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"Should I request further urinalysis/testing?"
I recently went to the doctor with itching at the tip of my penis and a very slight whitish discharge. The discharge, as far as I have noticed, ONLY occured when I was constipated and had to push hard to get stool out. The doctor had me give a urine sample which was tested in the office and I was told it was clean and negative for WBC and nitrates. I was tested for HIV, etc when I donated platelets in June through a blood bank (pre-current symptoms). Last protected sex was April and unprotected Nov 2011. Doctor said he didn't suspect STDs based upon my history and said it was most likely a yeast infection and prescribed fluconazole for two weeks (4 pills 1 every 4 days). Since he mentioned STDs I am a little worried and wonder whether I should get further gonorrhea/chlamydia testing even though I had negative urine sample and other STD tests were negative?
This is an issue that you should raise with your doctor. The possibility of acquiring a sexually transmitted disease can be very worrisome. Furthermore, any unprotected sex does place you at risk of acquiring an STD, although it would be somewhat more unusual to present with this diagnosis many months later. However, diagnosing STDs in men can be more difficult than in women because men are often asymptomatic for much longer periods than women, even if they do have an infection. For your own peace of mind, it would not be medically contraindicated to have specific testing for gonorrhea and chlamydia, since these would be the most likely infections to cause penile discharge and itching. This testing is very easily done from either a simple urethral swab or a urine test. In addition, if your symptoms were due to a yeast infection, they should have improved with the fluconazole. If they have not, you should let your doctor know. Overall, safe sexual practices and regular health screening are always appropriate. Your concern is valid, given your history of unprotected sex, since even one encounter can lead to an infection. In this situation, the best thing you can do is make sure to always use protection when sexually active, and continue to have regular appointments with your physician to discuss your concerns and consider additional testing. Again, please talk to your doctor.
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