Friday, April 4, 2008

Penile Discharge "Tulo"





A 24 year old, male, married, OFW, visited the clinic for a light yellow discharge coming out of his penis for the past 3 days, staining his underwear, he also complains of pain during urination. He admitted having sexual intercourse with a prostitute about 5 days before symptoms appeared. He is scheduled to depart for the Middle East in 3 days.
After physical examination and confirming the creamy penile discharge, with no laboratory test and no possibility of follow up, I gave the following meds.
1) Doxycycline 100mg tab. 2 tablets initially then 1 tablet every 12 hours(2xday) for 10 days plus
2) Cefixime 200mg Tab , 1 tab every 12 hours for 5 days

Gonococcal urethritis (check my latest blog on GC Urethritis,"Tulo" here -http://wazzupdok.blogspot.com/2010/12/tulo-or-gonococcal-urethritis.html

Gonorrhoea is caused by the bactterium Neisseria gonorrhoeae that grow and multiply in the reproductive tract of women(cervix ,uterus, fallopian tubes) and men (urethra). The bacteria can also multiply in eyes, mouth, throat and anus.

Incubation period usually takes two to five days from infection to symptoms and without treatment,the symptoms of urethritis (inflammation of the urethra) and purulent (pus-containing) discharge peak within two weeks.

Most notable symptom is the penile discharge which occurs in 95 per cent of men and is purulent in 75 per cent, white or cloudy in 10 per cent and clear in 5 per cent. Recent urination can make the discharge appear less purulent. When the infection begins to resolve, the discharge changes from purulent to mucoid (mucus-like).

Transmission of the disease is usually by sexual intercourse, including oral sex and without treatment, the infection can continue for many months.

Complications can occur and spread up the urethra to the epididymis (sperm-storing tube connected to the testicles) but is rare and infertility can be a rare late complication. Anal infection is common especially, but not only, when the infection is transmitted by anal intercourse. Bloodstream infection occurs in less than 1 per cent of patients, causing arthritis of the knees, wrists and hands plus fever, chills and skin lesions, usually papules or pustules (red or pus-containing raised spots or bumps) on the hands or feet.

Reminder: Article was written as a physician's personal experience and should be viewed for information and guide only, and was not intended to replace actual consultation with a medical practitioner.

Photos and Images compiled fromGoogle.com

35 comments:

Anonymous said...

i am keneth.. im sufferring tulo for almost 4days..i cant go to a doctor because im too shy ..i hope this medicine that is posted will give me cure..tnx doc

Anonymous said...

bro ok ba ung gamot? doc, may email add ka ba. or contact info?

Anonymous said...

i had sex saturday and yesterday bigla ko naramdaman na mahapdi.. and yes may signs na like discharge of semen can be seen the underwear..

i bought doxycycline in a botika which cost around 2.50 per capsule..

hopefully it works .. :(

Anonymous said...

Gusto ko lang makasiguro. kasi hindi naman sumasakit pero meron symptoms like tonsilitis, sensitive ung testicles and nung umihi ako may lumabas na white... ano ba to???

Anonymous said...

yeah, i have one i guest, i think i got it from a prostitute, i see this yellow spots on my undies but mine's itchy inside (yung dinadaanan ng ihi)..Is it herpes too?

Im too shy to go to a doctor. So I was hoping you could help. Thanks

kirk said...

i hope mag work to itong gamot na recommend nyo po..salamat po in advance...

Anonymous said...

grace,
Sna mk2long sken ung mga gmot n nbsa q dto..im so shy kc 2 go 2 a doctor.kya ngresearch nlng aq dto.tnx at nbsa q 2..sna mgwork =c tnx doc.

Anonymous said...

Hi, na cure ba ung tulo nyo?
I'm having the same problem with you guys. kung effective un i will also take that medicine. pls reply

Anonymous said...

dok plss help me.... i have same probsss i have a tulo maybe 4dayss now ......help me plss
can u tell me watss the besttablet to buy...can u email me plss

frozens said...

can u email me plss itss beeen 4dayss now...... can u tell me watss the best medicin to take........
heress my email add grandposans2000@yahoo.com ty

kcy said...

i have my husband, we really need your help :( he's now suffering from std. were not sure if he's in std disease or in uti. what's the best prescription in over the counter? we really need your help. please email us at rojo_joebell@yahoo.com thanks!

WazzupDoc said...

Hi, if the diagnosis is Gonococcal Urethritis (Tulo),we usually prescribe Cefixime Tab 200mg , 2tablets taken as single dose plus Azythromycin 500mg tab, 2 tablets as single dose. I advise everyone experiencing symptoms of STD to seek medical consultation.
Thanks.

wazzupdok

Anonymous said...

hi effective ba yong gamot??

Anonymous said...

anu poh b ang dapat qng inuming gamot???

Anonymous said...

hi doc! im stephen, i know im suffering this also ... inom ako inoflox ng 400mg sa umaga at 200mg sa gabi ... nabawasan sya pero di pa rin naalis ... 7 days na ko umiinom ng gamot pero meron pa rin... kulang pa ba yun antibiotics ko? salamat doc!

chen said...

Doc i need your help. wala naman may lumalabas na yellow or nana sa akin. pero masakit yung testicles ko ang ang kulay nang sperm ko po yellowish. at makati yung linalabasan nag ihi. pls help po. chenbryan33@yahoo.com. thx po. :(

mhik said...

i am mikel: dok need help yung sakin aman matagal na almost 1 month na siguro d cu lng pinapansin pero an syntoms lng ee ung may yellow na lumalabas... no po ba kailangan cu inumin salamat doc pa email aman po ng answer nio




chs_mikel@yahoo.com

dave said...

hi. hindi naman masakit pag umiihi, pero yung may green discharge, tapos yung frequency ng pagihi ko, soo, makakatulong ba yung gamot? nahihiya din akong magpacheck sa doctor eh.. sana matulungan niyo ako. please email niyo ako..

davey_rico@yahoo.com

Anonymous said...

doc ako din po pede po pa reseta ng gamot thanks po e2 po email add ko killah_allstar@yahoo.com thanks

Anonymous said...

doc, im also seeking ur help pls give me a prescription.ive had it for 3days na,
thanks

ialreadyknewthat@yahoo.com

Anonymous said...

hai...
grave na tlaga sa umpisa parang wala lng pero nung nkita ko ung may lumabas na bigla nlng ako nataranta..anu mbisang gamot dto dati pinagtatawan ko kbarkada ko ngayon ako na naman pinagtatawanan pls help...

Anonymous said...

I need help po,,plz lahat po ng nbasa q na symptoms ai meron po aq :-( galing na po aq sa oby my gamot po syang bngay at hygn wash kaso hbang patagl po ng patagl lalo po sya sumaskit lalo na po pag umiihi,, ano po bang gamot pwde ko inumin oh gawin plz po help me

Anonymous said...

hi doc i need help po katulad nang iba 3days napoh pag umiihi ako masakit ari ko... wala pung yellow na lumalabas masakit lang poh talaga sana poh matulungan nio ako anu pubang gamot sakin nahihirapan napoh ako doc .. help po maraming maraming salamat poh eto poh fb ko email nio poh ako sana help nio ako zaori_00@yahoo.com

Anonymous said...

hello guys!

i-share ko lang po ..... i have it for one week na

effective talaga yung AZITHROMYCIN / zophromax 500 mg

Anonymous said...

Azithromycin dihydrate. Zithromax ang brand from pfizer.l..yan ininom ko dati as advice ng doctor na kinunsulta ko sa makati med. Effective, 3 tablets ang naconsume ko.

Anonymous said...

Un lang ininum mo sir? Ilang times sa isang araw dapat inumin un?

jilbert mercado said...


sana nga mag work itong gamot;l;
na iinis na talaga aku doc';';'

Anonymous said...

effective ba yan pre,,sure ba yan?

Anonymous said...

1 9years old po yung brother q.. may tulo xa
....1 month na yata.. what is tje dosage doc? please po respond ..thnks..

Anonymous said...

MDs would advice against self-medicating with antibiotics. Whatever would work for one person might not work for the next. To add to that, these bacteria might become resistant to the antibiotics we have so self-medicating is not the way to go. As the blogger posted, this wasn't intended to replace a consult with a doctor. So please consult your doctor.

Anonymous said...

bale pang 3rd time ko na nagka tulo. buti n lng may friend akong doktor sa san lazaro.

intramuscular injection at azithromycin 500, once a day for 5 days.

mdyo nabawasan na ung discharge pero mahapdi pa rin umihi.

hopefully gumaling na talaga ako.

eto ung signs na may tulo ka:
1.madalas na pre cum o kaya yellow o green fluid na kusang lumalabas lalo pa pag piniga mo sa umaga.
o kaya may ganung mantsa sa undies mo.
2.mahapdi umihi o panay panay ihi at orange ang kulay.
3. masakit ang balakang o kasu kasuan.
4. hindi matigas ang pagdumi lalo nat kulay itim.
5. namamagang bayag o pakiramdam na mabigat o para kang binayagan sa sakit.
6. namumula ang pinaka butas ng ari.
7. para kang nilalamig o nilalagnat.
8. pag nagsarili ka, pakiramdam mo na maanghang o may menthol yung dinadaanan ng tubo ng ari mo, pag labas ng tamod mo.
9. may makating pakiramdam sa loob. pagitan ng ari at bayag.
10. at pag diinan mu ung tubo ng ari, daanan ng ihi. masakit lalo na sa may bandang ulo ng ari.

Anonymous said...

Doc pano ko po malalaman Kung magaling na ako???

Anonymous said...

Doc, I'm seb, 20 yearsold. I'm scared right now. First, HIV test ans it was Reactive then suddenly, It became negetative in final test nung San Lazaro. Then now Tulo naman. I'm a Bisexual and puro same sex ang mga nakasex ko, I'm not that active into sex. But if may partner ako (Boyfriend) nakikipag sex ako. May new partner ako, we were getting our first month this Saturday but now I'm suffering fot this disease. Doc please help me. I dont want to tell my partner because I got this. I know he has it. I'm placed the Top po kasi (Ako yung Tumitira sa kaniya Anal). That's why I think, he doesn't know that I got this. Please po prescribe some medication for me. Im so scared.

Ujie said...

prang effective rin po ung amoxicilin ( branded ) 3x a day. kasi ininom ko un ng 3days on the first day nawala agad ung hapdi kaso nung tinigil ko ung inom after 4 days bumalik n naman ung hapdi pero konti n lang tapos bumili ako ng amox na generic parang ndi naman effective ung generic na amoxicilin 3 days ko n xang iniinom pero mejo makirot parin ung pag ihi

Anonymous said...

saan pwede mag pa consult? yung mura lang pls pls pls pls.. i feel my tulo ako email me at leilee015@yahoo.com