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Urethral discharge and mild pain when holding urine
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STDs & Related Infections
Question #19025
141 days ago
308

Urethral discharge and mild pain when holding urine - #19025

Richard adio

Hello, I have a urethral discharge and it is painful when I urinate, especially if I try to hold my urine. When I urinate continuously, the pain eases and the discharge decreases. There is also some redness at the opening of the urethra, and inside, there is yellow and dark violet-like discharge under the thin skin of the penis. I have already been prescribed Azithromycin and Doxycycline Hyclate, but they seem to have no effect. Previously, the discharge was yellow inside the penis and dark violet-like, but there was no discharge when I started taking the medication. After 3 days of taking the medicine, discharge started again, and urination is painful. Please advise what kind of treatment or further evaluation I may need. Thank you.

Age: 24
Chronic illnesses: acute bacterial infection (posibleng urethritis / STD-related infection) na: Bigla lumitaw May specific onset
300 INR (~3.53 USD)
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Doctors' responses

Dr. Arsha K Isac
I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.
141 days ago
5

Hello,

This is persistent or resistant urethritis that needs targeted, organism-specific treatment, often different from standard first-line antibiotics, under care of a urologist or STD clinic.

🛑Possible causes : gonorrhea requiring ceftriaxone injection, Mycoplasma genitalium (often azithromycin-resistant), Trichomonas infection, viral urethritis (such as HSV).

🛑Tests to do ;

1.Urine NAAT test for: Gonorrhea Chlamydia Mycoplasma genitalium Trichomonas (if available)

2.Urethral swab (if discharge is present) 3.Urine routine & culture 4.HIV, Syphilis testing (standard when urethritis persists)

Meanwhile:

Sexual activity should be stopped for now Good hydration, Avoid urine retention Avoid alcohol and irritants.

I trust this helps Thank you

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Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
140 days ago
5

Investigation:

Urine routine & microscopy urine NAAT (PCR) for: Gonorrhea Chlamydia Mycoplasma genitalium Trichomonas Urethral swab culture & sensitivity HIV, Syphilis (VDRL/RPR), Hepatitis B & C Urine culture

Do NOT start new antibiotics before tests

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Your symptoms suggest a persistent urethral infection, particularly under concern when there’s ongoing discharge and pain despite treatment with Azithromycin and Doxycycline Hyclate. The failure of these antibiotics to resolve your symptoms may indicate antibiotic resistance or an infection not adequately covered by these medications. Common conditions like gonorrhea, chlamydia, or non-gonococcal urethritis come to mind, but they typically respond to these antibiotics. Therefore, further investigation is crucial. Start by revisiting your healthcare provider for a more comprehensive evaluation. It’s possible you might need a urethral swab or a urine test to precisely identify the bacteria or pathogen involved. Resistance testing could inform the selection of a more effective antibiotic. Ensure that any sexual partner is informed and evaluated to prevent reinfection. Avoid unprotected intercourse until you complete treatment and are symptom-free. Persistent symptoms could also rarely be due to other non-infectious causes, so it’s important to explore those with your physician if infections are ruled out. While specialists like urologists or infectious disease experts might assist further, your primary care doctor should be your first point of contact. Don’t delay; untreated infections may lead to complications, which could add to your discomfort and health concerns.

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Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
141 days ago
5

Hello dear I think as per clinical history it seems urethral infection probably UTI It is not completely eradicated. Iam suggesting fresh tests. Please get them done Urine analysis Urine culture Kidney USG Cbc Rft Esr Please share the result with urologist in person for better clarity Please donot take any medication ( already som much taken and still the treatment ineffective) without consulting the concerned physician Regards

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Dr. Prasannajeet Singh Shekhawat
I am a 2023 batch passout and working as a general physician right now, based in Hanumangarh, Rajasthan. Still kinda new in the bigger picture maybe, but honestly—every single day in this line teaches you more than textbooks ever could. I’ve had the chance to work under some pretty respected doctors during and after my graduation, not just for the clinical part but also to see how they handle people, real people, in pain, in panic, and sometimes just confused about their own health. General medicine covers a lot, right? Like from the smallest complaints to those random, vague symptoms that no one really understands at first—those are kinda my zone now. I don’t really rush to label things, I try to spend time actually listening. Feels weird to say it but ya, I do take that part seriously. Some patients just need someone to hear the whole story instead of jumping to prescription pads after 30 seconds. Right now, my practice includes everything from managing common infections, blood pressure issues, sugar problems to more layered cases where symptoms overlap and you gotta just... piece things together. It's not glamorous all the time, but it's real. I’ve handled a bunch of seasonal disease waves too, like dengue surges and viral fevers that hit rural belts hard—Hanumangarh doesn’t get much spotlight but there’s plenty happening out here. Also, I do rely on basics—thorough history, solid clinical exam and yeah when needed, investigations. But not over-prescribing things just cz they’re there. One thing I picked up from the senior consultants I worked with—they used to say “don’t chase labs, chase the patient’s story”... stuck with me till now. Anyway, still learning every single day tbh. But I like that. Keeps me grounded and kind of obsessed with trying to get better.
138 days ago
5

Hello Richard Thanks for sharing these details—your symptoms (urethral discharge, pain during urination, redness, and persistent colored discharge) suggest ongoing urethritis, possibly due to a resistant or atypical infection, or even a non-infectious cause. Since you’ve already completed a course of both azithromycin and doxycycline (which cover most common bacterial causes like chlamydia and gonorrhea), and your symptoms have returned or persisted, further evaluation is definitely needed.

Here’s what you should do next: 1. See a Urologist or STD Specialist: You need a thorough evaluation, including a physical exam and possibly a urethral swab or urine test to identify the exact cause (bacteria, fungus, or other organisms). 2. Repeat Urine and Discharge Tests: Ask for a urine routine, urine culture, and specific tests for gonorrhea, chlamydia, mycoplasma, and trichomonas. Sometimes, fungal or viral infections can also cause these symptoms. 3. Consider Non-Infectious Causes: Rarely, inflammation or irritation (from soaps, creams, or trauma) can mimic infection. 4. Avoid Self-Medication: Don’t start or change antibiotics on your own, as this can make things worse or mask the real cause. 5. Sexual Partner Evaluation: If you’re sexually active, your partner(s) should also be evaluated and treated if needed, to prevent reinfection.

Immediate Care: - Drink plenty of water. - Avoid irritants (soaps, lotions, harsh cleansers). - Practice good hygiene but don’t over-clean the area.

Rx- Flucanazole 150 mg. - once a day for 7 days .

Thank you

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