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Forum Name: Urinary tract infections

Question: Insignificant Urinalysis, but Symptomatic. What to do?


 llbrandonll - Sat Jul 03, 2010 1:33 pm

I think that I may have a Urinary Tract Infection. I am a 20 year old male. The tip (urethral opening) of my penis is sore (somewhat of a dull burn) at times and I feel like the inside of penis is sore as well. Sometimes, I have a clear discharge (though it's infrequent). The pain isn't terrible, but I am definitely uncomfortable at times. I thought I may have contracted this after having a sexual encounter two weeks ago (only received head) and went in to get tested. So to break it down it would be sexual encounter on Sunday (06/20), symptoms on Thursday, and STD screen and Urinalysis that upcoming Sunday (06/27).

Despite my symptoms, however, nothing was found. There were no GNIDS (cells found where there's gonorrhea) or white blood cells found in a gram stain. Two catches of urine were done (UA1 and UA2). The White blood cell count in UA2 was reported as 1 (greater than 10 being significant) and the rest (number of white blood cells/red blood cells in the other catches were 0.

I was told I had dysuria (urethral discomfort) with negative urinalysis, unknown cause. These tests were done at a free clinic with trained volunteers rather than medical professionals (if that means anything). I was told to take vitamin c and drink cranberry juice in order to acidify my urine thus killing any unknown microbe that might be there.

Here are my questions:

1.) Is that sufficient treatment, vitamin C and Cranberry juice?
2.) Is waiting a week after my sexual encounter too soon to get tested and should I go back and get it done again?
3.) I was feeling a little better (after starting the cranberry juice/vitamin C regimen) and masturbated a few times. My symptoms became worse afterward (no pain with ejaculation). Does masturbation worse healing time?
4.) I know some other causes of UTI's are: Chlamydia trachomatis (most common), Ureaplasma urealyticum, Trichomonas vaginalis (rare), Herpes simplex virus (rare), Adenovirus, Haemophilus vaginalis, Mycoplasm genitalium. Is it possible that the tests I had done were not capable of detecting one of those possibilities?
5.) What kind of follow up should I look into?

Any help would be greatly appreciated

Brandon
 Dr.M.Aroon kamath - Sun Jul 18, 2010 12:47 pm

User avatar Hi,

You said, "These tests were done at a free clinic with trained volunteers rather than medical professionals ".Therefore the question in your mind obviously is, whether the STD testing was "comprehensive" or not.

A "comprehensive" STD testing generally begins with a thorough history taking including a thorough sexual history. This guides the clinician as to which tests and which sites should be tested. This will undoubtedly determine the "yield" from the tests.

Following details regarding the Sexual activity are generally sought:
- regular/casual sexual partner(s),
- gender of partner(s), any history of male to male sex?,
- most recent sexual exposure and other exposures in the recent past,
- number of exposures since last tested,
- any known symptoms among recent partner(s),
- any known risk factor(s) in partners,
- use of protection(ex;condoms) – sometimes, always or never?,
- specific exposure sites: vaginal, oral,or anal?,
- history of IV drug abuse,
- where the sexual activity took place? Travel history,
- history of use of blood or blood products,
- any occupational exposure or needlestick injury?
- tattoos,
- body piercing - done non-professionally.

Kindly refer to the following link for additional information on sites to be tested and ideal specimens for testing.
(viewtopic.php?f=61&t=46560).

About testing for chlamydia: Urine samples for PCR chlamydia testing should be a first pass specimen, ideally collected at least 3 hours after voiding.
A urine test as evidence of cure for chlamydial infection is not routinely performed, as the PCR test may remain positive for several weeks after successful eradication of the live organism. This is because the test detects DNA fragments from dead chlamydiae.

About cranberry juice:
- Cranberry juice mainly prevents adhesion of certain microbes to the inner lining of the urinary tract (urothelium) - notably E.Coli.
- It 'prevents' to an extent UTI developing, but does not actually 'Treat' it.

Therefore, if one has already developed an established UTI, no amount of cranberry juice is going to help.The bacteria firmly attached to the urothelium will presumably watch the cranberry juice harmlessly pass by!!


Having gone through the aforesaid details, hopefully, you may be able to decide if the STD testing you underwent was "comprehensive" and if the history you provided was "comprehensive" or otherwise. If you feel that it was not, then you should perhaps get tested again where it is done professionally.
Best wishes!

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