The PEUS Protocol: A Novel Approach for DNA Profiling and Stealth Pathogen Detection in Male Urogenital Health

Abstract:

The PEUS Protocol, or Post Ejaculate Urine Sample Protocol, presents an innovative method for DNA profiling and stealth pathogen detection in male urogenital health. Developed by Dr. David Robertson, this protocol combines urine and a small amount of semen to enhance the scope of analysis in a single test, aiding in the identification of stealth pathogens in the male urogenital tract, prostate, and seminal vesicles. This paper outlines the methodology and implications and includes a case study highlighting the efficacy of the PEUS Protocol in identifying stealth pathogens that evade conventional tests.

Keywords: PEUS Protocol, DNA profiling, stealth pathogen detection, male urogenital health, NGS capabilities, experimental diagnostic tool

Problem Statement:

Identifying male genital infections accurately presents significant challenges (Solomon & Henkel, 2017). Non-gonococcal urethritis (NGU), while a prevalent sexually transmitted condition in men, presents a diagnostic conundrum due to its nonspecific nature and diverse infectious origins (CDC, 2022; Territo & Ashurst, 2024). Moreover, the complexity escalates with persistent polymicrobial male genitourinary conditions, complicating diagnosis, treatment, and management strategies (Epperly & Moore, 2000; Magri et al., 2018). Recent advances in next-generation sequencing improve the ability to detect novel pathogens, but there is another complication worthy of mention that may have gone largely unnoticed.

The male genitourinary is highly complex (Nieschlag et al., 2023). Hence, the detection of genitourinary pathogens in males may present a significant challenge due to the potential for missed infections in both urine and seminal fluid samples. While urine samples are commonly used for diagnostic testing, the potential exists that they may fail to capture pathogens residing in the seminal system, such as those within the prostate or seminal vesicles. Conversely, seminal fluid samples may overlook pathogens originating from the urinary tract if urine components are not present.

This potential limitation arises from the anatomical separation between the urinary and reproductive systems, as well as variations in pathogen-shedding patterns. Hence, relying solely on one sample type for testing may result in incomplete or inaccurate assessments of genitourinary infections. Similarly, attempting to test for both could be cost-prohibitive in some situations. Therefore, comprehensive diagnostic approaches that integrate multiple sample types or employ simultaneous testing of urine and seminal fluid are necessary to improve the detection of pathogens throughout the male genitourinary system.

This paper introduces the PEUS Protocol, a novel approach for DNA profiling and stealth pathogen detection in male urogenital health, developed to address these challenges. The protocol integrates urine and seminal samples to enhance diagnostic accuracy and broaden the scope of analysis, particularly in cases of suspected polymicrobial infections. This paper presents the methodology, results, and implications of the PEUS Protocol, along with a case study demonstrating its efficacy in identifying stealth pathogens in a challenging clinical scenario.

Materials and Methods:

The PEUS Protocol involves the collection of post-ejaculate urine samples immediately following ejaculation, otherwise adhering to standard urinalysis procedures. The protocol integrates current NGS capabilities to analyze both urine and semen in a single test, enabling the detection of stealth pathogens in the male urogenital tract. Semen samples are collected using a standardized method to ensure consistency and reliability of results. The protocol emphasizes stringent quality control measures to minimize contamination and ensure accurate detection of pathogens.

Comparison with Existing Methods:

The PEUS Protocol offers several advantages over existing methods for diagnosing male urogenital infections. Unlike conventional tests that rely on urine or seminal fluid samples alone, the PEUS Protocol integrates both sample types, enhancing the scope of analysis and improving the likelihood of detecting stealth pathogens residing in the male urogenital tract, prostate, and seminal vesicles. This holistic approach addresses the limitations of single-sample testing, which may overlook pathogens present in different anatomical compartments.

Furthermore, by leveraging next-generation sequencing capabilities, the PEUS Protocol enables comprehensive DNA profiling and detection of polymicrobial infections, providing valuable insights into the complex microbial dynamics of male urogenital health. While further validation and optimization are needed, the PEUS Protocol represents a promising advancement in the field of male urogenital diagnostics, offering potential benefits for patient care and management.

Case Study:

The case study features a male with persistent genitourinary symptoms indicative of a chronic polymicrobial infection. Initially, the patient experienced urethral meatus pain subsequent to engaging in oral sex with a heterosexual partner who was diagnosed with an upper respiratory infection, albeit with an unidentified pathogen. It is now theorized that the infection resided in the pharynx due to investigative studies demonstrating the pharynx as a potential source of unidentified pathogens contributing to subsequent urethritis (Barbee et al., 2016).

The patient’s symptoms progressed to include urethritis, upper vas deferens pain, orchitis, and semen discoloration. Despite undergoing multiple inconclusive tests and receiving various treatment modalities, such as antibiotics and alternative therapies, the infection persisted, leading to autoimmune complications such as lichen planus and Peyronie’s disease. However, while most tests were inconclusive, the implementation of the PEUS Protocol revealed significant levels of Corynebacterium pseudogenitalium and Gardnerella vaginalis, offering pivotal insights into the underlying pathogenesis of the infection.

Results:

Preliminary investigations using the PEUS Protocol demonstrated the feasibility of detecting stealth pathogens in the male urogenital tract. Analysis of the case study revealed the presence of known but elusive uropathogens Corynebacterium pseudogenitalium and Gardnerella vaginalis, highlighting the complexity of polymicrobial infections in this population. The PEUS Protocol offers a promising approach for comprehensive DNA profiling and stealth pathogen detection, with implications for improved diagnosis and treatment of male urogenital infections.

Limitations:

While the PEUS Protocol shows promise as an innovative approach for DNA profiling and stealth pathogen detection in male urogenital health, several limitations warrant consideration.

The protocol relies on next-generation sequencing (NGS), which may pose challenges in terms of cost, complexity, and data analysis, limiting its accessibility in certain clinical settings.
The lack of validation studies hinders the establishment of the protocol’s reliability and reproducibility across different patient populations and settings.
The integration of urine and seminal samples in a single test may introduce technical challenges related to sample processing, contamination, and variability in sample composition.
The protocol’s effectiveness in detecting rare or low-abundance pathogens remains to be fully elucidated.

Addressing these limitations through further research and validation efforts is essential to establish the PEUS Protocol as anything other than an experimental diagnostic tool for male urogenital infections.

Discussion:

The case study demonstrates the clinical utility of the PEUS Protocol in identifying stealth pathogens that evade conventional diagnostic tests. By integrating urine and seminal samples, the protocol offers a holistic approach to urogenital health assessment, particularly in cases of suspected polymicrobial infections. Collaboration between urologists, microbiologists, and NGS experts is essential to refine and validate the protocol for routine clinical use. Further research is warranted to validate the findings and optimize the protocol for broader applications in male urogenital health.

The integration of urine and seminal samples in a single test represents a novel approach to DNA profiling and stealth pathogen detection in male urogenital health. This innovative methodology fills a critical gap in current diagnostic techniques and offers a holistic solution for identifying pathogens that may be missed by conventional tests.

Polymicrobial infections in the male urogenital tract present significant challenges in diagnosis and treatment. Not only can this approach capture known culprits, but it can also catch opportunistic pathogens that might not otherwise be problematic. The PEUS Protocol offers a practical and effective tool for clinicians to accurately identify and characterize stealth pathogens, leading to improved treatment strategies and better outcomes for patients.

The PEUS Protocol has the potential to revolutionize the diagnosis and management of urogenital infections, particularly in cases where traditional tests yield inconclusive or false-negative results. By providing a comprehensive assessment of the male urogenital microbiome, this protocol has the potential to improve patient care and contribute to the development of targeted therapies for urogenital infections.

Conclusion:

The PEUS Protocol represents a significant advancement in DNA profiling and stealth pathogen detection in male urogenital health. The integration of urine and seminal samples offers a comprehensive approach to diagnosis, particularly in cases of persistent or complex infections. Continued research and validation efforts are needed to establish the protocol as a standard diagnostic tool in clinical practice, ultimately improving outcomes for patients with urogenital infections.

Acknowledgments:

We acknowledge and thank the healthcare professionals and researchers who continue to push the boundaries to find solutions to the problems that plague our nation’s health.

Instructions:

Detailed instructions can be found here.

Conflict of Interest:

Dr. David Robertson has NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, or affiliations) in the lab, or materials discussed in this protocol.

Disclaimers

The scientific validity of this is still under investigation. Know the risks and potential benefits of experimental protocols and talk to your healthcare provider before participating if you are unsure. Choosing to participate in and or otherwise use this information is an important personal decision. Before you participate in and or use this information, discuss all options with your healthcare provider and other trusted advisors.

Dr. Robertson is a health researcher and educator, not a physician. The information provided here is not medical advice, a professional diagnosis, opinion, treatment, or service to you or any other individual. The information provided is for educational and anecdotal purposes only and is not a substitute for medical or professional care. You should not use the information in place of a visit, call consultation, or the advice of your physician or other healthcare providers. Dr. Robertson is not liable or responsible for any advice, course of treatment, diagnosis, or additional information, services, or product you obtain or utilize. IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY, YOU SHOULD IMMEDIATELY CALL 911 OR YOUR PHYSICIAN.

References:

Barbee, L. A., Khosropour, C. M., Dombrowski, J. C., Manhart, L. E., & Golden, M. R. (2016). An estimate of the proportion of symptomatic gonococcal, chlamydial and non-gonococcal non-chlamydial urethritis attributable to oral sex among men who have sex with men: a case-control study. Sexually transmitted infections, 92(2), 155–160. https://doi.org/10.1136/sextrans-2015-052214

CDC. (2022, September 21). Urethritis and Cervicitis – STI treatment guidelines. Centers for Disease Control and Prevention. https://www.cdc.gov/std/treatment-guidelines/urethritis-and-cervicitis.htm

Epperly, T. D., & Moore, K. E. (2000). Health issues in men: Part I. Common genitourinary disorders. American family physician, 61(12), 3657-3664.

Magri, V., Boltri, M., Cai, T., Colombo, R., Cuzzocrea, S., De Visschere, P., … & Wagenlehner, F. M. (2018). Multidisciplinary approach to prostatitis. Archivio Italiano di Urologia e Andrologia, 90(4), 227-248.

Nieschlag, E., Behre, H. M., Kliesch, S., & Nieschlag, S. (Eds.). (2023). Andrology: male reproductive health and dysfunction. Springer Nature.

Solomon, M., & Henkel, R. (2017). Semen culture and the assessment of genitourinary tract infections. Indian journal of urology : IJU : journal of the Urological Society of India, 33(3), 188–193. https://doi.org/10.4103/iju.IJU_407_16

Territo, H., & Ashurst, J. V. (2024, January). Nongonococcal Urethritis. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved August 14, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK535411/