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Had unprotected sex, penis itching and burning when urinating. Which blood or urine tests to do to confirm STD?

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Dermatologist
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I had unprotected sex with a friend around 8-9 days back. Since last 3-4 days my penis itches and slightly burns from within - more when i am about to urinate but than goes away in 2 hrs post urine. I am worried if she gave me any STD. I want to 100% confirm if I have acquired any STD. Can you help to know which blood or urine tests i can do? And where can i do such a test in Mumbai, India - south mumbai preferred
Posted Sun, 16 Sep 2012 in Sexually Transmitted Diseases
 
 
Answered by Dr. Shanmugapriya 1 hour later
Hi,

Thanks for the query.

Since there is no external visible skin lesion and there is burning micturition we need to rule out gonorrhoea which presents initially as symptomatic urethritis.

You can get tested for the presence of the organism by Gramstain of the discharge, culture along with direct microscopy to rule out syphilis and p24 antigen with Elisa spot test for HIV. You also would require urine routine and culture study too.


You can get it done in an authorised laboratory with counselling. Almost all the STDs are curable nowadays with early diagnosis and prompt treatment.

So do not panic.

Hope this helps. Let me know if you have more enquiries.

Regards
Above answer was peer-reviewed by
 
Follow-up: Had unprotected sex, penis itching and burning when urinating. Which blood or urine tests to do to confirm STD? 22 hours later
Doctor,

I would appreciate if you could answer my question on which lab in SoUTH Mumbai offers all of the below that you mentioned as that was part of my question. Also can you write all the TESTs by #1, #2,etc so that I can PRINT and take it to a LAB WHERE they will understand your SUGGESTIONS.

"You can get tested for the presence of the organism by Gramstain of the discharge, culture along with direct microscopy to rule out syphilis and p24 antigen with Elisa spot test for HIV. You also would require urine routine and culture study too XXXXXXX --- WHAT TYPE OF CULTURE STUDY ?? what is GRAMSTAIN of discharge??....MAYBE IF you write the way I suggested in #1, #2, it will help the LAB technician and me by understanding how many tests are you suggesting.

In addition dont you think I should get tested for Chlamydia or Trichomoniasis via URINE ?? And What type of doctor do I go for couselling?

And again which LAB in South Mumbai. I am not aware of all the LABS and so was looking for a South Mumbai doctor to respond to my query with suggestion on Labs. But since you answered please do respond to LAB question as there are way too many labs in South Mumbai.

I am worried
 
 
Answered by Dr. Shanmugapriya 19 hours later
Dear Hs,
I am having to cover for your previous physician as she is not reachable at this minute. For the labs in Mumbai, , I would pick Wellspring labs in lower Parel.
As for your particular problem, shall we begin at the top? Firstly & most importantly, please enquire from your partner & ask her if she has similar symptoms or & explain your situation as it will benefit both of you & in either case, treatment of both partners is what i advocate for anyone in our situation.
Next, your clinical symptoms that resolve two hrs after urination, suggest a local problem in your urethra( urinary pipe) (most likely external penile portion). This can arise commonly due to friction during sex with a mild superadded infection & albeit it can be classified an STD, in reality it is a minor mechanical problem that can easily be 'flushed' out drinking loads of water.
Personally in your case, I would in addition, give you a one-time dose of Azithromycin (antibiotic)(depending on your body weight) & I am certain it will resolve. Please see your physician for this.
Should you still wish to do blood & urine tests to calm thin nerves or for completion sake, please do a simple
1) Urine (routine) test (culture tests only after seeing the result & if there is any infection of note) & Blood tests
2)STS/VDRL
3) PCR for HIV (as too early to detect HIV with ELISA)
4) Chlamydial antigen tests);
Once again, I dont recommend the last test as a routine as chlamydia if present is a notoriously difficult organism to isolate or pick in men as there is no discharge to swab of note.. I am sure all will be well. But remember to do all these tests before you start the antibiotic course as it will mask results otherwise!
We would need to check for trichomoniasis which manifests with severe itching & is MORE in women than men..again, do check symptoms with your partner.
Please do have protected intercourse the next time round. Do let me know if you have any more questions.
Dr Praveen Rodrigues
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Follow-up: Had unprotected sex, penis itching and burning when urinating. Which blood or urine tests to do to confirm STD? 12 days later
This is a response to Dr. XXXXXXX Rodrigues.

Dr Rodrigues,

I would appreciate if you can response to this question. Before proceeding I think I want to let you know that I am 35 yrs old male & weight of 74.5 kgs.

In addition I realized I forgot to mention one important information is that my partner performed oral sex also on me.

Its not 23-24 odd days since my last sex/oral sex with this partner. The status of my condition is that now the burning sensation is 50% lower or sometimes even lower than 80% that when I pee. However its existence is still there. In addition I get this feeling when I am peeing of a minor itch as well as something is there - something tiny.The itch of my penis is there but maybe three to four times in a day. Assume this is not abnormal. Having said that I also conducted the urine and blood tests you suggested:

The below tests were done on Aug. 20th which is ~16-17 days after the incident.

Results :
1) Routine Urine Test : All Normal Range
2) VDRL - Negative
3) Pro-viral PCR HIV test - Negative

I am still concerned that the burning sensation still exists. In addition I did get recently a sore/burning throat since past 2-3 days and it always is in the night. I would highly appreciate if you could inform me whether I should do ANY OTHER STD tests and if I should follow up on any of the other STD/HIV tests in the next month or two to confirm I dont have ANY ANY STD or HIV.

How many mg of Azithromycin should I have given my weight ? I have 1000mg and 500 mg with me in Singapore. Should I take it with food or after food - breakfast or dinner ? And what will this medicine help in ?

In addition what do you think is the reason for the penis itch (although limited) as well as the burning sensation which is reduced dramatically but still is there.

I also dont get erections now a days and so i am concerned even more. I would appreciate your advice on medicine, tests now and in future.

I am now back in Singapore and so would appreciate your clear advice on each item listed above.
 
 
Answered by Dr. Shanmugapriya 12 hours later
Hey there HS. Good to hear you are 80% better at the outset. I do understand that you would appreciate clear advice on each item listed above. However, may i suggest that sometimes, too much advice on different fronts, does often render the canvas a bit blurry. Having said that, i reviewed your history & lab tests results to date & my take on it is : Nothing needs to be done..You are Fine. Yes the 'itching' in the pipeline may remain for sometime & this is normal. Also, please do consider that the issue rests in the back of your head & this teeny bit of psychological trauma does have a role to play especially in an individual (more so) who has an IQ a touch more than the general populace. Having said that, objectively, please take a urinary alkalinser that your local pharmacist will readily provide & can be found in satchet or liquid forms as per your particular tastes. Couple that with drinking lots of water & an occasional beer (again alcoholic or otherwise as per your preference) & this will help flush out what little infection remians & reduce the itching/burning. The azithromycin i feel is NOT required at this stage. However, if you wish, you may take it in a dose of either 500mg twice/day after meals or 1 gm once/day for a period of 10 days to 2 weeks to rid yourself of any 'real' or 'imagined' chlamydial infection. Please note am not suggesting here that it is all in the mind but as i suggested earlier, chlamydia is a difficult organism to either include or exclude & given your situation, it would be prudent to take the course over 10 days & then put it all behind you. The sore throat etc is probably just a passing viral infection & unrelated. The erectile dysfunction is also probably related to the mental anguish or self-doubts you have had over the last 3 weeks. Dont worry..give it time & indulge yourself in any recreational activity or sport that interests you & these things usually heal with time sans any medical intervention. Review your situation vis-a-vis erection issues in about 2 weeks time & then the person to visit on the ground (not online) for an assessment would be first a urologist & then possibly a psychiatrist in that order depending on the former's opinion.
I do hope Singapore is bright & XXXXXXX at this point of the year & your disposition will reflect that. Cheers & Good Luck!
Please do close this query & send in your valuable feedback should time permit.
Dr Praveen Rodrigues MD
Dermatologist, Venereologist, cosmetologist, XXXXXXX Hospital, Bangalore, India
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