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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18664
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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31 year old male, I've had a new recent sex partner, and

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31 year old male, I've had a new recent sex partner, and within a month or so i've started having bladder pain that feels better after urination. I went to an std test center, and was tested for chlymadia and gonorrhea with NAAT test two weeks after that exposure, and both returned negative. What should i do, going forward?
It will help if you could provide some further information:
Was the test for chlamydia and gonorrhea done two weeks after the onset of symptoms or two weeks after the exposure (and two weeks before onset of symptoms, since symptoms started a month or so after the start of the relationship).
Have you had any physical examination done, particularly of the prostate?
Customer: replied 4 years ago.

Two weeks after exposure (no continued relationship). No physical exam.

Thank you for the additional information/clarification.

Since this was a single exposure to a new partner, a negative test for chlamydia and gonorrhea performed two weeks after that exposure is very reassuring, but it would not be considered perfect. These tests are excellent at detecting the germs when there is an active infection, when the number of germs present are greater. When there is not an active infection that has yet developed, when the number of germs is less, the tests are still good, but they are not as accurate as when there is an active infection.

In a man, a simple bladder infection is uncommon. In a man, pain or discomfort that feels like it is coming from the bladder is more often coming from the prostate, as prostate infections are far more common than bladder infections. Most cases of prostatitis are not caused by sexually transmitted germs, but it is still recommended to consider chlamydia or gonorrhea in any young man with evidence of a prostatitis.

The diagnosis of a prostatitis is by examination. Therefore, the next step is for you to be seen by your doctor for an appropriate examination. If there is evidence of an active infection, it would be appropriate to consider repeating the tests for chlamydia and gonorrhea. If chlamydia or gonorrhea is present, then there would be specific treatment for these germs, and if not present, then antibiotics for the germs that are not sexually transmitted would be appropriate.

If you have any further questions, please let me know.
Customer: replied 4 years ago.

So what would further evidence of an active infection entail? simply a re-test? I've read evidence that it would be highly unlikely to test positive for chlymidia / gonorrhea after a negative test after such a long and clear exposure. Any sense of the odds here? 1 in 1000? 1 in 100? So is the more likely case the latter you think?

And, as a child I was treated for anterior urethro diberticultis (spelling?). Any complications from that that it could entail?

As I said above, prostatitis is the most likely infection, and it is most likely not from a sexually transmitted germ, but it is still recommended that testing be performed for chlamydia and gonorrhea. There are no specific studies looking at the likelihood of a positive test when symptoms develop two weeks after a prior negative test. Certainly, in the absence of symptoms, there is little value in repeating the tests two weeks later, but the likelihood with new symptoms two weeks later is not studied.

The primary evidence of an active infection would be an examination, and primarily an examination of the prostate, as this is the most likely infection, which is why the appropriate next step is to be seen by your doctor for an examination, rather than simply getting re-tested.

It is possible that someone with an anterior urethral diverticulitis could develop further infections in the future, but it usually would cause symptoms before now.
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