Post-Antibiotic Symptoms: Urology Concerns Explained

Q: Post-Antibiotic Symptoms: Urology Concerns Explained

Hello： 1. Is this symptom more likely to be caused by Chlamydia or Mycoplasma infection? --> Both are possible, and it could also be due to other bacteria. 2. Are those clear mucus secretions really unrelated as the doctor said, and should I just wait it out?

Questions regarding symptoms after taking antibiotics?

Hello Dr.
Du:
On October 9th, I had unprotected oral sex with a woman, and two days later (October 11th), I started experiencing urethral pain, but there were no noticeable discharge symptoms.
After the pain worsened, I consulted a urologist.
Due to the absence of significant discharge, the doctor prescribed a standard antibiotic.
However, after taking it, I felt no improvement and returned for a follow-up two days later.
At that time, I noticed some clear discharge, which appeared green when it came into contact with my underwear.
The doctor then prescribed DOXYCYCLINE for me.
I continued to have follow-up visits and took DOXYCYCLINE for a total of two weeks.
After that, aside from experiencing pain during the first urination in the morning, I had no other noticeable symptoms, so I assumed everything was fine.
A week later, I tested for STDs, and all results came back normal, which relieved my worries.

However, two days later, I suddenly experienced significant itching and pain, along with clear discharge that also appeared green when it touched my underwear.
I returned to the doctor, who suggested that the previous bacteria might not have been completely eradicated, so he prescribed another antibiotic, "Cefixime 100mg." After taking it for three days, I noticed the itching and pain subsided, and the discharge returned to being clear (no longer green when it touched my underwear).
The doctor said everything should be fine and advised me to continue the medication for another three days.

After those three days, I still occasionally felt pain during the first urination in the morning (about two out of three days), and I also had a sensation of discharge flowing from the urethra (sometimes there was clear, sticky discharge, and sometimes there wasn't).
I went back to see the doctor and explained the situation, including the clear, sticky discharge and the occasional morning pain.
The doctor said it was nothing to worry about but prescribed another three days of antibiotics just to be safe, reassuring me not to overthink it.

However, after taking the antibiotics for three days (today), I still noticed a significant issue with clear discharge.
Therefore, I would like to ask you:
1.
Is this symptom more likely to be caused by gonorrhea or chlamydia infection?
2.
Is the clear mucus discharge really as the doctor said, not a concern, and should I just wait it out?
3.
Is this clear mucus a sign of a sexually transmitted infection, or could it be prostate fluid? If it can flow without any sexual arousal, doesn't that seem a bit strange?
4.
Given that I still have these symptoms (clear mucus, occasional sensation of discharge from the urethra, and occasional morning pain), should I trust the doctor and let it be, or should I return for another consultation? I am still concerned due to the ongoing symptoms.

5.
Although I have taken antibiotics, could the prolonged duration lead to any complications?
I apologize for the lengthy treatment period and the numerous questions.
Thank you for your assistance.

The Kai, 20~29 year old female. Ask Date: 2022/11/24

Dr. Du Shixi reply Urology

Hello:
1.
Is this symptom more likely to be caused by Chlamydia or Mycoplasma infection? --> Both are possible, and it could also be due to other bacteria.

2.
Are those clear mucus secretions really unrelated as the doctor said, and should I just wait it out? --> Engaging in safe sex and confirming through urinalysis that the urine is clean is advisable.

3.
Are those clear mucus secretions sexually transmitted disease secretions, or could they be prostatic fluid? Is it strange that they can flow even without any sexual arousal? --> If there is pain, it is mostly likely an infection.

4.
Since I still have these symptoms (clear mucus, occasional feeling of discharge from the urethra, and occasional pain during the first urination in the morning), should I trust the doctor and let it flow, or should I go back to see the doctor? I'm still concerned because the symptoms persist.
--> You should go to the hospital for a urinalysis.

5.
Although I have been taking antibiotics, could there be any long-term effects from this prolonged issue? --> The chance of long-term effects is not zero, but it is likely low.
Since antibiotics have been used, confirming through urinalysis 1-2 times to ensure the urine is clean is relatively safer.
Wishing you good health.

Reply Date: 2022/11/24

More Info

Hello! Thank you for your detailed inquiry regarding your urological symptoms following your recent sexual encounter. It’s understandable to feel concerned about ongoing symptoms, especially after a course of antibiotics. Let’s address your questions one by one.

1. Possible Infections: The symptoms you describe, including urethral pain and the presence of transparent discharge, could be indicative of several conditions. While the absence of significant discharge initially may suggest a non-gonococcal urethritis (NGU), the subsequent appearance of greenish discharge raises the possibility of a bacterial infection, such as gonorrhea or chlamydia. Doxycycline is effective against chlamydia, but if symptoms persist, it’s crucial to consider that there may be a resistant strain or another infection at play. A follow-up with a healthcare provider for further testing, including a culture or PCR test for sexually transmitted infections (STIs), would be advisable.

2. Transparent Discharge: The transparent discharge you’re experiencing could be a normal physiological secretion, possibly from the prostate or urethra. However, if it’s accompanied by discomfort, it’s essential to monitor it closely. While your doctor may have reassured you that it’s not a cause for concern, persistent symptoms warrant further evaluation to rule out any underlying infections or conditions.

3. Nature of the Discharge: The discharge you’re experiencing could be either prostatic fluid or urethral discharge. Prostatic fluid can sometimes leak, especially if there’s irritation or inflammation. However, if this occurs without sexual arousal, it may be unusual and should be discussed with your healthcare provider. It’s important to differentiate between normal secretions and those that may indicate an infection.

4. Follow-Up Care: Given that you still experience symptoms, it’s wise to return to your healthcare provider. Persistent symptoms after antibiotic treatment may indicate that the initial infection was not fully resolved or that a different issue is present. Your healthcare provider may consider additional tests or a referral to a urologist for specialized care.

5. Long-Term Effects: While antibiotics are generally safe, prolonged use can lead to side effects, including gastrointestinal disturbances and the potential for antibiotic resistance. If the infection is not adequately treated, there could be risks of complications, such as prostatitis or epididymitis. It’s crucial to address these symptoms promptly to prevent any long-term issues.

In summary, while some of your symptoms may not be alarming, the persistence of pain and discharge after treatment suggests that further evaluation is necessary. It’s essential to communicate openly with your healthcare provider about your ongoing concerns and symptoms. They may recommend additional testing or a different treatment approach to ensure that any underlying issues are addressed effectively. Remember, your health and peace of mind are paramount, so don’t hesitate to seek further medical advice. Thank you for reaching out, and I hope you find relief soon!

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