That Mild Burning Sensation...

[Savittre]

Hi Guys,

 

It would appear I have some (seemingly) mild dick infection. I post because I'm in Cambodia, working, don't really know where (if anywhere) in this country I can go for reliable medical care, and would not prefer to take time off to go to Bangkok to get this looked at.

 

 

 

I figure some of you guys know as much or more about STD's (if this is an STD) than some medical doctors, so I'll lay it out pretty much as I would if I were in a doctors office-

 

 

 

1. I get a *mild* burning sensation when I pee. I can also feel something's not quite right the rest of the time, in the upper part of my dick.

 

 

 

2.I've felt this for about 3 days now. I think it's getting a bit worse, but am not really sure.

 

 

 

3. There is absolutely no discharge at all in my underpants, but the tip of my dick looks on the reddish side and is slightly sensitive to touch.

 

 

 

4. If it matters, I have been having sex regularly, almost all of the time with a condom, (although I am guilty of vaginal intercourse without condom, last time that happened was late April). So, usually, it's been fucking with a condom (although occasionally not) and BBBJ's.

 

 

 

Now, I will check with some contacts I have here in Cambodia, regarding what to do about this, but in the meantime I'm quite sure some of you guys will know more about this than anyone I know here.

 

 

 

Advice and recommendations are much appreciated. Although I am not uncomfortable, this is something I must do something about, and I'd love to get it done without having to disrupt my working schedule.

 

 

 

Thank you in advance!!!

 

 

 

Savittre

[iuytrede]

SOS International have a clinic in Phnom Penh and in Siem Reap. There is a private Chinese hospital in Battambang, near Chaya Hotel.

 

 

 

Your problems might be unspecific urethritis, but I would have it checked by a doctor. One reason for this is that mixed infections are common.

[thalenoi]

Savittre,

 

 

 

I would not worry to much.

 

I had someting similar a few weeks ago, too much sex.

 

Try to get a relief cream at a pharmacy, just explain, nothing to be affraid

 

of. I was given Zevin Cream to treat genital Herpes, contains Aciclovir. Problem went away after a few days. Checked Herpes symptoms on the net, was nothing like that, just light hinder and redness and light burning sensation.

 

Nevertheless I went to see a doctor. Although I am sure his diag was wrong the cream relived. Some years ago I used Gyno Dactarin as cream, had this problem in heavy sexual activity periods (several times a day) Don`t know if you find that un Asia.

 

 

 

Do go find a doctor, must have in Cambodia

[Guest]

hi Savittre,

 

 

 

the most likely thing is obviously that you have some form of STD - gonorrhoea or chlamydia would be top of the list

 

 

 

the official line would be to go to a dr so that a urethral swab can be taken for defintive microbiology and a definitive diagnosis with antibiotic sensitivities- and that is definitely the route i would recommend

 

 

 

however.....if you decide (for whatever reason) that you did not want to see a doctor then the best empirical treatment would probably be to self-medicate with azithromycin 1g (a one-off dose) as well as ciprofloxacin 750mg twice daily for one week

 

 

 

the vast majority of gonorrhoea and chlamydial strains should be knocked out with this regime (in fact the azithromycin alone should do it- but take both to be extra sure) but you have to bear in mind the significant possibility that you have a resistant strain, particularly if you picked it up from a sex worker (although having initially self-medicated should not alter the outcome in this instance because you will most likely have taken the best choice first line therapy which is no different to that you would've been on if you had seen a dr initially)

 

 

 

it might be a good idea to swab your own dick and keep a urine sample stored before you take any antibiotics- if you turn out to have a resistant strain the pre-antibiotic samples might be useful

 

 

 

do you have any ocular irritation or redness?

 

 

 

disclaimer:- I'm not an STD specialist (although have had some experience in treating most STD's) and the advice i give is just my personal opinion so do what you like - best to see a dr though!

[tomc12]

Suggestions:

 

 

 

1)stop the BBBJ's for the time being as it may be a source of swelling in the periurethral glands, which could cause your symptoms.

 

2)empirically you could try some antibiotics:

 

a)Vibramycin 100mg bid for7 days-treats both NGU (Chlamydia included) and gonorrhea; may cause some photosensitivity

 

or

 

b)Azithromycin 2 grams X 1 treats both Chlamydia and gonorrhea

 

or

 

c)Azithromycin 1 gram X 1 for Chlamydia and Ciprofloxacin 500mg X 1 for gonorrhea

 

 

 

 

[tomc12]

hansum man,

 

You might check on the doses of the antibiotics that you reccommended. My understanding is different.

 

I don't think it is a good idea to advise someone to obtain a urethral swab or store a pre-antibiotic urine specimen unless you are sure they know about sterile containers, storage requirements, etc. and have access to transport media for the swab. Otherwise I'm not sure how much value the specimen would have

[Guest]

the dose of azithromycin 1g stat is standard and same as u recommended - the cipro 750mg x 1/52 is probably more than required but then cipro is so safe and the higher dosage/duration is unlikely to lead to additional toxicity over the 500mg single dose u recommend but will lead to increased plasma levels and does have a better bactericidal profile

 

 

 

the 750mg bd week dose is standard for many other systemic infections and commonly prescribed by hospital practitioners (although GP's probably more commonly prescribe the 500mg dose)

 

 

 

i'd agree with your point re. the need for sterile specimen containers - but i had assumed that any sensible person would've bought a sterile collection system from Boots or another chemist (perhaps too big an assumption on my part) also agree that there not too much value in taking such specimens - but then its easy to do and some info is better than none - eg. the absence of organisms from those specimens makes it less likely they are the culprit whilst the presence of organisms within the likely polymicrobial culture will at least help to narrow the list of possible bugs

[iuytrede]

Ciprofloxacin should not be used to treat anyone with gonorrhea acquired in Asia due to high rates of resistance (over 50%).

 

Recommended treatment in Thailand is usually Ceftriaxone (eg Rocephin) 125 mg intramuscular (single dose) - plus antichlamydial therapy (azithromycin 1g single dose or doxycycline (eg Vibramycin) 100 mg bid for 7 - 10 days). Ceftriaxone from Korean and Indian manufacturers is available in Cambodia for about 3 USD.

 

An alternative to ceftriaxone is cefixime 400 mg oral (single dose).

[tomc12]

Yes and no. There is a difference between decreased susceptibility and resistant strains and there is a difference depending on the Asian country. In the Philippines, 54% of gonorrhea shows a decreased susceptibility to Cipro while it is only 12% in Thailand. Values for resistant strains are even less.

 

So, yes, Cipro by itself shouldn't be used for gonorrhea acquired in Asia, but in combination with azithromycin.

 

No, I wouldn't recommend taking cefixime empirically.

[iuytrede]

agreed