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

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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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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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