Does pain during urination with discharge indicate infection?

Hello,

Welcome to icliniq.com.

I understand your concern.

Thanks for explaining the situation clearly. Your symptoms are most consistent with urethritis, most commonly due to a sexually transmitted infection such as gonorrhea and/or chlamydia.

The fact that you previously had what sounded like gonorrhea and improved after injections also supports that you are prone to recurrence or reinfection.

A green or yellow discharge is strongly suggestive of gonorrhea, and chlamydia can also cause discharge (often clearer or white).

Symptoms can fluctuate, so some days, no pain does not rule it out. If untreated or partially treated, it can persist and spread (epididymitis or testicular pain, prostatitis, and fertility issues).

I recommend you get tests as soon as possible (before taking antibiotics if possible).

• Nucleic acid amplification test or polymerase chain reaction (PCR) urine test for Gonorrhea and Chlamydia, nucleic acid amplification test for Trichomonas.

• Human immunodeficiency virus (HIV), syphilis (rapid plasma reagin), or venereal disease research laboratory, hepatitis B screening.

• Urinalysis or urine culture if burning is prominent to rule out a regular urinary tract infection.

• If your clinic can swab urethral discharge, that can also be useful, but a urine nucleic acid amplification test is usually enough.

Because discharge has been ongoing for a month, you should be treated by a clinician. Typical treatment depends on local resistance patterns and what is available, but many places treat for gonorrhea and chlamydia together unless tests prove otherwise. While you are waiting for testing, results, and treatment:

• No sex (including oral sex) until you and your partner are treated and symptoms are gone.

• Inform your recent partners so they can be treated too; you will get reinfected.

• Avoid squeezing or milking the penis for discharge (irritates the urethra).

Go to the emergency department urgently if any of these happen:

• Testicular pain or swelling.

• Fever or chills.

• Severe pelvic pain.

• Cannot pass urine.

• Rapid worsening discharge or pain.

The two injections in the arms could have been antibiotics, or sometimes one antibiotic and pain medicine. Even if it cured the last episode, this could be:

• Reinfection from an untreated partner, or incomplete or incorrect treatment for the organism.

• Another sexually transmitted infection, for example, chlamydia or trichomonas, or non-gonococcal urethritis, for example, mycoplasma genitalium, which needs different medicines.

Please help me with answers to the following questions:

• Any testicular pain, swelling, or groin pain?

• Any sore throat, rectal symptoms, or oral sex exposure?

• Any new partner or partners in the last two months, and is your partner having symptoms?

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.

Hello,

Welcome back to icliniq.com.

I understand your concern.

Thank you for the update and for sharing the urine report. Your report suggests white blood cells, 20 to 25 per high-power field in the urine, which indicates inflammation or infection. Other parameters are fairly normal.

So, this is not a completely normal urine test. It supports that there is urethral or urinary tract inflammation, which corroborates your symptoms. Because you had oral sex before this started, one important possibility is sexually transmitted urethritis, especially:

• Gonorrhea.

• Chlamydia.

• Sometimes other organisms cause non-gonococcal urethritis.

Even if you have not had sex in the last few months, an infection acquired during that last encounter can persist if untreated. A routine urine test like this cannot tell us exactly which germ is causing it. You still need proper testing for:

• Gonorrhea.

• Chlamydia.

• Ideally, Trichomonas if available.

The best test is a urine nucleic acid amplification test or polymerase chain reaction. Please go back to a clinic or doctor and ask for:

• Urine nucleic acid amplification test or polymerase chain reaction for gonorrhea and chlamydia.

• If available, Trichomonas testing.

• If the discharge is obvious, a urethral swab may also help.

Based on your symptoms and this report, you will most likely need antibiotic treatment, but this should be given after proper sexually transmitted infection-directed evaluation, because gonorrhea resistance is common.

The correct antibiotic depends on the likely organism. Your previous injections may not cover everything if this is a different or recurrent infection

Until then, please follow the instructions mentioned below:

• No sex until evaluated and treated.

• Do not self-medicate randomly.

• Drink enough water.

• If you have discharge, burning, or worsening pain, get seen sooner.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.