Brief Answer:
abstain from sexual intercourse unless completely treated..

Detailed Answer:
Hello XXXX, Welcome Back to HCM,

I've gone through your query and understand your concern..

Your concern is quite justified and at the same time some what complicated, so let me describe them thoroughly, please go through them carefully and let me know if anything's not clear in the first place..

First of all let me inform you that the penile image you've shared doesn't show any thing significant other than some tiny blood vessels which is normal findings only..

Secondly, I've reviewed the urine analysis (no problem due to the language as the important parameters are legible), it's within normal limits too..

Please note that unprotected oral sex is very unlikely to cause an STD like Gardnerella (I can understand why your doctor was so puzzled), however in a detected case of symptomatic Gardnerella, the recommendation is for Oral Metronidazole therapy 500 mg Twice daily for 7 days, so please let me know which antibiotic therapy were you prescribed for 5 doses in one day ?

Please also note recurrent/chronic prostatitis has an association with epididymitis(due to ascending infection) so needed a through clinical evaluation as well as investigations..

Good to know that Trichomonas, ureplasma, herpes were negative, but you haven't mentioned another important organism i.e. Gonorrhea , as this symptoms can be attributed due to gonorrhea also, so my advice will be to get tested for it in the first place..(please try to understand that it's not possible to comment on what couldn't been detected in spain, however in my opinion you should've retested to rule out Gonorrhea as well as chlamydia)..

Another important factor is to get investigated thoroughly for prostatic secretion routine microscopy as well as culture and sensitivity to look for any similar organism(if both the organisms co-relate, then it'll easy to treat)..I'd advice you to get clinically examined for this with a urologist..

Yes your quite right as chronic prostatitis has been documented non-infectitious in several medical case reports, but to establish that, all these infectious diseases must need to be ruled out in the first place..

No, I'd advice complete sexual abstinence until a proper diagnosis is made and you get treated accordingly..

Well, being in a foreign country at this point can certainly delay the process (unless you can get back to your own country), please try to check in to the Urgent Care facility there, as they do offer a wide range of management(but I doubt it'll be really that helpful as the priority for that is critical illness only)..unfortunately I can't help you much with this particular concern..may be you can find a friend or connection back there who'll help you to sought this out..

Meanwhile try to remain well hydrated, drink at least 3 ltr water per day, it'll help to keep your urine diluted thus lessen the symptoms..

I've tried to make it as simple as possible for you to understand..

Please let me know if your having any further doubts, i'll be glad to clarify..


Take Care
Kind Regards

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Brief Answer:
area of focus varies from organism to organism..

Detailed Answer:
Hello Dear,

Thanks for following up,

Please clarify to me when was the most recent sexual encounter (this is the most important information), did you mean the last unprotected oral encounter or there was any other encounter also (feel free to share, as this is the key information here), if any other encounter involved then please let me know the details (protected/unprotected, oral/intercourse, vaginal/anal etc.) specifically..also it matters after exactly how many days from the last encounter, you've got tested..

No, as I have already mentioned it's extremely unlikely (though not impossible, as by virtue of medicine, nothing is absolute, but still the chances are pretty remote) to get infected from oral encounter..

However, migration to different geographical location also activates certain pathogens (specially warm/humid regions) so if the pathogens were previously latent, it's quite possible that they can get active due to the climatic changes..

You should also note that area of focus varies from pathogen to pathogen, not all organism cause the same type of infections, neither they affect the similar body parts/organs(due to several biological factors), so even though it may look or sound strange, it's still possible..

Were I been your treating Doctor, I'd investigate you thoroughly once again completely for the full STD panel due the same reason..

Please consider this and discuss with a Urologist for a detailed clinical examination as well as those investigations I've already mentioned, treatment depends on the findings..

Wish you a good health..

Let me know how you stay later on..

Take Care
Kind Regards

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Brief Answer:
Follow the Advises as already mentioned..

Detailed Answer:
Welcome back Dear,

In that case no worries as such, however the clinical examination and those detailed investigations stand crucial as they'll help to rule out those other infective etiologies which are really important to determine if the chronic Prostatitis in infective or non-infective (or is there another etiology apart from this)..

So just go ahead with the investigations as I've already mentioned along with the clinical examination by the urologist and let me know how it goes in the due course..

Take Care
Kind Regards

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