How to manage testicular pain and urinary burning?

Question

Hello doctor,

I had unprotected oral sex a few months ago. After that, I felt nervous, so after ten days, I took Azithromycin 1 gram per day for two days, Doxycycline 100 mg twice daily for ten days, and also Cefixime 400 mg as a preventive measure. After two months, I experienced occasional mild testicular pain for a few days. Aside from that, I felt pain in the lower right rib cage; it lasted for a few days and then vanished.

After four months, I underwent blood testing for syphilis, HIV, hepatitis B, and C, and a urine test for eleven types of STDs, including chlamydia and gonorrhea, from a private laboratory. All tests were negative except for Gardnerella vaginalis. After eight months, I began to experience joint pain in my right hand and ankle. It lasted for one month and then subsided. The next month, I had severe right wrist pain, which receded after a month; subsequent pain appeared in the left wrist and then the left ankle, in sequence.

Occasionally, I feel a burning sensation in the penis while urinating, particularly after an interval of ten to twelve hours when I am dehydrated. The burning sensation does not appear during the next urination nor consistently after long gaps. Occasional pain in the lower right rib cage is still occurring. After ten months, I began to experience occasional anal itching. I am very worried. Kindly advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Let me first address the burning sensation during urination. It is common to experience burning if you hold urine for long periods. I would advise you not to do that. Ideally, you should pass urine every three to five hours or whenever your bladder is full. Holding urine for prolonged periods can cause problems such as prostatitis, bladder infection, or kidney infection.

With regard to testicular pain, please provide the following details:

How long has the pain been present?
Do you also have pain in the area between your anus and testicles?
Do you have difficulty passing urine, such as straining, feeling of incomplete bladder emptying, urgency, or a weak stream?
Do you experience any pain after ejaculation?
Are you sexually active, or do you masturbate regularly?
Do you sit for prolonged periods of time?

Regarding your concerns about STIs (sexually transmitted infections), if you have had a negative test, then you should not be worried. I suggest that you see an orthopedician for your bone and joint pains. Please review and respond to the questions above, and I will do my best to assist you. I will also order appropriate tests based on your responses.

I hope this helps.

Kindly follow up if you have more doubts.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern.

Gardnerella vaginalis is naturally present in the female vagina. When it multiplies excessively, it causes bacterial vaginosis in females and can often be transmitted to males during intercourse. As it is not causing you any symptoms at present, I would not recommend any treatment for it at this time.

Regarding your concerns about STIs, since you currently exhibit no symptoms such as penile ulcers, discharge, or flu-like illness, I suggest you put your mind at ease for now. Some infections can remain dormant and reactivate later, but I suggest you only undergo further investigation if and when symptoms recur.

For the time being, please undertake the following tests to evaluate your condition further:

Ultrasound of the scrotum with Doppler.
Uroflowmetry with post‑void residual urine (PVRU).
Vitamin D levels.
Urine routine microscopy.
Semen culture and sensitivity.

Additionally, please avoid sitting for prolonged periods and aim to drink at least three liters of water daily. When the test results are available, we will review them and plan the next steps.

I hope this helps.

Kindly follow up if you have more doubts.

Thank you.