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    What causes clear fluid urethral discharge and irritation in urethra?

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Posted on Wed, 2 Mar 2016 in Sexually Transmitted Diseases
Question: This is going to be a bit longer story - i would really appreciate if someone could help.

Middle of November 2015:
Felt like a BALANTITIS (dry glans, bit stingy/itchy, just not comfortable).
Had a "PIMPLE" on my penis, looked like some hair grown in. Hard, but not painful, not open. It was not possible to push it out.
Doctor just examined the glans, said everything is fine (he did not look at the pimple) and told me to put my Penis into CHLORHEXIDINE ACETATE SOLUTION daily for a few minutes.

December:
General Health Check up. Diagnosis of
THROAT INFLAMMATION and
CONJUNCTIVITIS in both eyes.
I could not feel any of these at that point. Prostate was normal.
Unusual FATIGUE started - i am more tired than normal.

Did not get better, instead it felt like it would go up the urethra. If pushing a bit, ONE DROP OF CLEAR DISCHARGE in the morning.
Inside the urethra a feeling of stingyness and like a cold needle was pushed up along the urethra.
Doctor gave me
1x500 mg of LEVOFLOXACIN for 7 days and
3xdaily RELINGQING KELI (something chinese obviously for urinary tract infections).

On my last 2 days of treatment with Levofloxacin pain in the achilles heel sometimes. According to internet might be a side effect of the treatment.
The pimple was gone (might be unrelated?).

December 24th:
I could feel dry eyes, a bit stingy sometimes. Discharge still there.
3x300 mg of CLINDAMYCIN HYDROCHLORIDE daily and
‌3x300 mg of NIFURATEL daily,
‌Both for 7 days.
‌Still no improvement.

Middle of January:
Usually i have to shit around every 2 days. Now it is up to 3 times daily.
Still can push out 1 drop of clear discharge in the morning but now it feels like the lower urethra around the glans is better but it has wandered "upwards", some irritation in urethra in the area of my balls, the balls themselves also sometimes feel irritated.
The pain is not always the same, sometimes stronger, sometimes (almost) gone.
It seems that my hands/feet easier "fall asleep" (they get numb and after moving them, they first tingle until the feeling comes back).

‌The tests for
‌Chlamydia trichomatis
‌Human papillovirus
‌Mycoplasma
HIV
Syphilis
Hepatitis
‌all came back NEGATIVE, urine screenings were also normal.
‌Very slight raised level of Monocytes in the blood screening (reference is 0.1-0.6, i have 0.69).
When i have sex, i always use condoms except for oral sex.

Since i stopped smoking a few months ago and switched to electronic cigarettes, i thought it might be an allergy to the propylene glycol or vegetable glycerine in the liquid so i stopped vaping for a few days - no improvement.

Two questions:

1.) Any idea what else could it be and what i can get tested for? According to my knowledge, almost every relevant bacteria should be killed by the antibiotics that i took. Or are there any left that might be unaffected by the medicine i took?
I am living in an asian country where the doctors might not have the best education - i consulted 2 urologists and a of them said "everything great". Any hint would be appreciated (Reiter syndrome? Anything that is not directly related to urology?)

2.) How probable is it that this is a reaction to the propylene glycol/vegetable glycerine of electronic cigarettes?

Thank you so much for any help!
This is going to be a bit longer story - i would really appreciate if someone could help.

Middle of November 2015:
Felt like a BALANTITIS (dry glans, bit stingy/itchy, just not comfortable).
Had a "PIMPLE" on my penis, looked like some hair grown in. Hard, but not painful, not open. It was not possible to push it out.
Doctor just examined the glans, said everything is fine (he did not look at the pimple) and told me to put my Penis into CHLORHEXIDINE ACETATE SOLUTION daily for a few minutes.

December:
General Health Check up. Diagnosis of
THROAT INFLAMMATION and
CONJUNCTIVITIS in both eyes.
I could not feel any of these at that point. Prostate was normal.
Unusual FATIGUE started - i am more tired than normal.

Did not get better, instead it felt like it would go up the urethra. If pushing a bit, ONE DROP OF CLEAR DISCHARGE in the morning.
Inside the urethra a feeling of stingyness and like a cold needle was pushed up along the urethra.
Doctor gave me
1x500 mg of LEVOFLOXACIN for 7 days and
3xdaily RELINGQING KELI (something chinese obviously for urinary tract infections).

On my last 2 days of treatment with Levofloxacin pain in the achilles heel sometimes. According to internet might be a side effect of the treatment.
The pimple was gone (might be unrelated?).

December 24th:
I could feel dry eyes, a bit stingy sometimes. Discharge still there.
3x300 mg of CLINDAMYCIN HYDROCHLORIDE daily and
‌3x300 mg of NIFURATEL daily,
‌Both for 7 days.
‌Still no improvement.

Middle of January:
Usually i have to shit around every 2 days. Now it is up to 3 times daily.
Still can push out 1 drop of clear discharge in the morning but now it feels like the lower urethra around the glans is better but it has wandered "upwards", some irritation in urethra in the area of my balls, the balls themselves also sometimes feel irritated.
The pain is not always the same, sometimes stronger, sometimes (almost) gone.
It seems that my hands/feet easier "fall asleep" (they get numb and after moving them, they first tingle until the feeling comes back).

‌The tests for
‌Chlamydia trichomatis
‌Human papillovirus
‌Mycoplasma
HIV
Syphilis
Hepatitis
‌all came back NEGATIVE, urine screenings were also normal.
‌Very slight raised level of Monocytes in the blood screening (reference is 0.1-0.6, i have 0.69).
When i have sex, i always use condoms except for oral sex.

Since i stopped smoking a few months ago and switched to electronic cigarettes, i thought it might be an allergy to the propylene glycol or vegetable glycerine in the liquid so i stopped vaping for a few days - no improvement.

Two questions:

1.) Any idea what else could it be and what i can get tested for? According to my knowledge, almost every relevant bacteria should be killed by the antibiotics that i took. Or are there any left that might be unaffected by the medicine i took?
I am living in an asian country where the doctors might not have the best education - i consulted 2 urologists and a of them said "everything great". Any hint would be appreciated (Reiter syndrome? Anything that is not directly related to urology?)

2.) How probable is it that this is a reaction to the propylene glycol/vegetable glycerine of electronic cigarettes?

Thank you so much for any help!


doctor
Answered by Dr. Noble Zachariah 3 hours later
Brief Answer:
My thoughts follow

Detailed Answer:
Hello,
Welcome and thanks for your query.
I understand your concern.
You probably had an infected hair follicle which responded to Levofloxacin.
Now from what I gather, you are concerned about the drop of clear fluid that comes out when you strain. I think you should have a microscopic examination of the fluid, if it has not been done. It would probably be prostatic secretion, normal or infected.
Reiter's syndrome has more components like mouth and other mucosal ulcers, arthritis and typical penile lesions and since your symptoms have not progressed to include them, RS is less likely.
Normal bowel movement can vary from 3 times a day to once in 3 days. So it may be normal or it may be IBS.
Any thing under the sun including the sun can produce allergy and your eye and throat symptoms may be caused by the components of the electronic cigarette. The penile symptoms are unlikely to be due to allergy.
Hope my thoughts have been of some help.
Take care,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Noble Zachariah 21 hours later
Thank you very much for your answer.

What concerns me most is the feeling of irritation in the urethra, which has an influence on the stability/duration of my erection.

Follow-up-questions:
1.) I did not use the electronic cigarette for about 10 days, my eyes are still dry, there seems to be no change. If it was an allergic reaction, from my understanding it should have become a bit better now?

2.) From my understanding, all "usual causes" of urethritis based on bacteria were either tested negative or should have cleared up after the antibiotics. Or is there anything left that would not react to the mentioned medication and was not tested negative?

3.) Are there any illnesses which are not directly related to the urinary tract but which can lead to the symptoms?

Sadly I am living in a country were education of doctors is not well and where they do not take a lot of time to talk with patients anyway. So if you would have other suggestions what the causes might be, i would be greatful.
A "list" would be very helpful, i can do the research on the internet myself, so no need to describe too much. But as described, from my point of view i thought that most of the possible causes would be eliminated already.

Thank you a lot!
doctor
Answered by Dr. Noble Zachariah 1 hour later
Brief Answer:
Discussion follows

Detailed Answer:
Welcome back.
If being off electronic cigarette hasn't reduced your allergic symptoms, the cause is likely to be something different like allergens in the air.
People may have discomfort in passing urine if an episode of urethritis has narrowed the urethra. If the urine microscopy doesn't show significant number of pus cells, there's no ongoing infection. As I had mentioned earlier, get the discharge examined. If there are significant pus cells, you may be having a prostatitis. Another common cause if you are in a hot climate is crystalluria which can lead to urinary stones . Drinking plenty of fluids may reduce symptoms.
best wishes,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2276 Questions

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