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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17516
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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When passing urine very painful and then stinging and sore

Customer Question

when passing urine very painful and then stinging and sore after. Have had urine sample taken and there is no infection or thrush.
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. D. Love replied 11 months ago.
Hello from JustAnswer.
It will help if you could provide some further information.
Was there a specific test done for gonorrhea or chlamydia?
Did you also have a prostate exam?
Was there a test done on prostate fluid?
Customer: replied 11 months ago.
No I have non of test. I have had two courses of antibiotic
Expert:  Dr. D. Love replied 11 months ago.
Which two antibiotics have been tried?
Customer: replied 11 months ago.
Trimothermin and nitropruphen
Expert:  Dr. D. Love replied 11 months ago.
Thank you for the additional information.
I am sorry, but I misread the original post, thinking that it said you were male, but I see now that you are female.
There are a couple of issues to consider in this situation.
The first issue is to try to make a clear diagnosis. It is OK to try a course of antibiotics for empiric treatment in someone with symptoms, but when the symptoms persist, it would be better to perform further evaluation. If tests specific for chlamydia and gonorrhea have not been done, this would be appropriate. Gonorrhea and chlamydia will usually cause symptoms in the female genital tract, but can present with urinary symptoms. When this happens, it may be missed on the standard test of the urine.
It is also possible that it is a common urinary tract infection that did not cause enough changes to be detected on the original urine tests. A culture is the most sensitive test to detect a bacterial urine infection, and if a germ is detected, it can also assess which antibiotics would best kill the germ.
Lastly, it also can be considered to use a stronger antibiotic, such as Levaquin. We prefer to avoid the use of stronger antibiotics as first-line treatment, as resistance may develop more quickly, but may be appropriate when there is no response to first-line antibiotics.
If I can provide any further information, please let me know.
Customer: replied 11 months ago.
Following our conversation, could you advise if the attached pathology results have tested for STI's you mentioned, I have been told it covers everything but wanted to confirm?Many Thanks
Expert:  Dr. D. Love replied 11 months ago.
No. This culture would detect all of the germs that would cause a standard bladder or urinary tract infection, but if the sexually transmitted germs cause these symptoms, it is more of a urethritis, inflammation and infection of the tube that drains the bladder. The sexually transmitted germs are actualy hard to grow on cultures in the lab, but there are specific tests to detect the sexually transmitted germs.
Customer: replied 11 months ago.
Hi I have had all tests done now including swabs, bacteria and sti' sand all results are negative. My doctor suspects vulvadynia although I do not have constant pain I only burn when I urinate. I have been suggested by a friend it could be urethritis and a dose of doxycycline would treat it but could I have this if all tests are negative?
Expert:  Dr. D. Love replied 11 months ago.
It is possible to have urethritis with normal tests, but with a negative test for STI germs, the germs that would cause urethritis would likely have responded to the antibiotics that you have taken as they would to doxycycline.

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