

^doc ung pagiging non vesicular nuong pimple is a good sign right? 3 days na siya, hindi naman nadadagdagan or nag pop.

 

thanks thanks!

 

 

yep, i believe it might be just an ordinary pustule or papule...

 

 

 

:mtc:

[MaxHardcore]

yup. that's why i promised myself that i will not do anything that will put myself in harms way again... i had a bad judgement that night... i was down and angry kasi with problems and i needed an outlet... bad choice...

 

Way to go bro. Let's not be to hasty next time or better yet... Abstain from other sex workers, but if you can't control your carnal cravings better use our head up there and think what is best and safe. Your also correct about staying away from forums... Not all members are helpful... some of them can scare you to death. Happy for you bro! Stay safe.

[peterparker]

yup. that's why i promised myself that i will not do anything that will put myself in harms way again... i had a bad judgement that night... i was down and angry kasi with problems and i needed an outlet... bad choice...

 

^doc ung pagiging non vesicular nuong pimple is a good sign right? 3 days na siya, hindi naman nadadagdagan or nag pop.

 

thanks thanks!

 

 

 

 

the thing is, when you engage in high-risk activities, you must be aware and be READY to face whatever the consequences of your actions...

 

i`m not trying to scare you or lecture you bro...

 

just a friendly piece of advice...

 

 

 

 

:mtc:

[MaxHardcore]

the thing is, when you engage in high-risk activities, you must be aware and be READY to face whatever the consequences of your actions...

 

i`m not trying to scare you or lecture you bro...

 

just a friendly piece of advice...

 

:mtc:

 

I agree!