Brief Answer: Kindly send details with previous reports Detailed Answer: Hi, Welcome and thanks for posting your query to healthcare magic. I can understand your concern towards the undetected Sexually Transmitted Diseases in yourself. Your query is too short to reach to any conclusive point and to guide you further accordingly. I can make out that you have difficulty in urination with feeling of lump in urethra. As per your description it appears to be rather "Urethritis/Prostatitis" or symptoms related to age related "Benign hypertrophy of Prostate". Therefore to guide you best I request you to kindly take pains in letting me know certain important information regarding your problems: 1. Since how long you have the difficulty in urination with feeling of lump in urethra (how many years exactly). Is the dripping urination present all the time and is it increasing progressively. 2. Have you any time felt some bump, rash or any discharge on skin surface along with difficulty in urination with feeling of lump in urethra. If yes then how often these bumps or rashes appear and disappears. 3. If you feel burning or pain or itching, then is it mild/moderate/severe. 4. What all tests you have gone so far to rule out the Sexually Transmitted Diseases. 5. Have you gone for urine and semen examination/culture examination to rule out prostatitis or urethritis. 6. Have you gone for ultra-sonography to rule out benign hypertrophy of prostate. 7. What all treatment taken so far. If the lump is visible on skin surface then it would be best to send few good resolution pictures of the area yourself so that it can be analyzed best. You can also upload your reports or relevant information. You have a feature to upload images by yourself at the right side of the query page, please utilize that so that I can answer your queries better. Or else, you can send as an attachment to YYYY@YYYY with the subject as "Attn: Dr. Sanjay Kumar Kanodia). "Wish you good health" with regards, Dr. Sanjay Kumar Kanodia (MD - Dermatology)

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Brief Answer: Prostatitis or urethritis; meet a urologist Detailed Answer: Hi, I have gone through your complete query and the further important informations with diligence. I can read out the complete sequence of the problem and can very well make out that your are quite stressed regarding possibility of sexually transmitted disease. So to guide you best let me first reassure you that you do not have any major or minor sexually transmitted disease or infection. This I can tell you on the basis of the complete information and teh type of symptoms you are explaining. You have all the problems since 1970. It is one of the adequate period when we can very confirmly tell the patient regarding the status of any of major sexually transmitted diseases including herpes, syphlis and HIV etc. We take 3-6 months as the base line period to declare that whether or not a person is suffering from any major STDs. Now to tell you regarding most of STDs : These manifest either as discharge or luceration or lymph node enlargement at or around genital area. There had been no such symptoms I have found in yourself. Rather after analyzing the complete situtation I can make out the possbility of basically urethritis due to nonspecific cause. The symptoms enumerated can be because of the Urinary tract infection (UTI). This can be because of both Sexually Transmitted Infection as well simple cause. In yourself it appears to be due to simple microorganisms present on the skin or due to nonspecific cause. To differentiate the simple cause to that of Sexually Transmitted Infection - there is profuse pus discharge with ulceration or lymph node enlargement in UTI caused by Sexually Transmitted Infections. This UTI part can be nonspecific also due to less drinking of the water other than infectious cause. I suggest you to follow the regimen below to reaxh to a coclusive diagnosis: - A proper base line ultrasonography is a must in this situation. An edema in the prostate can be easily find out by the sonograpphy. If the sonongraphy reveals the prostate higher than 30gm then it indicates some infection or inflammation. This can tell us the reason for dripping of urine as well frequency of urination. - The next step is to go for culture and sensitivity of the urine and semen both. A mid sample (meaning middle of the urination or secretion) is best sample. A proper of test will delineate the exact cause and the sensitive antibiotics so that it can be followed properly for adequate period of time. - There is another way out that an empirical course of combination therapy of antibiotic is best in this situation. For this tablet Levofloxacin 500 mg daily and Nitrofurantoin 100mg can be taken for a period of 21 days under medical supervision. A repeat test can be done after 1 month. Nitrofurantoin can be extended for another one month of period as maintenance therapy. - Tablet alfuzosin 10 mg can be added up once daily to relieve the symptoms of pain, irritation and swelling and other of the symptoms which you are feeling during urination or in the groin area and prostatic area. So this is one of the regimens which you can discuss with a urologist. The rest of teh symptoms of running nose, film in the corner of eyes all day long everyday and rashes on upper chest and neck area are never a symptom of any type of sexually transmitted disease. For the relief from all these symptoms you can take a simple antihistamine such as loratadine (Tab Calritin or Lorfast) once or twice a day. So do not worry about any type of STDs including HIV. YOUr condition is qyuite simple and a step by step proper well directed apprach will give you best relief. IF you have any further queries I will be glad to help or if not then can close the query and rate the answer. With regards, Dr Sanjay Kumar Kanodia MD ( Dermatology & Sexually Transmitted Diseases)

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Brief Answer: not yeast infection; Meet urologist for treatment Detailed Answer: Hello, Welcome the forum again. Let me first and foremost tell you that your symptoms or the presentation of the problem is not at all a manifestation of any type of sexually transmitted disease. As I said earlier, 40 years of time is more than enough for any type STD to manifest itself. Most of the STDs manifest clinically within 3 months and even HIV in maximum of few years. SO let you kindly take out and throw away your fear for any type of STDs in yourself. Even if you have had any unprotected intercourse any time in past then also I am quite confident that it is not a presentation of a STD. So relieve your stress for the same. In my opinion it is simple recurrent Urinary tract infection which is very well treatable. It is quite surprising for me to know that you haven’t had visited any doctor in past and tried your own self implicated therapies. Kindly stop this practice as it can harm you rather than benefiting you in your condition. It is not at all a manifestation of any type of yeast infection too. In yeast infection there is whitish discharge and deep redness on glans penis, if not treated then can result in ulceration and then discharge. In yourself there is no such kind of presentation, so ruling out the yeast infection. Dear Sir, you are quite elder than me and with my most humble request I suggest you to meet a urologist preferably, have confidence in him and let him decide the best measure to help you out in your problems. Now our medical science is so much advanced that with most simple of the methods we can diagnose your condition properly and the fear of any STDs can also be ruled out accordingly. I advise you to appraise my suggestions to your doctor, tell him about your fear of STDs and therefore get best and proper treatment. Finally, I request you to not to worry about any type of STDs including HIV and get a proper treatment from urologist. If you have any further queries I will be glad to help or if not then can close the query and rate the answer. With regards, Dr Sanjay Kumar Kanodia MD ( Dermatology & Sexually Transmitted Diseases)

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Brief Answer: Get tested and take second opinion Detailed Answer: Hi, I can understand your geat concern for the possibility of any STD or if not STD then some type of unknown ailments. In my last 15years of practice I have many times consulted your kind of cases who are really very much troubled with one or the other symptoms as in yourself. My approach to all these cases is to go for a thorough physical check up to see any sign or symtoms related to STDs (as already mentioned any ulcer or discharge or any swellings of lymph nodes). Once I get some direction towards a particular STD then analyze the patient for the same by particular directed tests or if there is confusion then go for battery of tests related to STDs. By these tests we are 100 % sure about presence or absence of STDs. Along with these specialised test I would have gone for all the routine tests including Complete blood counts, serum biochemsitry including blood sugar and lever and kidney function tests which can give a whole good idea about a STD or any other condition. If I were your treating soctor then would have followed the same approach. IN yourself I suggest you to meet a sexually transmitted disease specialist who can guide you properly or other way is to take a second opinion from another urologist. Taking antibiotic is not the solution for your problem. Till the time we are not reaching to a conclusive point, it would not be wise decison to take self course of antibiotic. Even if you take antibiotic and after some time reach to the same problems then all your antibiotic therapy will be wasted. So I request you to follow the same approach and get yourself out of all the health problems. Again I request you to not to worry about any type of STDs and I am fully confident that the problem of mutiple decades will be solved by simple systematic approach. If you have any further queries I will be glad to help or if not then can close the query and rate the answer. With regards, Dr Sanjay Kumar Kanodia MD

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