Bacterial STD Risk

[spacecowboy]

I posted this question in the patient forum, and I'm pretty sure still what you'll say about this, but for peace of mind, here goes. A little over 3 weeks ago I had a one night stand with a young lady I met in a college bar in the Northeast US earlier  the evening. The order of events were unprotected oral (me to her), some mutual hand to genital stimulation, with the tip of my penis coming into contact with the outside of her vagina a few times,(no real penetration I believe) and then male condom protected vaginal intercourse with a condom on the entire time. The condom did not break, tear, slip off, etc and the tip of my penis did not come into contact with the exterior of the condom after removal. I have not had any symptoms typically indicative of gonorrhea, chlamydia, trich or NGU. I have in the past day or so seemed to be urinating more than usual, (actually urinating a normal volume) but that may be just anxiety or my imagination. Am I worrying over nothing, or was there any real risk here?

[spacecowboy]

Sorry to bother you again Dr., but I have another question related to the same exposure I inquired about last week.  I have been experiencing some intermittent very slight tingling/twinges in my urethra  and a slight feeling of abdominal pressure from time to time.  I know I had stated in my initial post that during the encounter that the tip of my penis came into contact several times with the outside of the female's vagina, and that was "no real penetration." If i the tip of my penis had slipped inside briefly (no more than 5 seconds) would that be enough time to change your answer, or do you have the same thoughts that I am fine and overanalyzing. ?

[H. Hunter Handsfield, M.D.]

A small amount of clear mucus is commonly present in the urethra of many men, especially in the morning.  It's probably mostly pre-ejaculate secretions (pre-***) that accompany nocturnal erections, which occur in most men during sleep.

Almost all antibiotics are effective against some bacteria but not others.  The drugs you mention are not active against chlamydia and have variable activity against gonorrhea.  No oral antibiotics are recommended against syphilis--almost the only infection remaining for which old fashioned, garden-variety penicillin is always the drug of choice, either IV or by injection.

HHH, MD  

[spacecowboy]

Thank you for your quick and informative reply.  I have two further quick questions, largely academic, if you dont mind.

1.  Is it normal to have a slight amount of clear (not watery, more viscous like pre-ejacualte) fluid occasionally release from and appear in the uretha at the opening?

2.  How come antibiotics like amoxicillin, augmentin, etc. are not mentioned as being treatments for bacterial STD infections?  If someone was taking one of those at a high dose (500mg plus)for something else, like a strep infection, and contracted a bacterial STD, would they not be effective in curing that as well?

That will be all.  Thank you again.

[H. Hunter Handsfield, M.D.]

There might be a slight risk of viral STD (herpes, HPV) from the esposure you describe, but even that risk is low.  The risk for bacterial STD (gonorrhea, chlamydia, etc) was zero for all practical purposes and I would not recommend testing based on what you describe.  Increased urinary frequency is not an STD symptom (but a very common manifestation of anxiety or stress).  All sexually active people should get periodic STD testing, like once a year or thereabouts.  So if you have otherwise been sexually active in the past year, this might be a good time for testing, since it's on your mind.  But n ot because of this particular exposure.

Good luck--  HHH, MD