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Q. I have discomfort in urethra after intercourse. Is it STD?

Answered by
Dr. Aman Gupta
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 12, 2015 and last reviewed on: Feb 20, 2019

Hi doctor,

I am having a weird feeling and discomfort around the opening of my penis for several months now. I have got both UTI and STD urine test done but everything came up negative. The discomfort lessened considerably a week or two, after which it is still around. I went again for another UTI and STD urine sample and a blood test which was clear. But they said I did have a good bit of white blood cells in my urine. The discomfort is tolerable but still mind screwing. I have had genital herpes for about a decade and kidney stones before as well.

I am pretty rough when intimate and the first sign of this issue was a couple of days after intercourse. My main concern is that I am starting to get intimate with another person with genital herpes as well. There is no discharge, swelling or blood at all and my erections did not hurt. I did not even remember it unless I think about it or when I am occupied. It seems like its presence is less or gone when I am standing or walking for periods of time. I would like to confirm what it is?

#

Hi,

Welcome to icliniq.com.

Yours is one of the most common problems which I see in my outdoor department every day. It has different terminology amongst different clinicians such as urethritis, prostatitis, chronic pelvic pain syndrome, etc.

Probable reasons are some irritation of nerves around the prostate area. The reason for it is generally unknown but in majority tends to get worse with stress. It is physically harmless except that it is bothersome. Most of the tests will be normal.

It can be controlled with medicines. However, it tends to come and go; aggravated especially during the period of stress and tends to disappear when you stop bothering or thinking about it. Treatment steps are as follows:

  1. Take hot water bath in the evening for a few minutes or take a tub of warm water and sit in it every day for a few minutes.
  2. Analgesics like Ibuprofen (assuming no allergies or contraindications) for 5 to 7 days.
  3. Tablet Amitriptyline 10 mg every night for 6 to 8 weeks (it is a mild sedative and painkiller as well). The dose can be increased to 25 mg if effects are suboptimal. It can make you feel sleepy as a side effect. It will not be available without a prescription.
  4. If not taken before, a course of antibiotic Levofloxacin 500 mg once a day for two weeks.
  5. In some people, I add prostate medicine called Tamsulosin 0.4 mg once every night for one to two months.
  6. Stop thinking about the problem.
  7. Involve in some form of physical activity like walking and jogging.

Most of my patients respond to the above treatment. If the problem comes back again after a few weeks or months, then I generally repeat Amitriptyline for a few more days.


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