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Wee wee pain and Doctor privacy issues (NSFW)
April 4, 2014 7:05 AM   Subscribe

My penis hurts and I think I shouldn't have told my doctor about my lifestyle. I need advice on prognosis and dealing with privacy in a big HMO.

So my wife and I have been playing with another couple that we know for a few months. Up until a month or so ago it was just touching, kissing and some girl on girl. After having a lengthy and open talk amongst all of us about sexual history, being safe, how everyone was feeling, and what they were expecting, we decided to take things to the next level. The night ending up with both men receiving oral from the women. This was February 22.

A few days later I started feeling pain in my penis, in the urethra maybe an inch down from the tip. It was painful when I urinated. I sort of freaked out and went to my HMO doctor, and then sort of freaked out some more and told the doctor the very basics of the situation. When I said "new partner" he immediately went to prostitute and I assured him this was someone I had known for some time and they were not high risk.

The doctor performed a rectal exam and did find anything abnormal. Hr ordered a UTI screen and a chlamydia, gonorrhea and something else (syphilis?) screen. Everything was negative, and he said "well you have some sort of injury that needs to heal", and that there was "nothing to treat." He said he consulted with a specialist who agreed but that I could see him if I wanted to. By this time there was some irritation on the outside of the urethra also that was extremely sensitive.

He gave me a referral to urology and I ended up seeing the chief of the department just due to availability on 3/19. He was pretty much dismissive from the beginning of the visit and said "Your doctor told me everything, the lesson here is not to switch partners." He said it might be a yeast infection and put me on a 5 day diflucan treatment. The outside irritation cleared up but the painful urination/general all the time pain was still there, and I told him so in an email about a week later (he had asked that I follow up with him). He said that it can take a couple of weeks to get treated and we should continue for a bit. This was a week ago.

I'm struggling to not bother him again as this is affecting me very much. My wife and I's sex life which was very active even without the playtime with others has almost completely dried up as an orgasm is pretty painful for me. Even getting aroused causes pretty severe pain for a few hours afterwards. We do play to make sure she is getting satisfied but I big part of it for her is intercourse.

I think I'm starting to feels tabbing pains lower in my abdomen/testicles but can't decide if I've just had this so long didn't notice before. There was a lot of lube involved that night and I'm comfortable with a glycerin induced yeast infection scenario, but who knows.

Two main questions:
Should I just wait this out some more per the urologist's suggestions? Does diflucan treatment really take this long after you've stopped taking it?

And the bigger one that has me really worried - Is there a note now on my medical record that I am a swinger? Can that be used against me? I feel like it already has in that the doctors are pretty much dismissing my problems with a sort of you got into this mess attitude.
Is there anyway information removed from my record and/or can I request copies of correspondence? How would I do that?

I am in California and this is a big HMO if that matters.

I'm not looking for advice with respect to the playtime with the other couple. Everything is all good there emotionally and that is not the subject of this post.

throwawayforme12345@gmail.com
posted by anonymous to Health & Fitness (22 answers total) 3 users marked this as a favorite
 
Can you get a new urologist who is gay friendly? I realize that we're not talking about contact with another man here, but in general, a urologist who treats gay men may treat you with the respect that you deserve without judging you.
posted by roomthreeseventeen at 7:19 AM on April 4 [26 favorites]


I'm female, but my general experience with diflucan has been that the relief is near instantaneous if what you have is actually a yeast infection - like, start feeling better within an hour, can't even tell I've had a yeast infection within 24. Obviously everyone is different, but for me, if I wasn't feeling basically 100% better the next day that was a strong signal that it wasn't yeast in the first place.

Can't help you with the medical records question, sorry. What a pain, doctors can be so freaking judgmental.
posted by town of cats at 7:21 AM on April 4 [10 favorites]


I would not worry about expunging it from your medical record until you get it diagnosed properly and treated.

My money would be on this being a UTI. I used to have them when I was younger, regularly. Then one time, I simply could not get in to see a urologist, so I suffered through the whole thing without treatment (which is what I think you're doing), and once it completely ran its course I never had another one. So, I'd give in another week like the doc said, before going back, or to another uro, but if you go, insist on having the full range of tests all over again.
posted by beagle at 7:25 AM on April 4


You have a right to receive a copy of, or at least make an appointment to review in person, your own chart. I know nothing about whether or not you can have information that is objectively true (i.e. one-time non-wife sexual partner) removed, but you certainly could raise a complaint if it's recorded in a slut-shaming way (I'm not calling you a slut; I'm using it in the same tongue in cheek but outraged way that women do when it happens to them).
posted by blue suede stockings at 7:28 AM on April 4


Another vote for a new (and less judgmental) urologist. If things hurt down there, sitting around waiting seems like a very poor approach.
posted by Dip Flash at 7:28 AM on April 4 [3 favorites]


"Your doctor told me everything, the lesson here is not to switch partners."

This is a bullshit, moralistic, and non-science-y thing to say.

If it hurts when you urinate, start over with a fresh doctor.
posted by A Terrible Llama at 7:33 AM on April 4 [79 favorites]


I don't have much advice as I would have suspected a yeast or bacterial infection (yeast is very common and easy to transmit, especially since lots of folks have oral thrush), but I will say that a gay-friendly or just alternative-lifestyle friendly doctor will treat you much better. Try a Planned Parenthood.

That said, as a woman, I have dealt with this paternalistic attitude from doctors my entire adult life, even well before I chose to practice non-monogamy. The lesson here is not to "not switch partners", but rather to own the choices you make as a consenting, sexually-active adult and to not let the assholes grind you down. If you can't stand up to your doctor while in the office, stand up to him by finding a new doctor. Lastly, being a swinger is not that shocking and your secondary partner is most definitely not on your permanent record.

(Also, anxiety might be making this worse. Try and relax -- if the Diflucan doesn't clear things up, a better doctor will know what to do next. It's not fun dealing with unknown variables in high-emotion situations such as new non-monogamy, so take it easy on yourself.)
posted by theraflu at 7:39 AM on April 4 [6 favorites]


The best (and most probable) situation is that you have Non-Specific Urethritis (NSE). It's a bacterial infection that produces pain and a discharge of pus, but which is not dangerous.

Receiving a BJ without a condom is the easiest way to get it.

It has no other bad health effects and is quickly cured by antibiotics.

Ask your doctor, who is ethically bound not to tell anyone else. If you feel diffident, go to a public health clinic, where they will diagnose it in a few minutes.
posted by KRS at 7:40 AM on April 4


I'm a female, but I've had a urinary tract infection and it had the same main symptom - pain during urination. There's an over-the-counter medicine that does not cure it, but does relieve the pain until you can get antibiotics to fix the problem: AZO. It'll be on a bottom shelf somewhere in the pharmacy, along with cranberry pills and other things like that. Since it is OTC, pick up a box and ask the pharmacist if there would be any problems with giving it a try while you wait for a solution. Big warning: It dyes your urine. Don't be alarmed.

If you have a UTI, you need antibiotics. The infection can go up into your kidneys and then you really have a problem. Go to a new doctor, describe the symptoms, and leave off any details about your recent sex life except to say that you have multiple partners.

Your body gives you pain as a signal to alert you to a problem that needs resolution. Pay attention to it.
posted by Houstonian at 7:45 AM on April 4 [6 favorites]


Not sure if I've got the timeline right, but the STI screening was "a few days" after February 22, right?

"It takes 1-3 weeks after exposure to show accurate results."

Get the tests redone.
posted by travelwithcats at 7:46 AM on April 4 [1 favorite]


To speak to your concern about the HMO knowing, if there's anything in your "permanent record" it probably just says you've had multiple partners (it doesn't sound like you even told the doctor you were swinging?), and that's true of an awful lot of people - not something that's going to get you denied medical coverage or anything. If I had to guess as to what your PCP said to the urologist I'd bet it was something dumb and dismissive like, "Guy cheated on his wife and now he thinks his dick is going to fall off." If you'd like to stay with this doctor you might want to ask him what he said to the urologist and why.
posted by mskyle at 7:53 AM on April 4 [2 favorites]


It sounds like your physicians may not have adequately addressed your concerns or counseled you about what to expect e.g. for duration of symptoms and when to worry. It's impossible to judge the decision making from afar, but feeling that you have a poor relationship or communication with them is a fine reason to seek another option. I have no idea what your HMO will pay for.

Yes, they probably wrote in their notes that you have multiple sexual partners (because you do). Given how common that is, I don't really see how anyone would use that against you. Yes, you can call their office and request copies of their clinic notes / progress notes and lab results. There will be a form to fill out. It is extremely unlikely that they would remove that from their records, but if you think their understanding is incorrect, they can document a phone call about clarification of your social history.
posted by a robot made out of meat at 7:55 AM on April 4 [1 favorite]


Has anyone mentioned prostititis to you? It presents much like a UTI in women, but is an inflammation of the prostate. It's treatable with antibiotics but be prepared for a 6 week treatment. It heals very slowly.
posted by OkTwigs at 8:02 AM on April 4 [2 favorites]


Another thing that may be worth considering. It sounds like you have some pretty strong feelings about your experience. It has happened that genital pain can have a psychogenic component in some cases. I am not suggesting that it is necessarily the case for you however the knowledge that it does sometimes happen may have effected the urologists assumptions.

However add me to the list of people suggesting a second round of testing for STI's and to feel free to change medical practitioners if you are unhappy with the service you are receiving.

The fact you were with a new partner should probably stay on your record as it is helpful to know from a diagnostic perspective but I can't think of any reason it should be used against you.
posted by The Violet Cypher at 8:03 AM on April 4


As a medical professional myself I am always very careful about how I word sensitive subject matter in someone's chart. Making judgmental comments about your sexual activity is wrong. Recording in your chart that symptoms began after oral intercourse without a condom and with a new partner is completely appropriate and important to include because it supports his clinical reasoning and justifies what tests he has ordered.

The medical record is yours and most doctors I know are careful what they record in it. My point is that his tone was completely inappropriate but I bet his charting wasn't. Still, it is your record and you have the right to see it so I would go ahead and do that.

I would also make a follow up appointment with another doctor, if possible, because the original one was a judgey tool but not because your symptoms haven't resolved yet based on his original assessment. Diagnosing conditions isn't always straight forward and sometimes doctors get it wrong the first time. You probably need some additional and repeat lab work.
posted by teamnap at 8:21 AM on April 4 [2 favorites]


Stabbing pains in your abdomen are not good. You should follow up with your doctor(s) and tell them that this is happening, ASAP.

I'm also thinking UTI, or some other type of bacterial infection, that is spreading. I recently had one that I ignored and then, quel surprise, started having abdominal pain. A course of very cheap and only slightly inconvenient antibiotics cleared me right up.

It sucks that your doctor is being like this. In the future, I would see a different urologist. But in the meantime, taking your ball and going home because you're pissed that your doctor was sorta judgy is a dangerous choice to make. Follow up with your doctor, get the proper treatment, and then let your feelings flow about the whole situation.

Re getting this other sexual partner "expunged" from your medical records, this is not really a thing. Your doctors will ALWAYS need to know if you've had recent non-monogamous sexual partners. This particular sexual experience is nothing your doctors haven't heard before, and is 100% relevant to your current health issues. It's not like a criminal record where it's public knowledge and can have a wider impact on your life. Your doctors need to know if you're engaging in risky behavior that is very clearly connected to health complaints.

Women have to answer questions about our sex lives every time we go to the OBGYN. Welcome to being a person who takes care of their sexual/reproductive health.
posted by Sara C. at 8:59 AM on April 4 [3 favorites]


FWIW, yes, you should be allowed access to your medical records. There might be a fee associated with them copying and mailing them to you. There is likely also a process you can engage in to dispute inaccurate entries*. I'm not sure about outright expungement of something if it is accurate but embarrassing. I think the most likely scenario insurance wise is they receive a bill with a pretty vanilla code on it to the effect of 'urethra infection, prescription XYZ, consult with urologist'. Not - SWINGER !!! WOOT WOOT!!! MORAL SLACKER!!!
If there was a billing dispute or criminal investigation the medical notes likely could be accessed under HIPPA, but it is not likely the HMO is going to be reading everyone's medical notes and frankly doesn't care all that much.


*It actually is not a bad idea to review your medical records/notes every few years anyways, much as you would your credit reports annually.
posted by edgeways at 9:08 AM on April 4


Is there any possibility you have kidney stones? I have definitely had the full blown "OMG SO MUCH PAIN ALL THE TIME" experience with kidney stones, but also the last time I thought I had a UTI it turns out there was kidney stone dust in my urine and that the pain I was experiencing while urinating was probably due to irritation from that. I also had pain in my lower abdomen, but other than that none of the classic signs of kidney stones at all (honestly I'm not even sure if I had already passed them at that point or if I haven't passed them yet, it was fairly recently). Anyway, I just wanted to mention that as a possibility, especially if you have had them before. It could be something totally coincidental and unrelated to your sexual activity. I had also thought my situation was related to sexual activity, funnily enough.
posted by primalux at 10:22 AM on April 4


I am not a doctor; I was just an underpaid sexual health advocate for a long time. Have you had your prostate checked? Or a urinalysis (that's what would determine a UTI, too)? My family member has on and off prostate inflammation since he was in his mid 30's. I guess it's not uncommon; it just results from the pH getting slightly off kilter. It causes his urine to be too acidic, his prostate to sometimes swell, and for him to have pain and retention. There's no real cause for it, he's been told. Some dietary changes may have decreased episodes, but it's difficult to tell with something so episodic. (This was a big scare because there have been prostate deaths in our family. We were happy to find out my extended family member just had a chronic condition! He was not as happy.) So, yes, I'd say this could definitely be unrelated. I'd bet it is. Transmission of STIs through oral sex is rare though I have seen it happen (mostly with Herpes, though). These are much different symptoms. Not just on your skin.

Your doctor is not only being judgmental, he's not practicing good medicine. You shouldn't be experiencing pain after sex just because you had a lot of sex, no matter who the partner is. One possible exception is that you got a lot more, uh, vigorous attention than usual. It usually happens to women, but that could be it. This is called Honeymoon Cystitis. It usually found in women, but when I worked at a sexual health clinic, we saw plenty of new relationship/newly married male UTIs. Then again, we also treated lots of Herpes aquired by unprotected oral sex. Most people aren't ever tested for that unless there's an outbreak -- it's a blood test. However, you can have outbreaks inside your junk. But your penis isn't hurting to punish you. Jesus. That's outrageous.

If I were you I would switch to a PCP who treats gay men or who is sex positive (try googling that; there's sure to be a list and somebody within your system who is on it). S/he will have the skinny on who to send you to and why. If the stabbing pains continue and are worse, go to the ER. Your kidneys or prostate are serious business. Also, I would abstain from sex with your wife until this is on lock. You don't want to damage yourself if this is an unrelated health problem and you don't want to damage her if it's contagious. Reading your question again about the level of pain you're in and considering the kidney infection or prostate risk... is there anything to be lost from going to urgent care? This doesn't sound like it can wait.
posted by sweltering at 12:05 PM on April 4 [2 favorites]


I do agree that it sounds like you're really doubting yourself about your symptoms. Guilt over not having a gameplan (and buying into the bullshit guilt from the urologist -- you should have been like "I changed back to my partner who was right next to me! My life is awesome!") could be making you over-perceive your symptoms. I have gotten such flack from doctors before, too. My favorite was the one who said "you live a rock and roll lifestyle" in response to my partner count. This is a real thing with non monogamy. (Hardly anybody says swingers any more.) One nice things is that when you sign to have your records transferred to any doctor, you can specify not to have sexual health records transferred. Your knee surgeon doesn't have to know about your fetishes unless you want him to.

Great books, if you want them, are The Ethical Slut and Opening Up: A Guide to Creating and Sustaining Open Relationships. STIs and sexual dysfunction and talking about this sort of stuff after hooking up are covered at length in both.

A good thing for the future might be to have a safe sex elevator speech. It's good for knowing your own boundaries and it's good for having a plan in case you hit health problems and need to communicate. Also, pretty much the only way to make STI history foreplay that I can imagine. That website is pretty gold! And there's a directory there, if you want to keep this out of your health system file. It's wise to do an HIV test anonymously, for example, until you've talked with a social worker -- but that's not a worry of yours.

Finally, here is a Salon article with some solid public health statistics on unprotected oral sex.
posted by sweltering at 12:30 PM on April 4


Still dude. Stabbing pain with orgasm? Go to the ER. You could be getting blocked.
posted by sweltering at 12:33 PM on April 4


I'm not your doctor, but think it's unlikely you have a UTI/cystitis. I'm guessing you've probably had two urinalyses and likely a urine culture as well already, I mean if you go to the doctor with a complaint of dysuria (pain with urination) and you don't get a urinalysis, it's like going in with a traumatic deformity and not getting an x-ray. Kind of a no brainer.

Don't go to the ER for pain with orgasm. You'll most likely just get yet another urinalysis, possibly repeat STI testing, and be referred back to urology. We do not diagnose urethral stricture in the ER. Finding a new urologist is a better idea.

Remember that you don't need to tell your doctors any more than they need to know - they don't need to know the romantic/emotional details, they just need to know what exposure you've had to potential infections. You can stay technical with your description of this.
posted by treehorn+bunny at 1:15 AM on April 5 [4 favorites]


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